Functional Limitation, Arthritis, Depression, & Race

描述（由申请人提供）：本研究涉及PA02-043中与健康不良后果相关的健康的社会和文化层面的规划领域。本研究评估重度抑郁症与社会人口统计学、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危险因素。超过3500万美国人患有一种或多种导致生命活动受限的疾病，相关经济成本超过1700亿美元。在美国，抑郁症和关节炎是导致功能受限的两大主要原因。由于少数民族群体的负担过高，与关节炎相关的功能限制是一个特别值得关注的问题。本研究解决了与接近退休年龄的成年关节炎患者的功能限制和重度抑郁相关的主要公共卫生和公共政策问题。它使用1996-2000年健康和退休调查（HRS）的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。报告还估计了严重抑郁症对随后的功能损伤和使用医疗服务的影响。它进一步估计了功能障碍和重度抑郁症的种族/民族差异，并检查抑郁率、其他健康需求和/或医疗保健获取的差异是否部分解释了功能限制发病和随后使用医疗保健服务方面的种族/民族差异。调查人员提供了一系列卫生服务研究、统计、医疗康复、临床、精神卫生、公共卫生和经济学专业知识，以完成这项使用国家数据的方法复杂的研究。该项目扩展了他们基于1996年HRS数据的初步工作，该数据显示了关节炎患者在抑郁症和功能限制方面的种族/民族差异。本研究解决了健康人2010、国家医学康复研究中心和国家关节炎、肌肉骨骼和皮肤疾病研究所战略计划的目标。本研究检验的假设将提供信息，激励临床和公共卫生策略，以改善卫生保健和减少关节炎患者的功能损害。

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.