Arthritis & Rheumatism, Volume 62,
November 2010 Abstract Supplement
Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Atlanta, Georgia November 6-11, 2010.
Life Course Socioeconomic Position and Health Outcomes in People with Self-Reported Arthritis.
Shreffler3, Jack H., Schoster3, Britta, Martin2, Kathryn Remmes, Callahan1, Leigh F.
Childhood and adult socioeconomic status (SES) positions have been demonstrated to be independently associated with health status outcomes in cardiovascular and other chronic diseases. The purpose of this study is to determine if current SES and childhood caregiver SES positions are independently associated with health outcomes, including measures of disability, physical health, and mental health status, in people with self-reported arthritis.
A practice-based research network of 22 family medicine practices in rural and urban areas of a southeastern state was established in 2001. Participants completed telephone surveys assessing health status, chronic conditions, community characteristics, health attitudes and beliefs, and socio-demographic variables in 2004 and again in 2006. The 2006 follow-up questionnaire obtained participants' current SES and the SES of their parent or caregiver during childhood. Regression models were conducted on 937 people with arthritis for health outcomes including adult/childhood pairs of single SES variables (education, occupation, or homeownership) as main explanatory variables with adjustment for age, BMI, and gender. Outcomes were SF12v2 Physical (PCS) and Mental (MCS) Component Summary scores, Health Assessment Questionnaire disability scale (HAQ), Center for Epidemiological Studies-Depression depressive symptoms scale (CES-D), and the CDC Health Related Quality of Life 5-item general health response (dichotomized to fair/poor versus good/very good/excellent).
The average age of participants was 61 years (2394) and 74% were female. 16% did not complete high school (NHS), non-homeownership (NHO) was 18%, and low occupational status (LOC) was 42%. The 3 SES measures for the participants were considerably higher than those reported for their primary caregiver during childhood. PCS score, 38(13) [mean (sd)], was significantly (p<0.05) reduced by -4.2, -2.7, and -2.7 for caregiver NHS, LOC, and NHO, respectively. General health self-reported as fair/poor (39%) was more likely, OR=1.54 (95% CI=[1.17, 2.05]), for caregiver NHO, and nearly significantly, OR=1.6 (95% CI=[0.99, 2.70], p=0.056), for caregiver NHS. CES-D score, 11.9(12), was significantly increased by 2.6 and 2.5 for caregiver NHS and NHO, respectively. In addition, CES-D was nearly significant, b=1.6 [95% CI=-0.01, 3.25] (p=0.051) for LOC. Neither HAQ nor MCS was found to have independent, significant association with the three caregiver SES variables when the adult measures were included in the model. In the regression models producing the results above, SES measures for the adult participants were strongly associated with all outcomes, with the notable exceptions of PCS and MCS for homeownership.
SES measures at childhood show significant association with PCS, general health, and CES-D, independent of the participant's current adult SES levels. Healthcare providers should consider the potential influence of patients' SES as children when evaluating their current health status.
To cite this abstract, please use the following information:
Shreffler, Jack H., Schoster, Britta, Martin, Kathryn Remmes, Callahan, Leigh F.; Life Course Socioeconomic Position and Health Outcomes in People with Self-Reported Arthritis. [abstract]. Arthritis Rheum 2010;62 Suppl 10 :1460