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Arthritis
and Osteoporosis
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| Arthritis
Reduce
the percent of persons with arthritis who report their
general health as fair to poor.
Target:
31.8 percent.
Baseline, 1998: 35.2 percent of persons with arthritis
report their general health as fair or poor.
Target Setting Method: 10 percent improvement.
Osteoporosis
Reduce
the rate of adults age 65 and older who are hospitalized for vertebral
fractures associated with osteoporosis.
Target:
34.4 per 10,000.
Baseline, 1998: 38.2 per 10,000 adults age 65 and older
were hospitalized for vertebral fractures associated with osteoporosis.
Target Setting Method: 10 percent improvement.
Reduce
the rate of adults age 65 and older who are hospitalized for hip
fractures associated with osteoporosis.
Target:
81.2 per 10,000.
Baseline, 1998: 90.2 per 10,000 adults age 65 and older
were hospitalized for hip fractures associated with osteoporosis.
Target setting Method: 10 percent improvement.
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Chronic Disease
- Arthritis and Osteoporosis
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Arthritis
Arthritis, which
encompasses more than 100 diseases and conditions involving the joints,
the surrounding tissues, and other connective tissues, is the major
cause of disability in the United States. Arthritis affects one in
six Americans. It is estimated that 60 million people will be affected
by arthritis by the year 2020. Arthritis limits the independence of
affected persons and disrupts the lives of family members and other
caregivers. This is particularly alarming because some forms of arthritis
like osteoarthritis are preventable.
According to the Healthy People 2010 Report,
arthritis is the cause of at least 44 million visits to a health
care provider, 744,000 hospitalizations, and 4 million days of hospital
care per year. Estimated medical care costs for persons with arthritis
were $15 billion, and total costs (medical care plus lost productivity)
were $65 billion in 1992. Behavioral Risk Factor Surveillance System
data collected in North Carolina in 1998 showed North Carolina among
the states with the highest incidence of arthritis. According to
these estimates, arthritis is more prevalent in older individuals,
in those with lower income, and in those with fewer years of education.
Also, more persons with arthritis reported their general health
as fair to poor.
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Osteoporosis
Osteoporosis
is a disease characterized by low bone mass and structural deterioration
of bone tissue, leading to bone fragility and increased susceptibility
to fracture. Osteoporosis occurs in over half of all women and one
in eight men over age fifty. This translates into about one million
men and women in North Carolina with osteoporosis or low bone mass.
In 1995, and estimated 13,576 North Carolinians
were hospitalized with an osteoporosis-related fracture, representing
110,000 hospital days and charges of over $145 million. Nearly 60
percent of individuals who fracture a hip are discharged from the
hospital to a nursing home or rehabilitation center, and approximately
20 percent of hip fracture patients die within one year of the fracture.
National data for vertebral fractures show an overall hospitalization
rate of 14.5 per 100,000, and Medical Review of North Carolina data
indicate an average hip fracture rate among North Carolina Medicare
beneficiaries of 821 per 100,000 for 1994-1997. Also, the number
of hospitalizations due to osteoporotic fractures is expected to
increase 75 percent by the year 2020.
While osteoporosis is preventable and
treatable, many individuals do not realize their risk for the disease
and are not diagnosed until they sustain fracture. According to
the Piedmont Health Survey of older adults conducted by Duke University,
the proportion of older adults reporting osteoporosis is lower than
the proportion estimated to have osteoporosis. It is estimated that
osteoporosis is under-reported by 60 percent among White women age
80+ years, 66 percent among elderly African-American women, and
90 percent among elderly African-American men.
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Disparities
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Arthritis
Arthritis
is a leading health problem among all demographic groups. Arthritis
affects 50 percent of people age 65 years and older. However, most
people with arthritis are younger than 65 years of age and are working.
Arthritis is more common in women than in men. Whites and African
American/Blacks have similar rates of disease, but African American/Blacks
have greater rates of activity limitation. The rate of arthritis and
its associated disabilities is higher among persons with low education
and low income. The risk of chronic back pain increases with age.
Osteoporosis
White
women account for the majority of hospitalizations due to hip fracture;
however, both men and African American/Blacks face a higher mortality
rate after sustaining a fracture. The gap between the fracture risk
of African American/Blacks and Whites also decreases as age increases.
Currently, over 100,000 African American/Blacks in North Carolina
have low bone mass.
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Determinants/Risk
Factors
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Arthritis
Women aged
15 years and older account for 60 percent of arthritis cases; arthritis
risk increases with age; certain genes are known to be associated
with a higher risk of some types of arthritis; lower levels of education
and lower income; obesity; joint injuries; infections; certain occupations
(e.g., shipyard work, farming, heavy industry, and occupations with
repetitive knee-bending)
Osteoporosis
Bone resorption
can exceed bone formation as people age; females face greater risk
than males: Caucasians and Asians are at greater risk than African-American/Blacks
or Hispanics/Latinos; bone structure and body weight (person with
thin, small frame is at greater risk); early menopause (natural
or surgical) or disruption in menstrual cycle due to excessive exercise,
anorexia or bulimia; inactivity; smoking; excessive alcohol intake;
lack of calcium and/or vitamins; certain medications and medical
conditions increase risk; and family history
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NC Data
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| Chronic
Disease - Arthritis and Osteoporosis |
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