Healthy People 2010 Focus Area 2 Arthritis, Osteoporosis, and Chronic Back Conditions Progress Review July 20, 2006

Arthritis, Osteoporosis, and Chronic Back Conditions Arthritis and Other Rheumatic Conditions The leading cause of disability Affect 43M or 21% of adults (67M or 25% by 2030), most are under age 65 Limited activity for 16M or 7.8% of adults (25M or 9.3% by 2030) Cost $ 86B (1997) and $ 127B in 2003 Osteoporosis Responsible for more than 1.5M fractures, and $ 14B medical care costs annually Chronic Back Conditions Affect 26M Americans aged Cost about $ 100B per year

Focus Area 2 Arthritis, Osteoporosis, and Chronic Back Conditions Goal Prevent illness and disability related to arthritis and other rheumatic conditions, osteoporosis, and chronic back conditions Co-Lead Agencies Centers for Disease Control and Prevention National Institutes of Health

Arthritis and Other Rheumatic Conditions 2-1. Mean level of joint pain 2-2. Activity limitations due to arthritis 2-3. Personal care limitations 2-4a. Counseling about overweight and obesity 2-4b. Counseling about physical activity 2-5a. Unemployment rate 2-5b. Effect on paid work 2-6. Racial differences in total knee replacements 2-7. Seeing a health care provider 2-8. Arthritis education in adults Osteoporosis 2-9. Cases of osteoporosis Hospitalization for vertebral fractures Arthritis, Osteoporosis, and Chronic Back Conditions Chronic Back Conditions Activity limitations due to chronic back conditions Note: Objectives in red have had the national baseline established since Methodology for obj. 2-6 in blue has been defined in 2005.

Diagnosed Arthritis Adults 18 and Older, Age-adjusted percent Total BMI Female Male Less than high school High school At least some college Note: — 95% confidence interval. *Data are statistically unreliable and are suppressed. Data are age adjusted to the 2000 standard population. Education category is for adults 25 and older. Source: National Health Interview Survey, CDC. 8.8M 20.2M 8.5M 9.0M

Causes of Functional Activities Limitation Adults 18 years and older, 2004 Causes of Functional Activities Limitation** Note: *Having difficulty in performing specific physical tasks and engaging in social activities and recreation without the assistance of another person or using special equipment. **Based on 16,694 causes reported by 10,760 adults with functional activity limitations. Respondents were asked to report up to 3 causes. All others category includes amputation, endocrine, digestive, genitourinary, skin, blood, cyst, substance abuse, medical treatment, fatigue, and pregnancy. Source: National Health Interview Survey, CDC. Functional Activities Limitation* Not Limited 68% Limited 32%

28.5– –24.9 District of Columbia Diagnosed Arthritis Adults 18 and Older, 2005 Note: Data are age adjusted to the 2000 standard population. Source: Behavioral Risk Factor Surveillance System, CDC. Age-adjusted percent

Mean Level of Joint Pain Adults 18 and Older with Arthritis, 2003 Obj. 2-1 * Total American Indian Asian Native Hawaiian Black White 2 or more races Hispanic Female Male Less than high school High school At least some college Note: — 95% confidence interval. *Data are statistically unreliable and are suppressed. Data are age adjusted to the 2000 standard population. American Indian includes Alaska Native; Native Hawaiian includes other Pacific Islander. The categories black and white exclude persons of Hispanic origin. Persons of Hispanic origin may be any race. Respondents were asked to select one or more races. Data for the single race categories are for persons who reported only one racial group. Education category is for adults 25 and older. Source: National Health Interview Survey, CDC Level of joint pain on the scale of **** 2010 Target: 5.3 Decrease desired

Obj. 2-2 Activity Limitation Due to Arthritis Adults 18 and Older with Arthritis, Age-adjusted percent 2010 Target: 33% * Note: — 95% confidence interval. *Data are statistically unreliable and are suppressed. Data are age adjusted to the 2000 standard population. American Indian includes Alaska Native; Native Hawaiian includes other Pacific Islander. The categories black and white exclude persons of Hispanic origin. Persons of Hispanic origin may be any race. Respondents were asked to select one or more races. Data for the single race categories are for persons who reported only one racial group. Education category is for adults 25 and older. Source: National Health Interview Survey, CDC. Total American Indian Asian Native Hawaiian Black White 2 or more races Hispanic Female Male Less than high school High school At least some college Decrease desired

Counseling by Medical Care Provider Adults 18 and Older with Arthritis, 2003 Female Male Less than High At least high school school some college Obj. 2-4a and 2-4b Weight counseling* Exercise counseling Age-adjusted percent Total Note: I = 95% confidence interval. *for overweight or obese adults with arthritis. **Exercise counseling for all respondents with or without arthritis, target for weight counseling is 46% and exercise counseling is 67%. Data are age adjusted to the 2000 standard population. Education category is for adults 25 and older. Source: National Health Interview Survey, CDC target Increase desired

Weight Counseling by BMI Adults 18 and Older with Arthritis, 2003 Obj. 2-4a Note: I = 95% confidence interval. Data are age adjusted to the 2000 standard population. Source: National Health Interview Survey, CDC Age-adjusted percent target: 46% Increase desired

Total American Indian Asian Native Hawaiian Black White 2 or more races Hispanic Female Male Less than high school High school At least some college Age-adjusted percent Limited Ability to Work due to Arthritis Adults with Arthritis, 2003 ****** Note: — 95% confidence interval. *Data are statistically unreliable and are suppressed. Data are age adjusted to the 2000 standard population. American Indian includes Alaska Native; Native Hawaiian includes other Pacific Islander. The categories black and white exclude persons of Hispanic origin. Persons of Hispanic origin may be any race. Respondents were asked to select one or more races. Data for the single race categories are for persons who reported only one racial group. Education category is for adults 25 and older. Source: National Health Interview Survey, CDC. Obj. 2-5b 2010 Target: 23% Decrease desired

Obj. 2-8 Arthritis Education Adults 18 and Older with Arthritis, 2003 Note: — 95% confidence interval. *Data are statistically unreliable and are suppressed. Data are age adjusted to the 2000 standard population. American Indian includes Alaska Native; Native Hawaiian includes other Pacific Islander. The categories black and white exclude persons of Hispanic origin. Persons of Hispanic origin may be any race. Respondents were asked to select one or more races. Data for the single race categories are for persons who reported only one racial group. Education category is for adults 25 and older. Source: National Health Interview Survey, CDC. Total 6 American Indian Asian Native Hawaiian Black White 2 or more races Hispanic Female Male Less than high school High school At least some college ****** Age-adjusted percent 2010 Target: 13% * Diabetes education in 1999 Increase desired

Note: Data are age adjusted to the 2000 standard population. Source: National Hospital Discharge Survey, CDC. Hospitalizations for Vertebral Fractures Adults 65 and Older, Obj Age-adjusted rate per 10,000 population Decrease desired 2010 target

2010 Target: Total Female Male Less than high school High school At least some college Obj Activity Limitations Due to Chronic Back Conditions, Adults 18 Years and Older Note: — 95% confidence interval. Data are age adjusted to the 2000 standard population. Education category is for adults 25 and older. Source: National Health Interview Survey, CDC. Decrease desired Age-adjusted per 1,000

Summary Arthritis and Other Rheumatic Conditions Significant progress in surveillance and monitoring efforts Baselines established for all objectives to assess progress, including 8 developmental objectives Osteoporosis  Update data for cases of osteoporosis (obj. 2-9) available beginning 2005 NHANES (femur scans)  Increase in hospitalization rates since 2001, perhaps due to use of kyphoplasty Chronic Back Conditions Reduction in reported activity limitations due to chronic back conditions

Progress review data and slides are available on the web