Arthritis & Rheumatism, Volume 60,
October 2009 Abstract Supplement
The 2009 ACR/ARHP Annual Scientific Meeting
Philadelphia October 16-21, 2009.
Associations Between Individual and Community Socioeconomic Status (SES) Measures with Psychosocial Outcomes in Individuals with Arthritis
Callahan1, Leigh F., Shreffler1, Jack, Schoster1, Britta, Kaufman2, Jay, Schwartz1, Todd
To examine associations between individual level (education, income, occupation and home ownership) and census-based community-level (% poverty rate) SES measures with psychosocial outcomes in individuals with self-reported arthritis.
In 20042005, 1307 arthritis participants from urban and rural areas in the southeast completed a telephone survey assessing health status, chronic conditions, health attitudes and beliefs, and socio-demographic variables. Education [< high school (HS), HS degree, and > HS], income [<15, 1545, >$45K], occupation [professional, or not], and home ownership were individual level SES measures. The 2000 U.S. Census block-group-level variable "% of individuals living below the poverty line" (trichotomized into low, medium, high) was used as the community SES measure. Outcomes included the SF-12v2 Mental Component Summary (MCS), the CDC Health Related Quality of Life (HRQOL) Healthy Days mental health component, and the CES-D depression measure. Regression analyses with clustering on study sites were performed with STATAv9 and included adjustment for race, gender, BMI, and age in all cases.
When entered separately, lower education, lower income, non-professional occupation, and no home ownership were significantly (all p<.05) associated with poorer MCS, mental health days, and CES-D scores. Income, however, was more strongly associated with the outcomes than the other individual SES variables. For example, the MCS score is 7.2 higher for people in the high income group and 3.4 higher for people with >HS (both compared to <0.05). The highest block group poverty is significant (p<0.05) for high CES-D score when education, homeownership, or occupation are in the model, but becomes non-significant when income is in the model. Finally, a complete model with all 4 individual SES measures and block group poverty shows income significant for each of the 3 outcomes of mental health, with the MCS score 6.05 higher for the high income group. There was no significance for homeownership, and marginal significance only for occupation associated with MCS and block group poverty associated with mental health days.
When 4 individual SES measures are examined for associations with psychosocial outcomes in people with arthritis, poorer status on all outcomes is associated with lower SES levels. Income, however, is the strongest predictor of poorer psychosocial status. Community SES measured by block group poverty rate is mainly associated with CES-D when individual income is not included as a modeling variable.
To cite this abstract, please use the following information:
Callahan, Leigh F., Shreffler, Jack, Schoster, Britta, Kaufman, Jay, Schwartz, Todd; Associations Between Individual and Community Socioeconomic Status (SES) Measures with Psychosocial Outcomes in Individuals with Arthritis [abstract]. Arthritis Rheum 2009;60 Suppl 10 :1886