Equity360: Gender, Race, and Ethnicity-Trapped in the Joint Pain Vicious Cycle (Part I).

Orthopaedic surgeons treat patients with lower extremity joint pain on a regular basis. But are we effectively communicating with our patients that joint pain can be the beginning of a cycle that leads to poor health, and that this cycle affects women and individuals of color more so than men and whites? Movement is Life, a multistakeholder coalition formed in 2009 to decrease musculoskeletal healthcare disparities [13], calls this the Joint Pain Vicious Cycle—knee joint pain leading to limited mobility, which decreases overall physical activity, and likely results in weight gain. The addedweight increases pressure on the knee, potentially leading to more joint pain and raises the risk of developing co-morbid conditions (Fig. 1). Although any individual can fall into the Joint Pain Vicious Cycle, women and individuals of color are more likely to have joint pain related to arthritis [4]. The co-morbid and often life-threatening conditions seen in the cycle (heart disease [12], diabetes [14], and depression [1]) impact women or indiviudals of color more so than men or whites. This is important because the United States will be a non-white majority nation by 2045 (49.7% white, 24.6% Hispanic, 13.1% black, 7.9%Asian, 3.8%multiracial) [8]. We should also consider that: