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. ? ?
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