“When we do focus groups, people say, ‘When I first started it was hard. I got sore and I kind of wanted to stop.’ But then, when they stick with it they get pain relief; they get better function.”

Patience White, MD, vice president for public health policy and advocacy at the Arthritis Foundation, says that while it’s generally understood that people don’t exercise as much as they should this state-by-state breakdown is a serious call to action.

“What they are saying is, ‘Whoa! We have a pretty significant problem in terms of people doing the most simple exercise plan.’ We aren’t asking them to go to a gym or go running. We are just asking them to walk,” says Dr. White, who is also a professor of medicine and pediatrics at George Washington University’s School of Medicine in Washington, D.C. “We’ve got a lot of work to do to let people with arthritis know how good walking is for you.”

The findings are in line with previous research, Hootman says – and it isn’t clear why the message about the benefits of walking is not influencing people’s behavior.

Dr. White says she thinks it boils down to a misconception. “The myth is, ‘My joints hurt; therefore I cannot walk.’ And what happens is people’s muscles get weak around their joints and they lose good range of motion around their joints, so walking becomes more difficult. It’s a vicious cycle. I hurt and don’t walk, therefore I get weaker and don’t have as good range of motion,” she explains. “We really would like to get a call to action to get people to realize that physical activity is helpful if done appropriately. Appropriately is low-impact, and walking is a classic example of that.”

Dr. White hopes this study will spur community advocates, state legislatures and adults with arthritis to make changes.

“When they broke down states by obesity levels, you saw some states step up and say, ‘We should do something about this.’ They started campaigns and did things in schools and passed environmental policy legislation,” Dr. White says. “It’s about trying to get people to focus, since arthritis is such a common problem and will become so much worse – going from 50 million people affected today to 67 million by 2030.”

In an effort to help patients start improving their own walking rates, the CDC is highlighting programs like the Arthritis Foundation’s evidence-based Walk With Ease program. The six-week walking program includes a guidebook and online resources to help people increase their walking to 30-minute sessions, three days a week through group classes led by certified instructors or individually at home. The program offers tips and tools including how to set safe and reasonable activity goals.

Hootman says Walk With Ease is helpful because it allows you to ease into walking and build up to 30 minutes over the six-week program. And while some people prefer doing the program themselves, the social support of a group setting is key for others to get started and keep going.

The Arthritis Foundation also has outlined environmental and policy strategies to help communities increase activity among people with arthritis by helping communities figure out how to make their local area more walkable for citizens. Click here for more information about the program.