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National Center for Chronic Disease Prevention and Health Promotion
Division of Adult and Community Health
Health Care and Aging Studies Branch
Arthritis Program
Mailstop K-51
4770 Buford Highway NE
Atlanta, GA 30341-3724
Phone: 770.488.5464
Fax: 770.488.5964
Email Us |
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Arthritis Program Health Disparities Activities
Addressing health disparities is a central focus of the strategic
plans for both the U.S. Department of Health and Human Services (HHS)
and the Centers for Disease Control and Prevention (CDC), as well as
Healthy People 2010 and the National Arthritis Action Plan: A Public
Health Strategy. In keeping with this aim the CDC Arthritis Program
analyzes survey data to determine racial/ethnic and gender differences
associated with arthritis prevalence, incidence, risk factors, and
limitations. The Arthritis Program is engaged in extensive audience
research, which involves systematic research and message-testing among
diverse subgroups (racial/ethnic, socioeconomic, geographic, gender,
age, disability status, risk status) of adults with arthritis to
determine optimal messaging when promoting physical activity and
self-management education.
Epidemiology/Research Activities
Arthritis Conditions Health Effects Survey (ACHES)
The Arthritis Conditions Health Effects Survey (ACHES) was developed
and funded by theCDC Arthritis Program. ACHES is an
arthritis-specific nationally representative, random-digit-dialed
telephone survey that collected information from 2,238 persons with
arthritis or chronic joint symptoms ages 45 years or older between
June 2005 and March 2006. The survey design included oversampling of
Hispanics and Non-Hispanic blacks to allow more precise estimates to
be generated for these two vulnerable population groups. Data were
gathered for symptoms, limitations, levels of physical functioning,
effects of arthritis on work, knowledge and attitudes about
arthritis, self-management of arthritis, physical activity, anxiety
and depression, and demographics. ACHES analyses are ongoing and
have already identified substantial unmet need in current arthritis
treatment which would be decreased by wider availability and uptake
of evidence-based arthritis self-management education and physical
activity programs.
Racial/Ethnic differences for the prevalence and impact of
doctor-diagnosed arthritis
Arthritis is a large and growing problem for U.S. adults of all
racial/ethnic groups, but the disabling effects of arthritis (e.g.,
arthritis-attributable activity limitations, work limitations, and
severe pain) are disproportionately prevalent in racial/ethnic
minorities. CDC is currently analyzing multiple years of data to get
the first ever prevalence estimates for Native Americans, Hispanic
subgroups and Asian American. Results should be available in 2009...more
State-specific prevalence data
State-level data
broken down by race/ethnicity and gender is provided to state
health departments and partners.
The Johnston County Osteoarthritis Project: Arthritis & Disability
The Johnston County Osteoarthritis Project (JCOP) is a unique,
community-based, longitudinal study of approximately 3,200 white and
black residents aged 45 years or older from a transitioning
rural-to-urban area of North Carolina. The study is designed to
determine the risk factors associated with the prevalence,
incidence, and progression of hip and knee osteoarthritis (OA)—the
two most common and disabling types of arthritis. JCOP data was used
in a recent CDC study reporting that a person’s lifetime risk for
developing symptomatic knee osteoarthritis (OA) is nearly one in
two, or 46%. The study authors also found that nearly 2 of 3 obese
adults will develop painful knee osteoarthritis during their
lifetime. Results from JCOP have and will continue to be
instrumental in quantifying racial/ethnic disparities related to hip
and knee OA.
Lupus Registries
This project develops two population-based registries to better
define and monitor the incidence and prevalence of systemic lupus erythematosus and better characterize individuals with this
rheumatic condition. Lupus Registries are working to document the
incidence and prevalence of lupus among whites and blacks.
Documentation efforts will be expanding to Hispanic, Asian American,
American Indian and Alaskan Natives populations.
Read more.
Use of Complementary Therapies Among Hispanic and Non-Hispanic White
Adults with Arthritis
The use of complementary and alternative therapies (CAM) use is
reported to be high among people with arthritis, but little
information has been available on the use of CAM by Hispanic
ethnicity. CDC funded a study to assess the use of CAM among
predominantly urban Hispanic and non-Hispanic adults with
doctor-diagnosed rheumatoid arthritis (RA), osteoarthritis (OA), or
fibromyalgia. There were 612 adults with arthritis, who saw
physicians in primary care clinics associated with the University of
New Mexico and were interviewed to determine their use of CAM; of those
interviewed, 45% were Hispanic and 71% were female.
Read more
Total Knee Replacements (TKR) and Race
Although whites and blacks have a comparable lifetime risk of
symptomatic knee osteoarthritis (OA), blacks are less likely to
undergo total knee replacements (TKR). TKRs are an important
surgical intervention in reducing joint pain and restoring physical
function in people with knee OA. Recognizing the substantial impact
of TKR for reducing disability among people with painful knee
osteoarthritis, the Healthy People 2010 working group adopted
objective 2.6. "Eliminate racial disparities in the rate of total
knee replacements among persons aged 65 years or older." We are
generating race-specific TKR rates among US adults age ≥65 years
using 2000 to 2006 Medicare claims data and determining whether the
racial disparity in TKRs observed in 2000 has declined. Current
baseline data quantifies and illustrates existing disparities in
this area.
Programmatic Activities
Tomando Control de su Salud (Spanish Chronic Disease Self-Management Program
(CDSMP))
Tomando Control de su Salud is a self-management education
program developed for Spanish-speaking adults with a variety of
chronic health problems. Workshops for this program are given once a
week for two and a half hours, for a six week period, in a community
setting. Each session is facilitated by two trained leaders, one or
both of whom are non-health professionals with a chronic diseases
themselves. All workshops are given in Spanish without translators.
This program is similar in content and process to the English
language version of the Chronic Disease Self-Management Program, but Tomando Control de su Salud was
developed in Spanish to address health topics and concerns in a
culturally appropriate manner. Topics covered in the program
include appropriate use of the health care system, how to evaluate
new treatments, communicating effectively with family, friends, and
health professionals, healthy eating, appropriate use of
medications, techniques to deal with problems, and appropriate
exercises for maintaining and improving strength, flexibility, and
endurance. A similar
self management arthritis program* is also available.
Buenos Días, Artritis
This health communications campaign designed to reach
Spanish-speaking adults with arthritis between the ages of 45–64,
whose annual income is $35,000 or less. This campaign is targeted
primarily to persons within the audience whose symptoms have
advanced to the point where arthritis is perceived as interfering
with one or more life activities, such as work or family
commitments. The campaign is designed to do the following:
- Raise awareness of exercise as a way to manage arthritis
pain and increase mobility.
- Increase understanding of how to use exercise (which types and
for how long/duration) to ease arthritis symptoms and prevent
further disability.
- Enhance the confidence or belief of persons with arthritis
that they can engage in moderate exercise.
- Increase trial of moderate exercise behaviors.
Partnership with the AME church
The African Methodist Episcopal (AME) Church of South Carolina has 619 congregations and some active
253,792 members. There are 6,728 congregations and 2,511,578 members
across
the United States. The AME Church has the potential to reach members in
remote areas and provide education and activities to enhance the quality
of life for persons with arthritis.
The CDC Arthritis Program and The Palmetto Annual Conference, 7th
Episcopal District, which includes Charleston, South Carolina and
surrounding areas, are working together with the South Carolina Health
Department and Environmental Control to incorporate a physical activity
intervention (EnhanceFitness) into health programs of their
churches in underserved communities. More information about the AME Church http://www.ame-church.com
State funded programs
State programs use data to focus interventions in areas with the
greatest need, often partnering with organizations supporting
underserved populations. State arthritis programs have previously
focused on building capacity to disseminate and deliver
evidence-based interventions. The current funding cycle builds on
lessons learned from these activities, with a new emphasis to embed arthritis
interventions in existing systems
and expand their use.
State Health Department Arthritis Programs use CDC funding to
strengthen partnerships with state Arthritis Foundation chapters and
others, increase public awareness, improve their ability to monitor
the burden of arthritis, coordinate activities, and increase the
availability of interventions. The central aim is to improve the
quality of life among persons affected by arthritis. One of the most
important activities for states is to increase awareness of
arthritis management options and to promote self-management
education and physical activity.
* Links to non-Federal
organizations are provided solely as a service to our users. Links do not
constitute an endorsement of any organization by CDC or the Federal
Government, and none should be inferred. The CDC is not responsible for
the content of the individual organization Web pages found at this link.
Page last modified:
November 7, 2008
Content Source: Division of
Adult and Community Health,
National Center for Chronic Disease Prevention and Health Promotion
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