Functional Limitation, Arthritis, Depression, & Race

说明(由申请人提供)：这项研究涉及PA02-043《健康的社会和文化层面》中与健康不良后果有关的方案领域。这项研究结合社会人口学、健康和经济因素评估了严重抑郁症对关节炎相关功能限制的影响，以确定符合公共卫生/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，导致生命活动受限，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个主要原因。由于少数民族群体负担过重，与关节炎相关的功能限制是一个特别令人担忧的问题。这项研究解决了与接近退休年龄的成人关节炎患者的功能限制和严重抑郁有关的主要公共卫生和公共政策问题。它使用具有全国代表性的1996-2000年健康和退休调查(HRS)的纵向数据来估计关节炎患者的功能限制率和12个月的严重抑郁率。它还估计了严重抑郁症对随后的功能损害和医疗服务使用的影响。它还估计了功能障碍和严重抑郁症的种族/族裔差异，并审查了抑郁率、其他健康需求和/或医疗保健机会的差异是否在一定程度上解释了功能受限开始和随后使用医疗保健服务方面的种族/族裔差异。调查人员提供了一系列卫生服务研究、统计、医疗康复、临床、心理健康、公共卫生和经济专业知识，以使用国家数据完成这项方法复杂的研究。该项目在1996年HRS数据的基础上扩展了他们的初步工作，该数据显示了关节炎患者在抑郁障碍和功能限制方面的种族/民族差异。这项研究涉及2010年健康人、国家医疗康复研究中心和国家关节炎、肌肉骨骼和皮肤病研究所战略计划的目标。这项研究验证的假设将提供信息，这些信息将激励临床和公共卫生战略，以改善医疗保健，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.