A survey of rheumatic disablement in the population used a measure of physical independence handicap (PIH) to indicate the impact in terms of need for help. One in three households in Calderdale, West Yorkshire, were screened by using a postal questionnaire to identify individuals with disability and reporting a rheumatic disorder, followed by in-depth structured interviews with a stratified random sample. The estimated population prevalence of 8.2% (95% C.I.: 7.9-8.4; ages > or = 16 years) and degree of dependence increased with age, and was linked to disability in activities of daily living and locomotion. Few reported receiving services in their home during the previous 12 months; mainly nursing (18%) and local authority home helps (16%). Overall 84% reported contact with the primary health care team and 52% with hospital and rehabilitation services. Most people received informal care; 14% identified needs for help or care that were not being met. These findings highlight the wide-ranging impact on the lives of those affected.