RA May Be More Active in Poor People

Rheumatoid arthritis disease activity and disability higher in people of lower socioeconomic status

(RxWiki News) Rheumatoid arthritis is a chronic disease, meaning it can last for years to a lifetime. Throughout the course of the disease, symptoms can get better or worse. Many factors can affect disease activity, including wealth.

A lower socioeconomic status (the wealth and social standing of an individual) was associated with higher disease activity and disability among Latin Americans with rheumatoid arthritis.

That is, poorer people with rheumatoid arthritis may have more disease activity and disability than those with more money and education.

"Seek care to control your arthritis."

In their recent study, Professor Loreto Massardo, of the Pontificia Universidad Católica de Chile in Santiago, Chile, and colleagues wanted to see how socioeconomic factors affected disease activity in Latin Americans with early rheumatoid arthritis.

They found that women, Mestizos (mixed heritage), African Latin Americans and Amerindians developed rheumatoid arthritis earlier than men or whites.

A low to low-middle socioeconomic status was associated with a higher Health Assessment Questionnaire disability index (HAQ DI) - a score that marks a patient's level of disability.

People of a lower socioeconomic status also had higher disease activity scores, as measured by DAS28 - a measure of disease activity that looks at 28 joints.

According to the authors, "[These] findings suggest that low to low-middle socioeconomic status is important in determining disease activity."

The researchers also found that women, older patients and patients with partial medical coverage tended to have worse HAQ DI scores.

HAQ DI and DAS28 scores were different between countries. However, when country was taken out of the analysis, lower socioeconomic status, being a woman and no medical coverage were associated with worse HAQ DI and DAS28 scores.

In other words, disease activity and disability differed between countries. But when the researchers did not account for country, disease activity and disability were associated with lower socioeconomic status, female sex and no medical coverage.

Patients who were separated, divorced or widowed tended to have a higher disability score, while those who were older tended to have a higher disease activity score.

Out of 1,093 patients, 43 percent were Mestizo, 31 percent were Caucasian (white), 19 percent were African Latin American, 4 percent were Amerindian, and 3 percent were of other ethnicity.

A total of 58 percent of the patients came from a low to low-middle socioeconomic background, 42 percent had less than 8 years of education and 21 percent had no medical coverage.

Co-author Dr. Enrique R. Soriano has received fees from Pfizer and Abbott.

The study was funded by Abbott Laboratories and the Federico Wilhelm Agricola Foundation Research.

The research was published July 27 in Arthritis Care & Research.

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Review Date: 
August 13, 2012