Arthritis in the family practice setting: associations with education and community poverty.
OBJECTIVE
To examine associations of self-reported arthritis in 25 urban and rural family practice clinics with education (individual socioeconomic status) and community poverty (community socioeconomic status).


METHODS
A total of 7,770 patients at 25 family practice sites across North Carolina self-reported whether they had arthritis. Education was measured as less than a high school (HS) degree, a HS degree, and more than a HS degree. The US Census 2000 block group poverty rate (percentage of households in poverty in that block group) was grouped into low, middle, and high tertiles. We assumed heterogeneity by race (non-Hispanic white and African American) for the effects of these sociodemographic variables, and therefore stratified by race. Multilevel analyses were performed using a 2-level mixed logistic model to examine the independent associations and joint effects of education and poverty with self-reported arthritis as the outcome, adjusting for age, sex, and body mass index.


RESULTS
White participants with less than a HS degree living in block groups with high poverty had 1.55 times the odds (95% confidence interval [95% CI] 1.10-2.17) of reporting arthritis compared with white participants with more than a HS degree and low poverty rates. African American participants with less than a HS degree and high poverty rates had 2.06 times the odds (95% CI 1.16-3.66) of reporting arthritis compared with African American participants with more than a HS degree and low poverty rates.


CONCLUSIONS
In the family practice setting, both disadvantaged white and African American participants showed increased odds of self-reported arthritis, with stronger associations in African Americans.
Callahan
Leigh F
LF
The University of North Carolina at Chapel Hill, Thurston Arthritis Rsearch Center, Chapel Hill, NC 27599-7280, USA. leigh_callahan@med.unc.edu
Shreffler
Jack
J
Mielenz
Thelma
T
Schoster
Britta
B
Kaufman
Jay S
JS
Xiao
Changfu
C
Randolph
Randy
R
Sloane
Philip D
PD
D000328:Adult; D001741:Black or African American; D000368:Aged; D001168:Arthritis / Q000453:epidemiology* / Q000208:ethnology; D003430:Cross-Sectional Studies; D004522:Educational Status; D005194:Family Practice; D054624:Health Status Disparities; D006306:Health Surveys; D006801:Humans; D008875:Middle Aged; D009657:North Carolina / Q000453:epidemiology; D016017:Odds Ratio; D011203:Poverty / Q000706:statistics & numerical data*; D015995:Prevalence; D044465:White People