Relationship between area-level socio-economic deprivation and autoantibody status in patients with rheumatoid arthritis: multicentre cross-sectional study

McDermott, Michael; Taylor, John; Twigg, Sarah; Martin, Stephen G.; Steer, Sophia; Worthington, Jane; Barton, Anne; Wilson, Anthony G.; Hocking, Lynne J.; Young, Adam; Emery, Paul; Barrett, Jennifer; Morgan, Ann W

doi:10.1136/annrheumdis-2011-201003

Cited by 18 publications

(6 citation statements)

References 36 publications

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“…Our study is suggestive of a higher risk of RA in subjects with high SES. Findings regarding the risk of developing RA in relation to SES have not been uniform in the past 33,34,35,36 . There are some characteristics in this population that may be related to our findings.…”

Section: Discussionmentioning

confidence: 99%

The Prevalence of Rheumatoid Arthritis in Chile: A Nationwide Study Performed as Part of the National Health Survey

Durán¹,

Massardo²,

Llanos³

et al. 2019

J Rheumatol

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Objective.Genetic and environmental backgrounds influence the development of rheumatoid arthritis (RA). In Latin America, epidemiologic data are scarce. We aimed to determine the prevalence of RA in Chile in a population-based study.Methods.The National Health Survey was a cross-sectional household survey with a stratified multistage probability sample of 6233 participants performed between August 2016 and March 2017. A screening instrument for RA was applied to a random sample of 3847 subjects > 30 years old. Positive screening was defined by at least 1 of the following: 2 swollen joints for at least 4 consecutive weeks (past/present), and/or a diagnosis of arthritis in the past. Individuals with positive screening had rheumatoid factor, anticitrullinated protein antibodies, and C-reactive protein measured, as well as clinical examination performed by a rheumatologist. Self-report of doctor-diagnosed RA was also performed.Results.The screening questionnaire was applied to 2998 subjects. A positive screening was found for 783 (22.1%). Among subjects with positive screening, 493 (66%) had a clinical evaluation performed by a rheumatologist. Using the American College of Rheumatology/European League Against Rheumatism 2010 classification criteria, prevalence was 0.6% (95% CI 0.3–1.2). Prevalence was higher in women, and 3.3% of subjects self-reported having RA.Conclusion.According to this national population-based study, RA prevalence in Chile is 0.6% (0.3–1.2), a value similar to what has been found in developed countries and slightly lower than some Latin American countries. Self-reporting leads to overestimating RA.

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Section: Discussionmentioning

confidence: 99%

The Prevalence of Rheumatoid Arthritis in Chile: A Nationwide Study Performed as Part of the National Health Survey

Durán¹,

Massardo²,

Llanos³

et al. 2019

J Rheumatol

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“…Socioeconomic status (SES) also exerts influence on RA disease outcomes; those with lower SES have higher rates of comorbid disease (9). Current data reinforce the regional and sociocultural impact on clinical health outcomes, with identification of area level and personal factors that independently affect outcomes and interact to amplify the effect (10,11). The confluence of previously poorly described factors, such as residence, comorbidity, and access to care, has a significant impact on clinical outcomes and contributes to the overall burden of RA disease.…”

Section: Introductionmentioning

confidence: 86%

Geographic Variation in Disease Burden and Mismatch in Care of Patients With Rheumatoid Arthritis in the United States

Dowell

Yun

Curtis

et al. 2023

ACR Open Rheumatology

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Objective Our objective was to evaluate the factors associated with regional variation of rheumatoid arthritis (RA) disease burden in the US. Methods In a retrospective cohort analysis of Rheumatology Informatics System for Effectiveness (RISE) registry data, seropositivity, RA disease activity (Clinical Disease Activity Index [CDAI], Routine Assessment of Patient Index Data–version 3 [RAPID3]), socioeconomic status (SES), geographic region, health insurance type, and comorbidity burden were recorded. An Area Deprivation Index score of more than 80 defined low SES. Median travel distance to practice sites’ zip codes was calculated. Linear regression was used to analyze associations between RA disease activity and comorbidity adjusting for age, sex, geographic region, race, and insurance type. Results Enrollment data for 184,722 patients with RA from 182 RISE sites were analyzed. Disease activity was higher in African American patients, in those from Southern regions, and in those with Medicaid or Medicare coverage. Greater comorbidity was prevalent in patients in the South and those with Medicare or Medicaid coverage. There was moderate correlation between comorbidity and disease activity (Pearson coefficient: RAPID3 0.28, CDAI 0.15). High‐deprivation areas were mainly in the South. Less than 10% of all participating practices cared for more than 50% of all Medicaid recipients. Patients living more than 200 miles away from specialist care were located mainly in Southern and Western regions. Conclusion A disproportionately large portion of socially deprived, high comorbidity, and Medicaid‐covered patients with RA were cared for by a minority of rheumatology practices. Studies are needed in high‐deprivation areas to establish more equitable distribution of specialty care for patients with RA.

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“…Additionally, since the two studies only assessed the RA prevalence trend before 2014, the trend after that remained unknown. Other relevant research has suggested that high socioeconomic status (SES) is significantly associated with a lower risk of developing RA [ 9 ], so a better understanding and management of SES may result in preventing the onset of RA [ 10 ]. However, studies that examined the RA prevalence trend in different SES situations have been rare in the last decade.…”

Section: Introductionmentioning

confidence: 99%

Prevalence Trend and Disparities in Rheumatoid Arthritis among US Adults, 2005–2018

2021

JCM

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Rheumatoid arthritis (RA) trends among US adults and disparities in RA patients in recent years have not been well described. We aimed to examine the trend of RA prevalence and disparities among US adults. Data from the National Health and Nutrition Examination Survey (NHANES) of the years 2005–2018 were analyzed to examine the self-reported RA prevalence trend. Age-adjusted RA prevalence stratified by race/ethnicity and socioeconomic status (SES), as well as associated linear trends, were calculated for both genders. The multivariable adjustment was used to evaluate the association between race, SES, and RA. During 2005–2018, there was no significant linear trend in the age-adjusted self-reported RA prevalence among men and women, but significant differences among people from different races, educational levels, and family poverty income ratio (PIR) groups were observed. The RA rate difference was significant for both genders and between Non-Hispanic Caucasians and Non-Hispanic African Americans (both p-value ≤ 0.001). Both men and women with a higher educational level and a higher PIR had a lower age-adjusted RA rate. Age-adjusted RA prevalence fluctuated for both men and women during 2005–2018. Non-Hispanic African Americans and people with low SES had significantly higher age-adjusted RA prevalence and RA risk.

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Relationship between area-level socio-economic deprivation and autoantibody status in patients with rheumatoid arthritis: multicentre cross-sectional study

Cited by 18 publications

References 36 publications

The Prevalence of Rheumatoid Arthritis in Chile: A Nationwide Study Performed as Part of the National Health Survey

The Prevalence of Rheumatoid Arthritis in Chile: A Nationwide Study Performed as Part of the National Health Survey

Geographic Variation in Disease Burden and Mismatch in Care of Patients With Rheumatoid Arthritis in the United States

Prevalence Trend and Disparities in Rheumatoid Arthritis among US Adults, 2005–2018

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