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The impact of disabling arthritis.

OBJECTIVE
To use the WHO International Classification of Impairments, Disabilities, and Handicaps (ICIDH) as a framework to conceptualize how arthritis affects people and how the effects might be minimized.


METHODS
The ICIDH framework emphasizes that the impact of arthritis in terms of handicap is a product of an interaction between a person's social and environmental setting and his or her level of impairment and disability. Data from the Canadian Health and Activity Limitation Survey are used to illustrate the impact for the handicap dimensions.


RESULTS
Among persons who have arthritis, 25% cannot leave their residence or can leave only with help (mobility dimension), 45% have at least some level of physical dependence (physical independence dimension), 18% never participate in social activities (social integration dimension), 51% of those under age 65 are not in the labor force and 76% never go out to events such as sports or movies (occupation dimension), and 42% have out-of-pocket expenses because of disability (economic self-sufficiency dimension).


CONCLUSION
Policies for the control of handicap require not only medical and rehabilitation interventions to reduce disability, but also consideration of environmental and other social factors.