Functional Limitation, Arthritis, Depression, & Race

描述（由申请人提供）：本研究涉及PA 02 -043与健康不良后果相关的健康的社会和文化层面的方案领域。本研究评估了重性抑郁症与社会人口学、健康和经济因素对关节炎相关功能限制的影响，以确定适合公共卫生/公共政策预防或干预策略的风险因素。超过3500万美国人患有一种或多种疾病，导致生活活动受限，相关经济成本超过1700亿美元。抑郁症和关节炎是美国功能限制的两个主要原因。关节炎相关的功能限制是一个特别令人关注的问题，因为少数民族群体的负担不成比例地高。这项研究解决了与关节炎成年人接近退休年龄时的功能限制和严重抑郁症相关的主要公共卫生和公共政策问题。它使用来自健康和退休调查（HRS）的1996-2000年全国代表性纵向数据来估计关节炎患者的功能限制和12个月重度抑郁症的发生率。它还估计了重性抑郁症对随后的功能障碍和医疗服务使用的影响。它进一步估计种族/民族差异的功能障碍和抑郁症，并检查是否抑郁症的发病率，其他健康需求，和/或医疗保健的访问部分解释种族/民族差异的功能限制发病和随后使用的医疗保健服务。研究人员提供了一系列卫生服务研究，统计，医疗康复，临床，心理健康，公共卫生和经济专业知识，这些专业知识是使用国家数据完成这项方法复杂的研究所需的。该项目根据1996年HRS数据扩展了他们的初步工作，该数据显示了关节炎患者中抑郁症和功能限制的种族/民族差异。这项研究的目标是从健康的人2010年，国家医疗康复研究中心，和国家关节炎和肌肉骨骼和皮肤病研究所的战略计划。本研究验证的假设将提供信息，激励临床和公共卫生策略，以改善医疗保健和减少关节炎患者的功能障碍。

DESCRIPTION (provided by applicant): This study addresses the programmatic area from PA02-043 Social and Cultural Dimensions of Health related to consequences of poor health. This study evaluates the influence of major depression in conjunction with sociodemographic, health, and economic factors on arthritis-related functional limitations to identify risk factors amenable to public health/public policy prevention or intervention strategies. Over 35 million Americans have one or more conditions resulting in a limitation of life activities with an associated economic cost exceeding $170 billion. Depression and arthritis are the two leading causes of functional limitations in the United States. Arthritis-related functional limitations are a particular concern due to disproportionately high burdens among ethnic minority groups. This study addresses major public health and public policy questions related to functional limitation and major depression in adults with arthritis as they near retirement age. It uses nationally representative longitudinal 1996-2000 data from the Health and Retirement Survey (HRS) to estimate rates of functional limitation and 12-month major depression among persons with arthritis. It also estimates the impact of major depression on subsequent functional impairment and use of medical services. It further estimates racial/ethnic differences in functional impairment and major depression and examines whether differences in depression rates, other health needs, and/or health care access partly explain racial/ethnic disparities in functional limitation onset and subsequent use of health care services. The investigators provide a spectrum of health services research, statistical, medical rehabilitation, clinical, mental health, public health, and economic expertise needed to complete this methodologically sophisticated study using national data. The project extends their preliminary work based on the 1996 HRS data, which shows racial/ethnic differences in depressive disorders and functional limitations among persons with arthritis. This study addresses goals from Healthy People 2010, National Center for Medical Rehabilitation Research, and the National Institute of Arthritis and Musculoskeletal and Skin diseases strategic plan. Hypotheses tested by this study will provide information that would motivate clinical and public health strategies to improve health care and reduce functional impairment among people with arthritis.