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While the diversity of the American population is one of the Nation’s greatest assets, one of

its greatest challenges is reducing the profound disparity in health status of America’s racial

and ethnic minorities and other health-disparity populations compared to the population as

a whole. Among the noteworthy findings in their 2002 report entitled

Unequal Treatment:

Confronting Racial and Ethnic Disparities in Health Care

, the Institute of Medicine concluded

that, even when disease severity, socioeconomic status, education, and access are controlled

for, racial and ethnic minorities receive lower quality health care, including routine services,

compared to Whites, and these differences are associated with worse clinical outcomes.


Musculoskeletal disparities threaten

the health of the nation. One in

five Americans suffer from doctor-

diagnosed osteoarthritis, but among

three segments of the population,

the impact is worse. Women, African

Americans, and Hispanics/Latinos

have more severe arthritis and

functional limitations. (Note: Unless a

study specifies a particular population

such as Mexican American, this document defines Hispanics/Latinos per the U.S. Department of

Health and Human Services Office of Minority Health as follows: “This ethnic group includes any

person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture

or origin, regardless of race.”)


These same individuals are more likely to be obese, diabetic, and

have a higher incidence of heart disease - medical conditions that can be improved with physical

activity. Instead of moving, however, these groups have an inactivity rate of 40–50 percent

and this rate is going up!


According to a 2010 report from the Centers for Disease Control

and Prevention (CDC), 22.2% of adults aged ≥18 years had self-reported doctor-diagnosed

arthritis, and 42.4% of those with arthritis

had arthritis-attributable activity limitation

(AAAL). Among persons who are obese, an

age-adjusted 33.8% of women and 25.2%

of men reported doctor-diagnosed arthritis.

The CDC notes that while arthritis and AAAL

represent a major public health problem in

the United States, it can be addressed, at

least in part, by implementing proven obesity

prevention strategies and increasing the

availability of effective physical activity programs and self-management education courses in

local communities.


The role of the nurse in managing a patient’s risk and progression of osteoarthritis (OA) has been

evolving and can include evaluation, education of the patient, risk management for medications

and other management activities, care coordination among the patient and healthcare

professionals, and compliance strategies including proper medication use, weight reduction,


omen in the Framingham

OA study who lost 11 lbs.

reduced their risk of symptomatic

knee OA by half.