Hip and Knee Replacements
Over one million people undergo hip and knee replacements across the U.S. each year, and it is expected that more than four million people will have these procedures done annually by 2030. Increasing the quality of care and reducing costs for this extensive network of patients are critical public health issues. As director of research for the American Joint Replacement Registry (AJRR), SPH alumna Caryn Etkin, PhD, MPH ’97, is collaborating with SPH Professor Hal Morgenstern to address both issues. Morgenstern is lead epidemiologist for the U-M–based Michigan Arthroplasty Registry Collaborative Quality Initiative (MARCQI), a group of orthopedic surgeons and medical professionals devoted to improving the quality of care for patients undergoing hip and knee replacement procedures in Michigan.
“As a national registry, AJRR will be able to provide the most accurate and complete picture of the arthroplasty experience in the U.S.,” Etkin explains. “By providing benchmarking and monitoring the outcomes of arthroplasty, we can advance the efforts of patient safety and quality of care.” Working together, Etkin and Morgenstern hope to improve follow-up, decision-making, and early detection. After starting formal operations in 2012, AJRR has enrolled over 200 hospitals from 46 states and hopes to capture data on 90 percent of all total joint replacements being performed in the U.S. with assistance from organizations such as MARCQI. —Rachel Ruderman
Neal Krause, the Marshall H. Becker Collegiate Professor of Public Health and associate chair, Department of Health Behavior and Health Education, has received an $8 million grant from the John Templeton Foundation to conduct a landmark spirituality and health survey aimed at generating solid explanations for why religion has both positive and negative effects on human physiology.
Older adults with asthma face unique challenges, among them atypical asthma symptoms and an inability to distinguish asthma from other medical conditions. Under the direction of Alan Baptist, an assistant professor of health behavior and health education, a team of researchers in the U-M Center for Managing Chronic Disease is embarking on a study to implement and evaluate a self-regulation asthma intervention for adults 55 and older who have persistent asthma. Study participants include residents from inner-city, suburban, and rural communities. Funded by the National Institutes of Health, the randomized control trial will assess the impact of the intervention on quality of life, asthma control and symptoms, lung function tests, and health care utilization.
Carlos Mendes de Leon, professor of epidemiology, is examining racial and ethnic differences in the rates of decline among older Americans, with the hope of determining whether minority populations have more adverse aging-related declines than the majority non-Hispanic white population. Mendes de Leon says the evidence to date is mixed, and that “while minorities tend to experience greater declines in health before reaching older age, the rate of overall decline in older age itself is not necessarily worse than in older non-Hispanic whites.”