Socioeconomic factors and self-reported health outcomes in African Americans with rheumatoid arthritis from the Southeastern United States: the contribution of childhood socioeconomic status

• Type of Material: Article
• Authors: Antoine R. Baldassari, University of North Carolina at Chapel Hill; Rebecca J. Cleveland, University of North Carolina at Chapel Hill; My-Linh N. Luong, University of North Carolina at Chapel Hill; Beth L. Jonas, University of North Carolina at Chapel Hill; Doyt Conn, Emory University; Larry W. Moreland, Consortium for the Longitudinal Evaluation of African Americans with Early Rheumatoid Arthritis; S. Louis Bridges, Jr, Consortium for the Longitudinal Evaluation of African Americans with Early Rheumatoid Arthritis; Leigh F. Callahan, Consortium for the Longitudinal Evaluation of African Americans with Early Rheumatoid Arthritis
• Language: English
• Date: 2016-01-12
• Publisher: BioMed Central
• Publication Version: Final Published Version
• Copyright Statement: © Baldassari et al. 2016
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1186/s12891-016-0882-5
• Title of Journal or Parent Work: BMC Musculoskeletal Disorders
• ISSN: 1471-2474
• Volume: 17
• Issue: 1
• Start Page: 10
• End Page: 10
• Grant/Funding Information: The CLEAR Registry is supported by the National Institutes of Health (NIH), grant number: N01-AR-02247.; This project is supported by NIAMS and the NIH Office of Research on Women’s Health, grant number: R01-AR056717-02.
• Keywords: Life Sciences & Biomedicine; VISUAL ANALOG SCALE; DISABILITY; Rheumatology; DISEASE; QUESTIONNAIRE; LIFE; IMPACT; Orthopedics; RISK; Science & Technology; FATIGUE; HELPLESSNESS; CHALLENGES
• Research Categories: Health Sciences, Rehabilitation and Therapy; Health Sciences, Health Care Management; Health Sciences, General

Abstract

BACKGROUND: There is abundant evidence that low socioeconomic status (SES) is associated with worse health outcomes among people with Rheumatoid Arthritis (RA); however, the influence of socioeconomic disadvantage in early life has yet to be studied within that population. METHODS: Data originated from the cross-sectional arm of the Consortium Evaluation of African-Americans with Rheumatoid Arthritis (CLEAR II), which recruited African-Americans with RA from six sites in the Southeastern United States. We used linear regression models to evaluate associations of parental homeownership status and educational level at participant time of birth with participant-reported fatigue (Visual Analog scale, cm), pain (Visual Analog scale, cm), disability (Health Assessment Questionnaire) and helplessness (Rheumatology Attitudes Index), independently of participant homeownership status and educational level. Models included random effects to account for intra-site correlations, and were adjusted for variables identified using backward selection, from: age, disease-duration, sex, medication use, body-mass index, smoking history. RESULTS: Our sample included 516 CLEAR II participants with full data on demographics and covariates. 89 % of participants were women, the mean age was 54.7 years and mean disease duration was 10.8 years. In age adjusted models, parental non-homeownership was associated with greater fatigue (β = 0.75, 95 % CI = 0.36-1.14), disability (β = 0.12, 95 % CI = 0.04-0.19) and helplessness (β = 0.12, 95 % CI = 0.03-0.21), independently of participant homeownership and education; parental education had a further small influence on self-reported fatigue (β = 0.20, 95 % CI = 0.15-0.24). CONCLUSIONS: Parental homeownership, and to a small extent parental education, had modest but meaningful relationships with self-reported health among CLEAR II participants.