# Presentation: 926207

## Healthy People 2010Focus Area 2  Arthritis, Osteoporosis, and Chronic Back Conditions

**P****rogress 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 ****$****14B medical care costs annually**
**Chronic Back Conditions**
**Affect 26M Americans aged 20-64 **
**Cost about ****$****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, Osteoporosis, and Chronic Back 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**
**2-10. Hospitalization for vertebral fractures**

**Arthritis, Osteoporosis, and ****Chronic Back Conditions**

**Chronic Back Conditions**
**2-11. ****	****Activity limitations due to chronic back conditions**

- Note: Objectives in red have had the national baseline established since 2000.
- Methodology for obj. 2-6 in blue has been defined in 2005.

## Diagnosed Arthritis

**Diagnosed Arthritis**
**Adults 18 and Older, 2004**

**0                           20                                40                              60 **
**                               ****Age-adjusted percent**

**Total**
**18-44**
**45-64**
**65-74**
**75+**
_**BMI**_
**-18.4**
**18.5-24.9**
**25.0-29.9**
**30.0-34.9**
**35.0-39.9**
**40.0+**
**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%**

## Diagnosed Arthritis

**28.5–32.1**

**25.0-28.4**

**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.

**0                 2                  4                  6                 8                10 **
**                 ****Level of joint pain on the scale of 1 - 10**

*****
*****

**2010 Target: 5.3**

**Decrease desired**

## Activity Limitation Due to Arthritis

**Obj. 2-2**

**Activity Limitation Due to Arthritis**
**Adults 18 and Older with Arthritis, 2004**

**0                    20                     40                    60****	****     80     **
**                                ****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

**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, 2001.  2010 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.

**100**
**80**
**60**
**40**
**20**
**0**

**2010 target**

**Increase desired**

## Weight Counseling by BMIAdults 18 and Older with Arthritis, 2003

**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.

**100**
**80**
**60**
**40**
**20**
**0**

**Age-adjusted percent**

**25.0+                18.5-24.9                   25.0-       30.0-       35.0-     40.0+                  **
**                                                               ****29.9        34.9        39.9**

**2010 target: 46%**

**Increase desired**

## Limited Ability to Work due to Arthritis Adults 18-64 with Arthritis, 2003

**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**

**0                    20                     40                    60****	****     80     **
**                                ****Age-adjusted percent**

**Limited Ability to Work due to Arthritis ****Adults 18-64 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**

## Arthritis Education

**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**

*****
*****
*****

**0                     20                     40                   60                   80**
**                                ****Age-adjusted percent **

**2010 Target: 13%**

*****

**Diabetes education in 1999**

**Increase desired**

## Hospitalizations for Vertebral Fractures 

- Source: National Hospital Discharge Survey, CDC.

**Hospitalizations for Vertebral Fractures **
**Adults 65 and Older, 1998 - 2004**

**Obj. 2-10**

**1998     1999      2000      2001     2002      2003     2004**

**25**
**20**
**15**
**10**
**5**
**0**

**Age-adjusted rate **
**per 10,000 population**

**Decrease desired**

**2010 target**

## Activity Limitations Due to Chronic Back Conditions, Adults 18 Years and Older

**2010 Target: 25**

**1997**
**2004**

**Total**
**Female**
**Male**
**Less than high school**
**High school**
**At least some college**

**Obj. 2-11**

**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**

**0                   20                     40                      60                    80  **
**                              ****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

**Progress review data and slides are available on the web**

**www.cdc.gov/nchs/hphome.htm**