title: Individual and community socioeconomic status: impact on mental health in individuals with arthritis.
abstract: To examine the impact of individual and community socioeconomic status (SES) measures on mental health outcomes in individuals with arthritis, participants with self-reported arthritis completed a telephone survey assessing health status, health attitudes and beliefs, and sociodemographic variables. Regression analyses adjusting for race, gender, BMI, comorbidities, and age were performed to determine the impact of individual and community level SES on mental health outcomes (i.e., Medical Outcomes Study SF-12v2 mental health component, the Centers for Disease Control and Prevention Health-Related Quality of Life Healthy Days Measure, Center for Epidemiological Studies Depression [CES-D] scale). When entered singly, lower education and income, nonmanagerial occupation, non-homeownership, and medium and high community poverty were all significantly associated with poorer mental health outcomes. Income, however, was more strongly associated with the outcomes in comparison to the other SES variables. In a model including all SES measures simultaneously, income was significantly associated with each outcome variable. Lower levels of individual and community SES showed most consistent statistical significance in association with CES-D scores. Results suggest that both individual and community level SES are associated with mental health status in people with arthritis. It is imperative to consider how interventions focused on multilevel SES factors may influence existing disparities.
authors.affiliation: Gerontology Institute, Georgia State University, P.O. Box 3984, Atlanta, GA 30302, USA.
authors.forename: Chivon A
authors.initials: CA
authors.lastname: Mingo
authors.affiliation: Epidemiology Group, School of Medicine and Dentistry, University of Aberdeen, Aberdeen AB25 2ZD, UK.
authors.forename: Kathryn R
authors.initials: KR
authors.lastname: Martin
authors.affiliation: Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
authors.forename: Jack
authors.identifier: 0000-0001-8210-0061
authors.initials: J
authors.lastname: Shreffler
authors.affiliation: Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
authors.forename: Britta
authors.initials: B
authors.lastname: Schoster
authors.affiliation: Departments of Medicine and Social Medicine, Thurston Arthritis Research Center, Department of Epidemiology, Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
authors.forename: Leigh F
authors.initials: LF
authors.lastname: Callahan