Creating Musculoskeletal Programs for Culturally Diverse, Underserved Communities: a Community-Based Participatory Research Survey

HSS Journal Volume 10, Number 3 October 2014

Sandra Goldsmith, MA, MS, RD

Education and Academic Affairs, Public and Patient Education, Hospital for Special Surgery

Dana Friedman, MPH

Education and Academic Affairs, Hospital for Special Surgery

Roberta Horton, LCSW, ACSW

Department of Social Work Programs, Hospital for Special Surgery

Mavis Seehaus, MS, LCSW

Department of Social Work Programs, Hospital for Special Surgery

Laura Robbins, DSW

Education and Academic Affairs, Hospital for Special Surgery


Arthritis and other musculoskeletal diseases are the most prevalent health conditions in the USA, causing enormous financial and social burdens, especially in underserved communities. Targeted care and prevention programs are urgently needed.

Within an overall goal of revealing health disparities, the questionnaire explored (1) the use of and access to healthcare, (2) the factors affecting quality of life, and (3) the levels of provider–patient communication.

A New York City musculoskeletal hospital conducted a community health needs survey among its diverse ethnic/racial communities. A 39-item questionnaire was administered online, by mail, and in person (in English, Spanish, and Chinese). Answers were analyzed in terms of sociodemographics, to define health disparities within a total sample and two subsamples.

In the total sample, respondents were 60% White, 16% Black, 14% Hispanic/Latino, and 11% Asian, mostly female, and aged 50 to 79. More than 17% of the total sample indicated they could not access a healthcare provider when needed. Poor nutrition and lack of physical activity were large areas of concern, as were falls and poor self-reported health status. Nearly all respondents said they took steps to communicate with their healthcare providers. Dramatic health disparities were found between Whites and non-Whites (e.g., non-Whites were most likely to rate their health poorly, consider their diet fair or poor, lack health insurance, and be unable to access a healthcare provider).

The findings are being used to further refine, develop, and expand the hospital’s community programs, especially for culturally diverse and underserved communities.

Level of Evidence: Socioeconomic Analysis Level II

This article appears in HSS Journal: Volume 10, Issue 3.
View the full HSS Journal article at

About the HSS Journal

HSS Journal, an academic peer-reviewed journal published three times a year, February, July and October. The Journal accepts and publishes peer reviewed articles from around the world that contribute to the advancement of the knowledge of musculoskeletal diseases and disorders.


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