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Week of 16 April, 1999

Vol. II, No. 31

Feature Article

An aging population at risk

SPH dean named secretary of Arthritis Foundation

By Hope Green

Many people think of arthritis as merely aches and pains, says Robert Meenan, dean and professor of health services at BU's School of Public Health. Yet no other disease disables more adults in the United States.

By the year 2020, an estimated 20 percent of the U.S. population will suffer from some form of arthritis, and nearly 43 million Americans already do -- costing the economy $65 billion a year in medical expenses and disability insurance.

Robert Meenan

Robert Meenan, dean and professor of health services at BU's School of Public Health, was recently named secretary of the Arthritis Foundation.

Spreading awareness about arthritis, and supporting efforts to prevent it, are among Meenan's primary concerns in his new role as secretary of the Arthritis Foundation. The Atlanta-based voluntary health agency supports research into causes, treatments, potential cures, and prevention of the disease's more than 100 forms. Meenan has long been active in the Massachusetts chapter, but as foundation secretary, he helps to lead 600,000 volunteers and staff members throughout the country in fundraising and public information campaigns. He also works with a team of doctors and scientists who are responsible for allocating some $20 million in research funds annually.

In studies supported by the foundation, Meenan sees promise for the prevention of osteoarthritis, or arthritic conditions mainly caused by wear and tear. Such research has shown that healthy adults can stave off joint problems by maintaining a reasonable weight, taking care to avoid sports injuries, and reducing repetitive strain in the workplace.

Scientists have yet to discover preventive measures for rheumatoid arthritis, which is tied to a failure of the immune system, and as Meenan describes it, "is almost an attack of the body on itself." But for those already affected, he adds, new injectable drugs have shown dramatic results in improving mobility.

One of the foundation's most successful ventures has been the Arthritis Self Help Course, a 10-year-old national program that teaches patients how to cope with their pain and physical limitations. In Boston, the Partners HealthCare System has conducted research showing that patients completing the program dramatically reduce their doctor's appointments and medical costs. "The results have been remarkable," says Meenan. "Our research confirms that as with any chronic disease, the most important caregiver is the patient."

Meenan, once a practicing rheumatologist, has developed a serious case of rheumatoid arthritis himself and will undergo a hip replacement in June. The disease requires corrective surgery for thousands of people each year, exacting a toll on the economy that, according to Meenan, is overlooked by policy makers. "Arthritis tends to get lost in the health-care debate because 70 percent of the costs are not medical," he explains. "The bulk of the social cost is indirect, in lost wages. So someone might need a $10,000 knee operation, but if he can't work he might lose $30,000 to $40,000 a year. For the company, that really adds up in disability expenses."

While getting the public to take arthritis seriously is a challenge, Meenan expects this to change as the population of older Americans continues to expand.

"Now that people are living longer," he says, "they are recognizing it's not just the quantity of life that matters -- it's the quality."