The Association of Disability and Pain with Individual and Community Socioeconomic Status in People with Hip Osteoarthritis

Abstract

Objective:To examine associations between disability and socioeconomic status (SES) in persons with hip radiographic OA (rOA) or symptomatic OA (sxOA) in the Johnston County Osteoarthritis Project.Methods:Cross-sectional analyses were conducted on individuals with hip rOA (708) or sxOA (251). rOA was defined as Kellgren-Lawrence ≥ 2. Educational attainment (<12 years or ≥12 years) and occupation (managerial or non-managerial) were individual SES measures. Census block group poverty rate (<12%, 12-25%, ≥25%) was the community SES measure. Disability was measured by the HAQ-DI and the WOMAC (function, pain, total). Covariates included age, gender, race, BMI, and presence of knee symptoms. Analyses examined associations of disability with each SES effect separately, followed by multivariable analyses using all SES variables, adjusting for covariates.Results:In models with single SES variables adjusted for covariates, WOMAC scores were associated significantly (p<0.05) with low educational attainment and non-managerial occupation in rOA and sxOA. HAQ was significantly associated with low educational attainment in rOA and sxOA and with high community poverty in rOA. In models including all SES variables, the patterns of association were similar although with diminished significance. There was indication that education was more strongly associated with HAQ and WOMAC function, while occupation was more strongly associated with WOMAC pain.Conclusion:Our data provide evidence that individual SES is an important factor to consider when examining disability and pain outcomes in older adults with hip OA.

Association of cartilage defects, and other MRI findings with pain and function in individuals with mild–moderate radiographic hip osteoarthritis and controls

“…The discordance between the relationship of hip degeneration with self-reported vs. physical function suggests that there may be an interaction of structural, socio-economic and psychological factors which affects the magnitude of disability. [18, 43, 44] Another possibility could be that the performance based tests used here are not sensitive enough to evaluate physical function for this population. Using 3-D motion analysis techniques, it has been shown the people with mild-moderate hip OA walk with reduced joint excursion and reduced hip flexion moment in late stance.…”

Sleep Disturbance in Osteoarthritis: Linkages With Pain, Disability, and Depressive Symptoms

“…The current research therefore examined cross-sectional and one-year longitudinal relationships of sleep difficulties with pain, depression, and functional disability in older adults with physician-diagnosed knee OA. Because variables of interest are known to vary with both demographic characteristics (28–30) and health status (31), those factors were examined as covariates, and their effects controlled as needed in all analyses.…”

Social Determinants and Osteoarthritis Outcomes

“…With the aging of the population worldwide, the prevalence of OA is expected to increase and is likely to result in substantial economic costs for health-care systems. As noted in the recent Institute of Medicine report , Living Well with Chronic Illness: A Call for Public Health Action , although the health of Americans is better now than any other time in history, the gains are not shared by all members of our society [22]. …”

“…Recent data suggest that the social context (i.e., factors in society that cannot be directly measured at the individual level), or socioeconomic environment of an individual’s neighborhood may be relevant to arthritis prevalence and health outcomes as well. Although studies have focused on how community contexts interact with individual characteristics for individuals with rheumatoid arthritis (R A), systemic lupus erythematosus and self-reported arthritis [32–38], far fewer studies have investigated this relationship with populations of individuals with OA [22,39,40]. …”