By Mary I. O’Connor, MD

Summit focuses on musculoskeletal health disparities

As we strive to deliver the highest levels of patient care and surgical excellence, members of the orthopaedic profession often gather to discuss the challenges and opportunities facing us as individuals and as a community of surgeons. We appreciate this sharing of knowledge and experiences as a means to advance our goals.

In September, I attended the inaugural National Summit on Arthritis and Musculoskeletal Health Disparities in Washington, D.C. I was joined by an incredibly diverse group of attendees—leaders representing more than 10 stakeholder groups engaged in the continuum of care of women and racial/ethnic minorities, with a specific focus on individuals who are disproportionately affected by arthritis.

Daily, persistent chronic joint pain determines the choices people make—whether they are able to leave the house, if they are able to work, how they function at work, and if they can perform basic tasks for themselves and their family. The mission of the Summit is to decrease musculoskeletal health disparities among women and ethnic/racial minorities by raising awareness of its impact on chronic disease management and quality of life. By promoting the importance of early intervention, Summit participants hope to slow musculoskeletal disease progression, reduce disability, and encourage physical activity and daily movement to improve the overall health of the nation.

The Summit program included the following keynote presentations: Louis Sullivan, MD, former U.S. Health and Human Services Secretary; Cato Laurencin, MD, PhD, dean, School of Medicine, University of Connecticut; Maria Suarez, MD, PhD, rheumatology chief, MD Anderson Cancer Center, and Brian Smedley, PhD, director of the Washington, D.C.-based think tank, Joint Center on Political and Economic Studies.

A panel discussion on Public Policy/Private Foundations featured Stephen Katz, MD, PhD, director, National Institute of Arthritis, Musculoskeletal and Skin Diseases; Wayne Giles, MD, chief administrator of the Centers for Disease Control and Prevention’s Arthritis Program; and Jeffrey Lewis, JD, president, Heinz Family Philanthropies. They were joined by several orthopaedic surgeons and engaged in dynamic conversations with other professionals and leaders on a variety of issues.

Because we came from different backgrounds and had different perspectives, the result was a broader dialogue than previous discussions on this challenging problem. The differences produced fresh ideas and a pathway toward better outcomes. The following topics were among those covered in small group discussion sessions:

• Racial/ethnic musculoskeletal health disparities and the role of culture
• Gender musculoskeletal health disparities and social/psycho-logical factors
• Community programs, faith-based outreach, and research
• Communication processes: primary care physician/orthopaedist; healthcare professional/patient; patient activism, and communication materials and resources
• Cultural competency, pipeline/education, and health ethics

The topic of musculoskeletal health disparities continues to need efforts to raise awareness in terms not only of the impact on individuals but also on the health of our nation. I believe that many of our leaders know such disparities exist, but do not truly understand the severity of the problem and the serious consequences that these disparities create.

The multidisciplinary Summit on Musculoskeletal Health Disparities laid the groundwork for a fresh approach to responding to the unique needs of individuals disproportionately impacted by arthritis, a “new and broader” definition of the orthopaedic patient care team, and action steps to address disparities and lay the framework for its elimination.

Our efforts will continue; our patients are counting on us.

Mary I. O’Connor, MD, is chair, Department of Orthopaedics, Mayo Clinic Florida; president, American Association of Hip and Knee Surgeons; and vice president, Association of Bone and Joint Surgeons.

Steering Committee
The Summit Steering Committee included representatives from the Arthritis Foundation; American Association of Latino Orthopaedic Surgeons; Association of Black Cardiologists; Association of Minority Health Professions Schools, Inc.; Black Women’s Health Imperative, Center for Urban Families; J. Robert Gladden Orthopaedic Society; Full Gospel Baptist Fellowship; National Association of Orthopaedic Nurses; National Hispanic Council on Aging; National Urban League; Ruth Jackson Orthopaedic Society; To Our Children’s Future with Health; U.S. Bone and Joint Decade; W. Montague Cobb NMA Health Institute; and Zimmer, Inc.

AAOS fellows who served on the Steering Committee included Alberto A. Bolanos, MD; Daryll C. Dykes, MD, PhD; Richard E. Grant, MD; Melvyn A. Harrington, MD; Ramon L. Jimenez, MD; Randall C. Morgan Jr, MD; Charles L. Nelson, MD; Michael L. Parks, MD; Aaron G. Rosenberg, MD; Kimberly J. Templeton, MD; Augustus A. White III, MD; and James Wood, MD.

Mary I. O’Connor, MD, and Said Ibrahim, MD, served as the meeting co-chairs.

Did you know…?

• Arthritis is the single greatest cause of chronic pain and disability among Americans.
• Eighty percent of Americans either have or know someone with arthritis, and the numbers continue to escalate.
• Women are disproportionately affected by arthritis and related disability. According to the Arthritis Foundation, in 2003, women with a primary diagnosis of arthritis accounted for most of the estimated 43 million visits to physicians’ offices and outpatient clinics and approximately 1 million hospitalizations.
• In April 2010, the Centers for Disease Control and Prevention reported that severe joint pain, activity limitation, and work limitation were significantly higher among African-Americans and Latinos.