Healthcare workers are aware of the need for culturally competent care, yet
current assessment tools cannot identify measures that are effective and those that are not.
More effective training needs to be developed for healthcare providers to consider the potential
roles of conscious and unconscious bias. And, equally if not more importantly, patients must
be educated on the importance of becoming active partners in their own care.
OSTEOARTHRITIS AND OBESITY
Among the 50 million U.S. adults with arthritis, obesity is associated with progression of
arthritis, activity limitation, disability, reduced quality-of-life, and poor clinical outcomes after
In middle-aged women, higher weights (BMI) results in an increased
likelihood of hip and knee replacement, although the magnitude of risk is much greater for a
In particular, obesity is associated with onset of knee OA (the most common
type of arthritis), disease progression, disability, total knee joint replacement, and poor clinical
outcomes after knee joint replacement, and likely has a critical role in the increasing impact
of arthritis on disability, health-related quality of life, and healthcare costs.
for symptomatic knee OA alone is 60.5% among persons who are obese, double the risk for
those of normal/underweight.
For hip OA, U.S. and international studies have demonstrated
mixed results, with obesity generally associated with symptomatic OA and joint replacement.
An ongoing study of 238,00 female nurses that started in 1976 found that women who were
obese, especially at age 18, had an increased risk of undergoing a hip replacement in later life.
Women in the Framingham OA study who lost 11 lbs. reduced their risk of symptomatic knee
OA by half.
During 2003–2009, obesity prevalence among U.S. adults with arthritis was 54%
higher than among adults without arthritis, and obesity prevalence among adults with arthritis
increased significantly in 14 states and Puerto Rico during that time period.
Some form of arthritis affects 50 million adults
in the United States and the CDC has predicted
that the number will increase to 67 million, or
25% of the adult population, by 2030.
and arthritis are critical public health problems
with high prevalences and medical costs. In the
United States, an estimated 72.5 million adults
aged ≥20 years are obese, and 50 million adults
have arthritis. Medical costs are estimated at
$147 billion for obesity and $128 billion for
arthritis each year.
Osteoarthritis (OA), the most
common type of arthritis,
accounts for much of
As a nation, we pay an inordinate price for the pain and disability from OA. In 2004, OA
resulted in over 11 million physician and outpatient visits, 662,000 hospitalizations, and more
than 632,000 total joint replacements, with accompanying hospital costs of $22.6 billion.
In addition, employment rates are lower among adults with arthritis because of arthritis-
attributable work limitations; hence, they either are working less or not working due to their