Focus Area 2: Arthritis, Osteoporosis, and Chronic Back Conditions: Objectives and Subobjectives

As a result of the Healthy People 2010 Midcourse Review, changes were made to the Healthy People 2010 objectives and subobjectives. These changes are specific to the following situations:

Changes in the wording of an objective to more accurately describe what is being measured.
Changes to reflect a different data source or new science.
Changes resulting from the establishment of a baseline and a target (that is, when a formerly developmental objective or subobjective became measurable).
Deletion of an objective or subobjective that lacked a data source.
Correction of errors and omissions in Healthy People 2010.

Revised baselines and targets for measurable objectives and subobjectives do not fall into any of the above categories and, thus, are not considered a midcourse review change.¹

When changes were made to an objective, three sections are displayed:

In the Original Objective section, the objective as published in Healthy People 2010 in 2000 is shown.
In the Objective With Revisions section, strikethrough indicates text deleted, and underlining is used to show new text.
In the Revised Objective section, the objective appears as revised as a result of the midcourse review.

Details of the objectives and subobjectives in this focus area, including any changes made at the midcourse, appear on the following pages.

¹See Technical Appendix for more information on baseline and target revisions.

Arthritis and Other Rheumatic Conditions

ORIGINAL OBJECTIVE
2-1.	(Developmental) Increase the mean number of days without severe pain among adults who have chronic joint symptoms. Potential data sources: Behavioral Risk Factor Surveillance System (BRFSS), CDC, NCCDPHP; National Health Interview Survey (NHIS), CDC, NCHS.
OBJECTIVE WITH REVISIONS
2-1.	~~(Developmental) Increase~~Reduce the mean level of joint ~~number of days without severe~~ pain among adults with doctor-diagnosed arthritis. Target: 5.3 mean pain level. Baseline: Based on a scale of 0 (no pain) to 10 (pain as bad as it can be), 5.6 was the mean pain level rating among adults aged 18 years and older with doctor-diagnosed arthritis in 2002 (age adjusted to the year 2000 standard population). Target setting method: Better than the best. ~~Potential d~~Data sources: ~~Behavioral Risk Factor Surveillance System (BRFSS), CDC,~~ ~~NCCDPHP;~~ National Health Interview Survey (NHIS), CDC, NCHS.
REVISED OBJECTIVE
2-1.	Reduce the mean level of joint pain among adults with doctor-diagnosed arthritis. Target: 5.3 mean pain level. Baseline: Based on a scale of 0 (no pain) to 10 (pain as bad as it can be), 5.6 was the mean pain level rating among adults aged 18 years and older with doctor-diagnosed arthritis in 2002 (age adjusted to the year 2000 standard population). Target setting method: Better than the best. Data source: National Health Interview Survey (NHIS), CDC, NCHS.

ORIGINAL OBJECTIVE
2-2.	Reduce the proportion of adults with chronic joint symptoms who experience a limitation in activity due to arthritis. Target: 21 percent. Baseline: 27 percent of adults aged 18 years and older with chronic joint symptoms experienced a limitation in activity due to arthritis in 1997 (age adjusted to the year 2000 standard population). Target setting method: Better than the best. Data source: National Health Interview Survey (NHIS), CDC, NCHS.
OBJECTIVE WITH REVISIONS
2-2.	Reduce the proportion of adults with ~~chronic joint symptoms~~doctor-diagnosed arthritis who experience a limitation in activity due to arthritis or joint symptoms. Target: 2133 percent. Baseline: 28 36 percent of adults aged 18 years and older with doctor-diagnosed ~~chronic joint symptoms~~arthritis experienced a limitation in activity due to arthritis or joint symptoms in ~~1997~~ 2002 (age adjusted to the year 2000 standard population). Target setting method: Better than the best. Data source: National Health Interview Survey (NHIS), CDC, NCHS.
REVISED OBJECTIVE
2-2.	Reduce the proportion of adults with doctor-diagnosed arthritis who experience a limitation in activity due to arthritis or joint symptoms. Target: 33 percent. Baseline: 36 percent of adults aged 18 years and older with doctor-diagnosed arthritis experienced a limitation in activity due to arthritis or joint symptoms in 2002 (age adjusted to the year 2000 standard population). Target setting method: Better than the best. Data source: National Health Interview Survey (NHIS), CDC, NCHS.

ORIGINAL OBJECTIVE
2-3.	Reduce the proportion of all adults with chronic joint symptoms who have difficulty in performing two or more personal care activities, thereby preserving independence. Target: 1.4 percent. Baseline: 2.0 percent of adults aged 18 years and older with chronic joint symptoms experienced difficulty performing two or more personal care activities in 1997 (age adjusted to the year 2000 standard population). Target setting method: Better than the best. Data source: National Health Interview Survey (NHIS), CDC, NCHS.
OBJECTIVE WITH REVISIONS
2-3.	Reduce the proportion of ~~all~~ adults with ~~chronic joint symptoms~~ doctor-diagnosed arthritis who have difficulty in performing two or more personal care activities, thereby preserving independence. Target: 1.54 percent. Baseline: 2.01 percent of adults aged 18 years and older with doctor-diagnosed arthritis had~~chronic joint symptoms experienced~~ difficulty performing two or more personal care activities in 2002 ~~in 1997~~ (age adjusted to the year 2000 standard population). Target setting method: Better than the best. Data source: National Health Interview Survey (NHIS), CDC, NCHS.
REVISED OBJECTIVE
2-3.	Reduce the proportion of adults with doctor-diagnosed arthritis who have difficulty in performing two or more personal care activities, thereby preserving independence. Target: 1.5 percent. Baseline: 2.1 percent of adults aged 18 years and older with doctor-diagnosed arthritis had difficulty performing two or more personal care activities in 2002 (age adjusted to the year 2000 standard population). Target setting method: Better than the best. Data source: National Health Interview Survey (NHIS), CDC, NCHS.

ORIGINAL OBJECTIVE

2-4.

(Developmental) Increase the proportion of adults aged 18 years and older with arthritis who seek help in coping if they experience personal and emotional problems.

Potential data sources: National Health Interview Survey (NHIS), CDC, NCHS; Behavioral Risk Factor Surveillance System (BRFSS), CDC, NCCDPHP.

OBJECTIVE WITH REVISIONS

2-4.

~~(Developmental)~~ Increase the proportion of adults with doctor-diagnosed arthritis who receive ~~the proportion of adults aged 18 years and older with~~ ~~arthritis who seek help in coping if they experience personal and emotional~~ ~~problems~~ health care provider counseling.

Target and baseline:

Objective	Increase the Proportion of Adults Aged 18 Years and Older With Doctor-Diagnosed Arthritis Who Receive Health Care Provider Counseling	2002 Baseline* Percent	2010 Target Percent
2-4a.	For weight reduction among overweight and obese persons	35	46
2-4b.	For physical activity or exercise	52	67

* Age adjusted to the year 2000 standard population.

Target setting method: Better than the best.

~~Potential d~~Data sources: National Health Interview Survey (NHIS), CDC, NCHS; ~~Behavioral Risk Factor Surveillance System (BRFSS), CDC, NCCDPHP.~~

REVISED OBJECTIVE

2-4.

Increase the proportion of adults with doctor-diagnosed arthritis who receive health care provider counseling.

Target and baseline:

Objective	Increase the Proportion of Adults Aged 18 Years and Older With Doctor-Diagnosed Arthritis Who Receive Health Care Provider Counseling	2002 Baseline* Percent	2010 Target Percent
2-4a.	For weight reduction among overweight and obese persons	35	46
2-4b.	For physical activity or exercise	52	67

* Age adjusted to the year 2000 standard population.

Target setting method: Better than the best.

Data source: National Health Interview Survey (NHIS), CDC, NCHS.

ORIGINAL OBJECTIVE

2-5.

Increase the employment rate among adults with arthritis in the working-aged population.

Target: 78 percent.

Baseline: 67 percent of adults aged 18 to 64 years with arthritis were employed in the past week in 1997 (age adjusted to the year 2000 standard population).

Target setting method: Better than the best.

Data source: National Health Interview Survey (NHIS), CDC, NCHS.

OBJECTIVE WITH REVISIONS

2-5.

~~Increase~~Reduce the impact of doctor-diagnosed arthritis on employment ~~rate among adults with arthritis~~ in the working-aged population.

Target and baseline:

Objective	Reduction in the Impact of Doctor-Diagnosed Arthritis on Employment in the Working-Aged Population Aged 18 to 64 Years	2002 Baseline* Percent	2010 Target Percent
2-5a.	Reduction in the unemployment rate among adults with doctor-diagnosed arthritis	33	27
2-5b.	Reduction in the proportion of adults with doctor-diagnosed arthritis who are limited in their ability to work for pay due to arthritis	30	23

* Age adjusted to the year 2000 standard population.

Target: 78 percent.

Baseline: 67 percent of adults aged 18 to 64 years with arthritis were employed in ~~the past week in 2002 (age adjusted to the year 2000 standard population).~~

Target setting method: Better than the best.

Data source: National Health Interview Survey (NHIS), CDC, NCHS.

REVISED OBJECTIVE

2-5.

Reduce the impact of doctor-diagnosed arthritis on employment in the working-aged population.

Target and baseline:

Objective	Reduction in the Impact of Doctor-Diagnosed Arthritis on Employment in the Working-Aged Population Aged 18 to 64 Years	2002 Baseline* Percent	2010 Target Percent
2-5a.	Reduction in the unemployment rate among adults with doctor-diagnosed arthritis	33	27
2-5b.	Reduction in the proportion of adults with doctor-diagnosed arthritis who are limited in their ability to work for pay due to arthritis	30	23

* Age adjusted to the year 2000 standard population.

Target setting method: Better than the best.

Data source: National Health Interview Survey (NHIS), CDC, NCHS.

ORIGINAL OBJECTIVE
2-6.	(Developmental) Eliminate racial disparities in the rate of total knee replacements. Potential data sources: Medicare data, CMS; National Hospital Discharge Survey (NHDS), CDC, NCHS; Hospital Cost and Utilization Project (HCUP), AHRQ.
OBJECTIVE WITH REVISIONS
2-6.	~~(Developmental)~~ Eliminate racial disparities in the rate of total knee replacements among persons aged 65 years and older. Target: 0 percent. Baseline: In 2000, the rate for the white non-Hispanic population was 34 percent higher than the rate for the black non-Hispanic population. Target setting method: Total elimination. ~~Potential d~~Data sources: Medicare Parts A and B, ~~Medicare data, HCFA; National~~ ~~Hospital Discharge Survey (NHDS), CDC, NCHS; Hospital Cost and Utilization Project~~ ~~(HCUP), AHRQ~~CMS.
REVISED OBJECTIVE
2-6.	Eliminate racial disparities in the rate of total knee replacements among persons aged 65 years and older. Target: 0 percent. Baseline: In 2000, the rate for the white non-Hispanic population was 34 percent higher than the rate for the black non-Hispanic population. Target setting method: Total elimination. Data source: Medicare Parts A and B, CMS.

ORIGINAL OBJECTIVE
2-7.	(Developmental) Increase the proportion of adults who have seen a health care provider for their chronic joint symptoms. Potential data source: National Health Interview Survey (NHIS), CDC, NCHS.
OBJECTIVE WITH REVISIONS
2-7.	~~(Developmental)~~ Increase the proportion of adults with chronic joint symptoms who have seen a health care provider for their ~~chronic joint~~ symptoms. Target: 61 percent. Baseline: 56 percent of adults aged 18 years and older with chronic joint symptoms saw a health care provider for their symptoms in 2002 (age adjusted to the year 2000 standard population). Target setting method: Better than the best. ~~Potential d~~Data source: National Health Interview Survey (NHIS), CDC, NCHS.
REVISED OBJECTIVE
2-7.	Increase the proportion of adults with chronic joint symptoms who have seen a health care provider for their symptoms. Target: 61 percent. Baseline: 56 percent of adults aged 18 years and older with chronic joint symptoms saw a health care provider for their symptoms in 2002 (age adjusted to the year 2000 standard population). Target setting method: Better than the best. Data source: National Health Interview Survey (NHIS), CDC, NCHS.

ORIGINAL OBJECTIVE
2-8.	(Developmental) Increase the proportion of persons with arthritis who have had effective, evidence-based arthritis education as an integral part of the management of their condition. Potential data sources: National Health Interview Survey (NHIS), CDC, NCHS; Behavioral Risk Factor Surveillance System (BRFSS), CDC, NCCDPHP.
OBJECTIVE WITH REVISIONS
2-8.	~~(Developmental)~~ Increase the proportion of ~~persons~~ adults with doctor-diagnosed arthritis who have had effective, evidence-based arthritis education as an integral part of the management of their condition. Target: 13 percent. Baseline: 11 percent of adults aged 18 years and older with doctor-diagnosed arthritis had effective, evidence-based arthritis education as an integral part of the management of their condition in 2002 (age adjusted to the year 2000 standard population). Target setting method: Better than the best. ~~Potential d~~Data sources: National Health Interview Survey (NHIS), CDC, NCHS; ~~Behavioral Risk Factor Surveillance System (BRFSS), CDC, NCCDPHP~~.
	REVISED OBJECTIVE
2-8.	Increase the proportion of adults with doctor-diagnosed arthritis who have had effective, evidence-based arthritis education as an integral part of the management of their condition. Target: 13 percent. Baseline: 11 percent of adults aged 18 years and older with doctor-diagnosed arthritis had effective, evidence-based arthritis education as an integral part of the management of their condition in 2002 (age adjusted to the year 2000 standard population). Target setting method: Better than the best. Data source: National Health Interview Survey (NHIS), CDC, NCHS.

Osteoporosis

NO CHANGE IN OBJECTIVE

2-9.

Reduce the proportion of adults with osteoporosis.

Target: 8 percent.

Baseline: 10 percent of adults aged 50 years and older had osteoporosis as measured by low total femur bone mineral density (BMD) in 1988–94 (age adjusted to the year 2000 standard population).

Target setting method: 20 percent improvement.

Data source: National Health and Nutrition Examination Survey (NHANES), CDC, NCHS.

NO CHANGE IN OBJECTIVE

2-10.

Reduce the proportion of adults who are hospitalized for vertebral fractures associated with osteoporosis.

Target: 14.0 hospitalizations per 10,000 adults aged 65 years and older.

Baseline: 17.5 hospitalizations per 10,000 adults aged 65 years and older were for vertebral fractures associated with osteoporosis in 1998 (age adjusted to the year 2000 standard population).

Target setting method: 20 percent improvement.

Data source: National Hospital Discharge Survey (NHDS), CDC, NCHS.

Chronic Back Conditions

NO CHANGE IN OBJECTIVE

2-11.

Reduce activity limitation due to chronic back conditions.

Target: 25 adults per 1,000 population aged 18 years and older.

Baseline: 32 adults per 1,000 population aged 18 years and older experienced activity limitation due to chronic back conditions in 1997 (age adjusted to the year 2000 standard population).

Target setting method: Better than the best.

Data source: National Health Interview Survey (NHIS), CDC, NCHS.

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