Health status disparities in ethnic minority patients with rheumatoid arthritis: a cross-sectional study.
OBJECTIVE
To examine disparities in disability, pain, and global health between Caucasian (n = 4294) and African American (n = 283) and Caucasian and Hispanic (n = 153) patients with rheumatoid arthritis (RA).


METHODS
Patients were from 9 Arthritis, Rheumatism, and Aging Medical Information System databanks. Cross-sectional data were derived from the Health Assessment Questionnaire. Staged multivariate analysis of covariance was used to explore roles of possible contributing factors (age, sex, education, disease duration, number of comorbid conditions, and treatment) to ethnic minority disparities.


RESULTS
The cohort was 91% Caucasian and 76% female. Caucasians were significantly older than African Americans and Hispanics (62 vs 56 and 55 yrs; both p < 0.0001 from Caucasians), better educated (13 vs 12 and 12 yrs; both p < 0.0001 from Caucasians), and had their RA longer (16 vs 13 and 15 yrs; p < 0.01 for African Americans). Unadjusted disability scores were statistically indistinguishable, but pain was worse in both ethnic groups (p < 0.01), and global health worse in Hispanics (p < 0.05). After adjustment for covariates, African Americans had the poorest outcomes in all 3 measures, although only pain in African Americans (p < 0.05) was statistically different from Caucasians.


CONCLUSIONS
Results of this exploratory study suggest that in a relatively similar cohort of patients with RA, minority health disparities exist. Both ethnic groups had poorer outcomes for all 3 measures than Caucasians after adjustment. Additional study and longitudinal research with larger numbers of patients are needed to improve our understanding of these differences and to assess potential causal roles.
Bruce
Bonnie
B
Division of Immunology and Rheumatology, Stanford University School of Medicine, Palo Alto, California 94304, USA. bbruce@stanford.edu
Fries
James F
JF
Murtagh
Kirsten Naumann
KN
D001741:Black or African American; D001172:Arthritis, Rheumatoid / Q000208:ethnology* / Q000503:physiopathology*; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D005006:Ethnicity; D005260:Female; D006304:Health Status; D006630:Hispanic or Latino; D006801:Humans; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D044465:White People