Global Disability and Economic Burden Caused by Rheumatoid Arthritis, Osteoarthritis, Neck Pain, and Low Back Pain in Women of Childbearing Age from 1990 to 2021

Yuming Yao,1,* Dongliang Yuan,1,* Yusheng Li,1,2 Yaping Wang2,3 1Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan, People’s Republic of China; 2National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, People’s Republic of China; 3Teaching and Research Section of Clinical Nursing, Xiangya Hospital of Central South University, Changsha, Hunan, People’s Republic of China*These authors contributed equally to this workCorrespondence: Yaping Wang, Email [email protected]: This study utilized data from the Global Burden of Disease (GBD) to systematically analyze the years lived with disability (YLDs) and direct economic costs attributable to rheumatoid arthritis (RA), osteoarthritis (OA), neck pain (NP), and low back pain (LBP) among women aged 15– 49 between 1990 and 2021, aiming to inform public health intervention strategies.Methods: Using GBD 2021 data, we reported the YLDs and age-standardized rates (ASYR) for four major musculoskeletal diseases (MSD) in women of childbearing age (WCA) from 1990 to 2021. The temporal trends in disease burden were assessed by estimated annual percentage change (EAPC), and a non-linear frontier model was used to examine the association between the sociodemographic index (SDI) and disease burden. Additionally, the direct economic burden imposed by the four diseases in WCA was estimated.Results: In 2021, the YLDs among WCA worldwide due to RA, OA, NP, and LBP were 610,000, 1.61 million, 6.35 million, and 19.51 million, respectively, reflecting increases of 86.8%, 111%, 58%, and 40% compared to 1990. The ASYR for RA and OA increased by 13.6% and 11.2%, respectively, while the ASYR for NP and LBP slightly decreased. High SDI regions bear the heaviest burden, but regions with low-middle SDI show a faster growth rate. The global economic burden of these four diseases totaled $43.66 billion, with LBP accounting for the largest portion ($16.7 billion), and about 80% of the expenditure concentrated in high-SDI and high-middle SDI countries.Conclusion: MSD pose a persistent and growing health and economic challenge for WCA, with RA and OA showing a clear trend toward younger age groups. Although the ASYR for LBP has decreased, its absolute disability burden has still increased due to population growth. High-income countries bear the majority of the economic cost, reflecting the unequal distribution of global health resources.Keywords: global burden of disease, women of childbearing age, musculoskeletal diseases, years lived with disability, economic burden