The association of race/ethnicity with the receipt of traditional and alternative arthritis-specific health care.
BACKGROUND
The role of race/ethnicity in the receipt of arthritis-specific health care has not been well defined.


OBJECTIVE
To examine the association of race/ethnicity with the utilization of arthritis health care among community-dwelling older adults.


METHODS
We used a computer-assisted telephone interview.


METHODS
A population-based random sample was drawn from 6 preselected Alabama counties. Eligible respondents had self-reported arthritis and were over 50 years of age; 1424 people responded to the survey.


METHODS
Logistic regression was used to examine the association of race/ethnicity with the use of conventional (including use of a rheumatologist, primary care physician, and prescription arthritis medicines) and complementary and alternative medicines (CAM), including the use of chiropractic care, glucosamine and/or chondroitin, and herbals.


RESULTS
Reflecting stratified sampling, respondents were white (n=852, 60%) or black (n=528, 37%), female (72%), and had a mean age of 65 years. After multivariable adjustment, race/ethnicity was not a significant determinant of receiving rheumatology care or prescription arthritis medicines. However, whites were more likely than blacks to have seen a primary care physician for arthritis care (adjusted odds ratio [OR], 1.49; 95% confidence interval [CI], 1.12-1.98) or to have used CAM (OR, 1.47; 95% CI, 1.13-1.91) and twice as likely to have used glucosamine and/or chondroitin (OR, 1.99; 95% CI, 1.30-3.05).


CONCLUSIONS
In this population of community-dwelling older adults, white race was significantly associated with CAM use and visits to primary care physicians for arthritis care. In contrast, the use of specialists and prescription arthritis medications was better explained by factors other than race/ethnicity, which included female gender, urban residence, higher educational level, and other arthritis-specific variables.
Mikuls
Ted R
TR
Department of Medicine, Section of Rheumatology and Immunology, University of Nebraska Medical Center and the Omaha VA Medical Center, Omaha, Nebraska, USA.
Mudano
Amy S
AS
Pulley
LeaVonne
L
Saag
Kenneth G
KG
D001741:Black or African American; D000367:Age Factors; D000368:Aged; D000701:Analgesics, Opioid / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D001168:Arthritis / Q000188:drug therapy / Q000628:therapy*; D000529:Complementary Therapies; D016001:Confidence Intervals; D004493:Education; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data*; D006801:Humans; D007182:Income; D007407:Interviews as Topic; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011320:Primary Health Care; D011897:Random Allocation; D012424:Rural Population; D012494:Sampling Studies; D012737:Sex Factors; D014505:Urban Population; D044465:White People
D000701:Analgesics, Opioid; D000894:Anti-Inflammatory Agents, Non-Steroidal