A Healthier Future for West Virginia - Healthy People 2010

Message Credits Objectives
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2 - ARTHRITIS, OSTEOPOROSIS, AND CHRONIC BACK CONDITIONS

Objectives | References

Background

West Virginia has the oldest population in the nation according to 1996 population estimates. This has focused attention on preserving quality and quantity of life. Chief concerns involving preserving the quality of life are the prevention and treatment of musculoskeletal conditions. Musculoskeletal conditions such as arthritis and other rheumatic conditions, osteoporosis, and chronic back conditions are the major causes of disability in the United States. As the population continues to age, the need for individuals to work at older ages will have a direct effect on social and economic consequences of activity limitation.

Arthritis
Arthritis encompasses more than 100 diseases and conditions that affect joints and the surrounding tissues. It affects nearly one of every six Americans, making it one of the most common diseases in the United States. By the year 2020, an estimated 60 million people will be affected. In addition, arthritis is the leading cause of disability, limiting daily activities for more than seven million citizens. Another aspect of this disease is the cost of treating arthritis and its complications. These medical and social costs total nearly $65 billion. In West Virginia, 43% of adults surveyed in the Behavioral Risk Factor Surveillance System reported having pain, aching, stiffness, or swelling in or around a joint in the past year, and 41% reported current limitations in many activities because of joint symptoms.

Osteoporosis
Osteoporosis, or porous bone, is a disease characterized by low bone mass and structural deterioration of bone tissue, leading to bone fragility and an increased susceptibility to fractures of the bone. Osteoporosis is considered the "silent disease" because its progression is so insidious; most individuals are not aware they have osteoporosis until they actually fracture a bone (most commonly the hip, spine, or wrist). Ten million individuals are already afflicted with osteoporosis in the United States, and 18 million more have low bone mass, placing them at increased risk for this disease. One out of every two women and one out of every eight men over 50 will have an osteoporosis-related fracture in their lifetime. Osteoporosis is responsible for more than 1.5 million fractures in the United States annually. A woman's risk of a hip fracture is equal to her combined risk of having breast, uterine, or ovarian cancer.

In West Virginia in 1996, an average of 416 out of every 1,000 people aged 50 and older had osteoporosis or were at risk due to low bone density. Over one-half (½) of all women in this age group, or approximately six out of 10, were at risk for osteoporosis. The National Osteoporosis Foundation (NOF) predicts that by the year 2015, 227, 246 women and 43,383 men in the state will have osteoporosis or low bone mass. Because osteoporosis primarily affects our older citizens, it is of particular concern to health professionals in West Virginia. After age 35, both men and women begin to lose bone mass (0.3% to 0.5% yearly) as a normal part of aging, through an imbalance of the bone remodeling process. During the years following menopause, a woman's bone loss, especially of trabecular bone, accelerates due to her decreased estrogen levels.

Chronic Back Conditions
Chronic back conditions are the most common physical complaint among American adults. Chronic back pain is described in different ways, such as the occurrence of back pain lasting for more than seven to 12 weeks, back pain lasting beyond the expected period of healing, or frequently recurring back pain. Chronic back pain is measured by where the pain occurs (such as lower back pain), activity limitation, impairment, and disability. Most back problems originate from bad habits, generally developed over a long period of time: poor posture; overexertion in work and play; sitting incorrectly at a desk or steering wheel; or pushing, pulling, and lifting things carelessly. The annual incidence of low back pain is 5% to 14%, and the lifetime reported prevalence ranges from 60% to 90%. In 1983-85, chronic back conditions rivaled arthritis and heart disease as a major cause of activity limitations.

The Objectives

OBJECTIVE 2.1. (Developmental) Increase to 35% the proportion of youth aged 13-18 years who are educated about good bone health and osteoporosis prevention. (Baseline data available in 2000)

Data Source: West Virginia Department of Education, Office of Healthy Schools, Youth Risk Behavior Survey

OBJECTIVE 2.2. Increase to 35% the proportion of persons aged 18 and over who have received counseling from their health care provider concerning osteoporosis and/or osteoporosis prevention. (Baseline: 22.5% in 1999)

Data Source: West Virginia Bureau for Public Health (WVBPH), Office of Epidemiology and Health Promotion (OEHP), Behavioral Risk Factor Surveillance System (BRFSS)

FLAGSHIP OBJECTIVE
OBJECTIVE 2.3. Reduce the prevalence of osteoporosis, as defined by low bone mineral density (BMD), in West Virginia to no more than 30% among people aged 50 and older. (Baseline: 41.6% in 1996)

Data Source: WVBPH, OEHP, The Burden of Osteoporosis in West Virginia

OBJECTIVE 2.4. Reduce hospitalizations due to osteoporosis-related fractures among persons aged 45 or older to 50%. (Baseline: 68.1% in 1996)

Data Sources: West Virginia Health Care Cost Authority; WVBPH, OEHP, The Burden of Osteoporosis in West Virginia

OBJECTIVE 2.5. Reduce to no more than 30% the proportion of people with arthritis who experience a limitation in activity due to arthritis. (Baseline: 40.1% in 1999)

Data Source: WVBPH, OEHP, BRFSS

OBJECTIVE 2.6. (Developmental) Reduce activity limitation due to chronic back conditions by 20% of the individuals affected. (Baseline data available in 2000)

Data Source: WVBPH, OEHP, BRFSS

Meeting the Objectives

Health Promotion Channels for Achieving Objectives:

• Work Sites
• Schools
• Public Health Programs
• Networks
• Health Care Systems
• Higher Education

The Osteoporosis Prevention Education Program will use the objectives as the framework to guide the program's work plan for the upcoming year. A special emphasis will be placed on working with the schools within the state to begin to educate West Virginia's children about osteoporosis and other conditions. The Program will also use the assistance of the Osteoporosis Prevention Education Program Advisory Panel to develop community-based programs that will help meet the objectives. The Osteoporosis Program will also award Community-Based Initiative Grants to programs to continue to educate West Virginians based on these objectives.

Work Group Members

References/Resources

Brown SE. Better Bones, Better Body. New Canaan, CT: Keats Publishing, Inc, 1996.

Griffin LY. Women's Musculoskelatal Health: Update for the New Millennium. Philadelphia, PA: Lippincott, Williams & Wilkins, 2000.

National Osteoporosis Foundation. Education Kit. 2000.

National Resource Center. Osteoporosis and Related Bone Diseases. Bethesda, MD: National Institutes of Health, 1999.

West Virginia Bureau for Public Health. Behavioral Risk Factor Survey 1997. Charleston, WV: West Virginia Department of Health and Human Resources, 1998.

West Virginia Bureau for Public Health. The Burden of Osteoporosis in West Virginia. Charleston, WV: West Virginia Department of Health and Human Resources, 1998.

West Virginia Bureau for Public Health. West Virginia Vital Statistics 1998. Charleston, WV: West Virginia Department of Health and Human Resources, March 1999.

For More Information

Osteoporosis Prevention Education Program
Office of Epidemiology and Health Promotion
Room 319
350 Capitol Street,
Charleston, WV 25301-3715
Phone: (304) 558-0644; Fax: (304) 558-1553

This page was last updated June 8, 2001.
For additional information about HP2010, contact Chuck Thayer at (304) 558-0644 or Chuck.E.Thayer@wv.gov