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Socio-economic status and the risk of developing hand, hip or knee osteoarthritis: a region-wide ecological study

Socio-economic status and the risk of developing hand, hip or knee osteoarthritis: a region-wide ecological study
Socio-economic status and the risk of developing hand, hip or knee osteoarthritis: a region-wide ecological study
OBJECTIVE: To determine the association between socio-economic status (SES) and risk of hand, hip or knee osteoarthritis at a population level.

DESIGN: Retrospective ecological study using the SIDIAP database (primary care anonymized records for > 5 million people in Catalonia (Spain)). Urban residents > 15 years old (2009-2012) were eligible.

OUTCOMES: Validated area-based SES deprivation index MEDEA (proportion of unemployed, temporary workers, manual workers, low educational attainment and low educational attainment among youngsters) was estimated for each area based on census data as well as incident diagnoses (ICD-10 codes) of hand, hip or knee osteoarthritis (2009-2012). Zero-inflated Poisson models were fitted to study the association between MEDEA quintiles and the outcomes.

RESULTS: Compared to the least deprived, the most deprived areas were younger (43.29 (17.59) versus 46.83 (18.49), years (Mean SD), had fewer women (49.1% versus 54.8 %), a higher percentage of obese (16.2 % versus 8.4 %), smokers (16.9 % versus 11.9%) and high-risk alcohol consumption subjects (1.5% versus 1.3 %). Compared to the least deprived, the most deprived areas had an excess risk of osteoarthritis: age-sex-adjusted IRR 1.26 (1.11-1.42) for hand, 1.23 (1.17-1.29) hip, and 1.51 (1.45-1.57) knee. Adjustment for obesity attenuated this association: 1.06 (0.93 -1.20), 1.04 (0.99-1.09), and 1.23 (1.19-1.28) respectively.

CONCLUSIONS: Deprived areas have higher rates osteoarthritis (hand, hip, knee). Their increased prevalence of obesity accounts for a 50% of the excess risk of knee osteoarthritis observed. Public health interventions to reduce the prevalence of obesity in this population could reduce health inequalities
osteoarthritis, socioeconomic status, primary health care, database
1063-4584
Reyes, C.
c1098594-2699-47c5-9727-fa52f11233ef
Garcia-Gil, M.
a6969a4d-8312-4637-b874-91ab974bbef3
Elorza, J.M.
55a2edfc-c0e9-4455-bb1c-322e31d91374
Mendez-Boo, L.
cb4d2768-8725-44d7-bae8-b1a29c0f4537
Hermosilla, E.
b4e67d76-a01f-4c8b-9991-62c333dcad89
Javaid, M.K.
51d3310b-032e-4c15-83ac-b878bce090f3
Cooper, C.
e05f5612-b493-4273-9b71-9e0ce32bdad6
Diez-Perez, A.
19f89c53-003a-469c-92ac-69b0b979f3ec
Arden, N.K.
23af958d-835c-4d79-be54-4bbe4c68077f
Bolibar, B.
eaac980e-6296-4582-a8d0-79129abc71fb
Ramos, R.
d347d8ac-9a5e-4841-abb0-c2b08b8a0bbb
Prieto-Alhambra, D.
19a5643f-5969-4c0e-b6a9-863fb9e9d1c7
Reyes, C.
c1098594-2699-47c5-9727-fa52f11233ef
Garcia-Gil, M.
a6969a4d-8312-4637-b874-91ab974bbef3
Elorza, J.M.
55a2edfc-c0e9-4455-bb1c-322e31d91374
Mendez-Boo, L.
cb4d2768-8725-44d7-bae8-b1a29c0f4537
Hermosilla, E.
b4e67d76-a01f-4c8b-9991-62c333dcad89
Javaid, M.K.
51d3310b-032e-4c15-83ac-b878bce090f3
Cooper, C.
e05f5612-b493-4273-9b71-9e0ce32bdad6
Diez-Perez, A.
19f89c53-003a-469c-92ac-69b0b979f3ec
Arden, N.K.
23af958d-835c-4d79-be54-4bbe4c68077f
Bolibar, B.
eaac980e-6296-4582-a8d0-79129abc71fb
Ramos, R.
d347d8ac-9a5e-4841-abb0-c2b08b8a0bbb
Prieto-Alhambra, D.
19a5643f-5969-4c0e-b6a9-863fb9e9d1c7

Reyes, C., Garcia-Gil, M., Elorza, J.M., Mendez-Boo, L., Hermosilla, E., Javaid, M.K., Cooper, C., Diez-Perez, A., Arden, N.K., Bolibar, B., Ramos, R. and Prieto-Alhambra, D. (2015) Socio-economic status and the risk of developing hand, hip or knee osteoarthritis: a region-wide ecological study. Osteoarthritis and Cartilage. (doi:10.1016/j.joca.2015.03.020). (PMID:25819582)

Record type: Article

Abstract

OBJECTIVE: To determine the association between socio-economic status (SES) and risk of hand, hip or knee osteoarthritis at a population level.

DESIGN: Retrospective ecological study using the SIDIAP database (primary care anonymized records for > 5 million people in Catalonia (Spain)). Urban residents > 15 years old (2009-2012) were eligible.

OUTCOMES: Validated area-based SES deprivation index MEDEA (proportion of unemployed, temporary workers, manual workers, low educational attainment and low educational attainment among youngsters) was estimated for each area based on census data as well as incident diagnoses (ICD-10 codes) of hand, hip or knee osteoarthritis (2009-2012). Zero-inflated Poisson models were fitted to study the association between MEDEA quintiles and the outcomes.

RESULTS: Compared to the least deprived, the most deprived areas were younger (43.29 (17.59) versus 46.83 (18.49), years (Mean SD), had fewer women (49.1% versus 54.8 %), a higher percentage of obese (16.2 % versus 8.4 %), smokers (16.9 % versus 11.9%) and high-risk alcohol consumption subjects (1.5% versus 1.3 %). Compared to the least deprived, the most deprived areas had an excess risk of osteoarthritis: age-sex-adjusted IRR 1.26 (1.11-1.42) for hand, 1.23 (1.17-1.29) hip, and 1.51 (1.45-1.57) knee. Adjustment for obesity attenuated this association: 1.06 (0.93 -1.20), 1.04 (0.99-1.09), and 1.23 (1.19-1.28) respectively.

CONCLUSIONS: Deprived areas have higher rates osteoarthritis (hand, hip, knee). Their increased prevalence of obesity accounts for a 50% of the excess risk of knee osteoarthritis observed. Public health interventions to reduce the prevalence of obesity in this population could reduce health inequalities

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More information

Accepted/In Press date: 15 February 2015
e-pub ahead of print date: 26 March 2015
Keywords: osteoarthritis, socioeconomic status, primary health care, database
Organisations: Human Development & Health

Identifiers

Local EPrints ID: 375791
URI: http://eprints.soton.ac.uk/id/eprint/375791
ISSN: 1063-4584
PURE UUID: bb3622fb-e052-48ac-95ce-077976511535
ORCID for C. Cooper: ORCID iD orcid.org/0000-0003-3510-0709

Catalogue record

Date deposited: 14 Apr 2015 12:19
Last modified: 18 Mar 2024 02:45

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Contributors

Author: C. Reyes
Author: M. Garcia-Gil
Author: J.M. Elorza
Author: L. Mendez-Boo
Author: E. Hermosilla
Author: M.K. Javaid
Author: C. Cooper ORCID iD
Author: A. Diez-Perez
Author: N.K. Arden
Author: B. Bolibar
Author: R. Ramos
Author: D. Prieto-Alhambra

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