title: Contribution of ethnic group and socioeconomic status to degree of disability in rheumatoid arthritis in Chilean patients.
abstract: The aim of this study was to estimate the contributions of ethnic group and socioeconomic status as social determinants related to disability and disease activity in Chilean Mapuche and non-Mapuche patients with rheumatoid arthritis (RA). Descriptive cross-sectional study with a stratified hospital-based sample of 189 patients in treatment with disease-modifying anti-rheumatic drugs. We assessed disability as categorical variable with the Health Assessment Questionnaire, disease activity with the Disease Activity Score instrument, and socioeconomic status with a standard questionnaire used by the Chilean government. Measures of association, stratified analyses and a multiple logistic regression model were used to analyze the data using the Stata 12.1 software package. Low socioeconomic status (annual income below US$ 7,200) is associated with disability (OR 3.87 CI 1.68-9.20) and Mapuche ethnic identity also contributes to disability (OR 2.48, CI 1.09-5.89). Relevant but not statistically significant in multivariable models were variables such as age, gender and place of residence. RA patients with a low socioeconomic status have almost three times the odds of having a moderate to high disability, independent of their ethnic group, gender or place of residence. Therefore, healthcare efforts should be aimed at promoting early diagnosis and prompt treatment among populations with high levels of poverty, which in the region of the Araucanía means primarily indigenous rural areas.
authors.affiliation: Department of Public Health- CIGES, Universidad de La Frontera, Manuel Montt 112, Temuco, Chile, amalarc1@gmail.com.
authors.forename: Ana M
authors.initials: AM
authors.lastname: Alarcón
authors.forename: Sergio
authors.initials: S
authors.lastname: Muñoz
authors.forename: Jay S
authors.initials: JS
authors.lastname: Kaufman
authors.forename: Carlos
authors.initials: C
authors.lastname: Martínez
authors.forename: Pablo
authors.initials: P
authors.lastname: Riedemann
authors.forename: Sonia
authors.initials: S
authors.lastname: Kaliski
mesh_terms: D000328:Adult; D001172:Arthritis, Rheumatoid / Q000175:diagnosis*; D002677:Chile; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D006233:Persons with Disabilities; D005006:Ethnicity; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D012923:Social Class; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires