1. Healthy People 2010 Focus Area 2 Arthritis, Osteoporosis, and Chronic Back Conditions Progress Review September 18, 2002

2. Healthy People 2010 Focus Area 2 11 objectives Three musculoskeletal areas   Arthritis (8 objectives – 5 developmental)   Osteoporosis (2 objectives)   Chronic Back Conditions (1 objective)

3. Arthritis

4. Arthritis prevalence Adults age 18 and older with arthritis, by gender, family income, and education, 2000 Data are age adjusted to the 2000 standard population. I = 95% confidence interval. SOURCE: National Health Interview Survey (NHIS), CDC/NCHS. Age-adjusted percent Total Female Male Poor Near Middle/ Less High At least (<100% poor high than school some poverty) (100%- (>=200% high graduate college 199% poverty) school poverty) 20 22 18 27 25 20 25 23 21

5. Arthritis prevalence Adults age 18 and older with arthritis, by race/ethnicity, 2000 Data are age adjusted to the 2000 standard population. *Includes persons of Hispanic and non-Hispanic origin. **Persons of Hispanic origin may be of any race. I = 95% confidence interval. SOURCE: National Health Interview Survey (NHIS), CDC/NCHS. American Indian/ Asian/Pacific Hispanic** Black, not White, not Alaska Native* Islander* Hispanic Hispanic Age-adjusted percent 22 18 1513 29

6. Prevalence of arthritis among adults age 18 and older by state, 2000 Percent with arthritis (quartiles) 22.7 - 30.4 30.8 - 31.8 32.2 - 33.9 34.6 - 39.4 Data not available Date are not age adjusted. SOURCE: Behavioral Risk Factor Surveillance System (BRFSS), CDC/NCCDPHP.

7. Measurable Arthritis Objectives 2-2. Reduce the proportion of adults with chronic joint symptoms who experience a limitation of activity due to arthritis. 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. 2-5. Increase the employment rate among adults with arthritis in the working-aged population.

8. Developmental Arthritis Objectives 2-1. Increase the mean number of days without severe pain among adults who have chronic joint symptoms. (National data expected from the 2002 NHIS by 2004.) 2-4. Increase the proportion of adults aged 18 years and older with arthritis who seek help in coping if they experience personal and emotional problems. (National data expected from the 2002 NHIS by 2004.) 2-6. Eliminate racial disparities in the rate of total knee replacements. (Numerator will be derived from 2000 NHDS and Medicare inpatient data; denominator from 2000 NHIS by 2003.) 2-7. Increase the proportion of adults who have seen a health care provider for their chronic joint symptoms. (National data expected from the 2002 NHIS by 2004.) 2- 8. 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. (National data expected from the 2002 NHIS by 2004.)

9. Arthritis 2-2. Adults age 18 and older with arthritis reporting activity limitation due to arthritis, by gender Data are age adjusted to the 2000 standard population. I = 95% confidence interval. SOURCE: National Health Interview Survey (NHIS), CDC/NCHS. 2010 Target Age-adjusted percent 28 27 32 31 23 21 Total Female Male

10. Arthritis 2-2. Adults age 18 and older with arthritis reporting activity limitation due to arthritis, by race/ethnicity Data are age adjusted to the 2000 standard population. *Includes persons of Hispanic and non-Hispanic origin. **Persons of Hispanic origin may be of any race. I = 95% confidence interval. SOURCE: National Health Interview Survey (NHIS), CDC/NCHS. American Indian/ Asian/Pacific Hispanic** Black, not White, not Alaska Native* Islander* Hispanic Hispanic Age-adjusted percent 2010 Target 20 19 16 29 30 33 27 26 25

11. Arthritis 2-2. Adults age 18 and older with arthritis reporting activity limitation due to arthritis, by income and education Data are age adjusted to the 2000 standard population. *Ages 25 and older. I = 95% confidence interval. SOURCE: National Health Interview Survey (NHIS), CDC/NCHS. Age-adjusted percent Poor Near poor Middle/high ( =200% poverty) poverty) poverty) 2010 Target Less High At least than school some high school* graduate* college* 25 30 34 36 34 37 32 30 26

12. Arthritis 2-3. Adults age 18 and older with arthritis reporting personal care activity limitations, by gender Age-adjusted percent 2010 Target Data are age adjusted to the 2000 standard population. I = 95% confidence interval. SOURCE: National Health Interview Survey (NHIS), CDC/NCHS. 1.8 1.7 2.4 2.3 2.2 2.1 Total Female Male

13. Arthritis 2-3. Adults age 18 and older with arthritis reporting personal care activity limitations, by race/ethnicity Data are age adjusted to the 2000 standard population. *Persons of Hispanic origin may be of any race. I = 95% confidence interval. SOURCE: National Health Interview Survey (NHIS), CDC/NCHS. Age-adjusted percent Hispanic* Black, not Hispanic White, not Hispanic 2010 Target 1.8 4.9 3.5 2.7 3.8

14. Arthritis 2-3. Adults age 18 and older with arthritis reporting personal care activity limitations, by income and education Poor Near poor Middle/high ( =200% poverty) poverty) poverty) 2010 Target Age-adjusted percent 2.1 1.4 1.8 2.3 3.4 1.3 1.0 2.4 4.4 5.4 Data are age adjusted to the 2000 standard population. *Data do not meet criteria for statistical reliability, data quality, or confidentiality. **Ages 25 and older. I = 95% confidence interval. SOURCE: National Health Interview Survey (NHIS), CDC/NCHS. Less High At least than school some high school** graduate** college** *

15. Arthritis 2-5. Employment rate among adults age 18-64 with arthritis, by gender 2010 Target Data are age adjusted to the 2000 standard population. I = 95% confidence interval. SOURCE: National Health Interview Survey (NHIS), CDC/NCHS. Age-adjusted percent 73 75 65 61 69 67

16. Arthritis 2-5. Employment rate among adults age 18-64 with arthritis, by race/ethnicity Data are age adjusted to the 2000 standard population. *Includes persons of Hispanic and non-Hispanic origin. **Persons of Hispanic origin can be of any race. I = 95% confidence interval. SOURCE: National Health Interview Survey (NHIS), CDC/NCHS. American Indian/ Asian/Pacific Hispanic** Black, not White, not Alaska Native* Islander* Hispanic Hispanic Age-adjusted percent 2010 Target 59 6159 46 52 62 54 61 71

17. Arthritis 2-5. Employment rate among adults age 18-64 with arthritis, by income and education Poor Near poor Middle/high ( =200% poverty) poverty) poverty) Age-adjusted percent 2010 Target 39 55 38 56 79 68 64 46 78 75 Data are age adjusted to the 2000 standard population. *Ages 25 and older. I = 95% confidence interval. SOURCE: National Health Interview Survey (NHIS), CDC/NCHS. Less High At least than school some high school* graduate* college*

18. Osteoporosis

19. 2-9. Reduce the proportion of adults with osteoporosis. 2-10. Reduce the proportion of adults who are hospitalized for vertebral fractures associated with osteoporosis. Osteoporosis Objectives

20. Total Mexican Non-Hispanic Female Male American Black White Osteoporosis 2-9. Adults age 50 and older with osteoporosis by race/ethnicity and gender, 1988-94 Data are age adjusted to the 2000 standard population. I = 95% confidence interval. SOURCE: National Health and Nutrition Examination Survey (NHANES), CDC/NCHS. 2010 Target Age-adjusted percent 10 7 16 3

21. 65 years and over White BlackFemaleMale 65-74 years** 75-84 years** 85 years and over** Osteoporosis 2-10. Hospitalizations for vertebral fractures associated with osteoporosis among adults age 65 and older by race/ethnicity, gender, and age, 1999 Data are age adjusted to the 2000 standard population. I = 95% confidence interval. *Data do not meet the criteria for statistical reliability, data quality, or confidentiality. **Age groups are not age adjusted. SOURCE: National Hospital Discharge Survey (NHDS), CDC/NCHS. 2010 Target * 15.5 21.3 11.2 9.8 17.4 49.4 17.3 Age-adjusted rate per 10,000 standard population

22. Chronic Back Conditions

23. 2-11. Reduce activity limitation due to chronic back conditions. Chronic Back Conditions Objective

24. Chronic Back Conditions 2-11. Activity limitation due to chronic back conditions among adults age 18 and older, by gender Data are age adjusted to the 2000 standard population. I = 95% confidence interval. SOURCE: National Health Interview Survey (NHIS), CDC/NCHS. Age-adjusted rate per 1,000 standard population 2010 Target 32 26 33 26 31 27

25. Chronic Back Conditions 2-11. Activity limitation due to chronic back conditions among adults age 18 and older, by race/ethnicity Age-adjusted rate per 1,000 standard population American Indian/ Asian/Pacific Hispanic** Black, not White, not Alaska Native* Islander* Hispanic Hispanic 2010 Target Data are age adjusted to the 2000 standard population. *Includes persons of Hispanic and non-Hispanic origin. ** Persons of Hispanic origin may be of any race. I = 95% confidence interval. SOURCE: National Health Interview Survey (NHIS), CDC/NCHS. 71 46 18 12 29 20 37 25 32 28

26. Chronic Back Conditions 2-11. Activity limitation due to chronic back conditions among adults age 18 and older by family income and education Data are age adjusted to the 2000 standard population. *Ages 25 and older. I = 95% confidence interval. SOURCE: National Health Interview Survey (NHIS), CDC/NCHS. Age-adjusted rate per 1,000 standard population Poor Near poor Middle/high ( =200% poverty) poverty) poverty) Less High At least than school some high school* graduate* college* 2010 Target 58 47 20 49 31 23 29 55 25 36 54 78

27. Chronic Back Conditions 2-11. Activity limitation due to chronic back conditions among adults age 18 and older, by age 18-44 years 45-64 years 65 years and older I = 95% confidence interval. SOURCE: National Health Interview Survey (NHIS), CDC/NCHS. Rate per 1,000 population 19 15 45 37 47 33

28. Supplemental data Employment rate among people with and without arthritis

29. With and without arthritis Employment rate among adults age 18-64 with and without arthritis by gender, 2000 Data are age adjusted to the 2000 standard population. I = 95% confidence interval. SOURCE: National Health Interview Survey (NHIS), CDC/NCHS. Age-adjusted percent Total Female Male 69 78 65 71 73 85

30. With and without arthritis Employment rate among adults age 25-64 with and without arthritis by race/ethnicity, 2000 Data are age adjusted to the 2000 standard population. *Includes persons of Hispanic and non-Hispanic origin. **Persons of Hispanic origin can be of any race. I = 95% confidence interval. SOURCE: National Health Interview Survey (NHIS), CDC/NCHS. American Indian/ Asian/Pacific Hispanic** Black, not White, not Alaska Native* Islander* Hispanic Hispanic Age-adjusted percent 46 59 61 74 62 73 61 74 71 80

31. With and without arthritis Employment rate among adults age 25-64 with and without arthritis by income and education, 2000 Data are age adjusted to the 2000 standard population. I = 95% confidence interval. SOURCE: National Health Interview Survey (NHIS), CDC/NCHS. Age-adjusted percent Poor Near poor Middle/high ( =200% poverty) poverty) poverty) Less High At least than school some high school graduate college 38 49 56 69 79 85 46 65 68 78 75 86

32. Supplemental data Limitation of activity due to all chronic conditions

33. Activity Limitation Activity limitation due to all chronic conditions among adults age 18 and older, by gender Data are age adjusted to the 2000 standard population. I = 95% confidence interval. SOURCE: National Health Interview Survey (NHIS), CDC/NCHS. Age-adjusted rate per 1,000 Total Female Male 155 135 163 140 145 130

34. Activity Limitation Activity limitation due to all chronic conditions among adults age 18 and older, by race/ethnicity Data are age adjusted to the 2000 standard population. *Includes persons of Hispanic and non-Hispanic origin. ** Persons of Hispanic origin may be of any race. I = 95% confidence interval. SOURCE: National Health Interview Survey (NHIS), CDC/NCHS. American Indian/ Asian/Pacific Hispanic** Black, not White, not Alaska Native* Islander* Hispanic Hispanic Age-adjusted rate per 1,000 281 262 84 86 119 152 200 167 152 135

35. Activity Limitation Activity limitation due to all chronic conditions and due to back conditions among adults age 18 and older Data are age adjusted to the 2000 standard population. I = 95% confidence interval. SOURCE: National Health Interview Survey (NHIS), CDC/NCHS. Age-adjusted rate per 1,000 155 26 32 135 All chronic conditions Back conditions