Harrison, Mark J., Farragher, Tracey M., Clarke, Alexandra M., Manning, Stephanie C., Bunn, Diane K. and Symmons, Deborah P. M. (2009) Association of functional outcome with both personal- and area-level socioeconomic inequalities in patients with inflammatory polyarthritis. Arthritis & Rheumatism, 61 (10). pp. 1297-1304. ISSN 1529-0131
Full text not available from this repository.Abstract
Objective To describe the relationship between baseline area- and person-level social inequalities and functional disability at 3 years in patients with early inflammatory polyarthritis (IP). Methods A total of 1,393 patients with new-onset IP were recruited and allocated an Index of Multiple Deprivation (IMD) 2004 score based on their area of residence, and a social class based on baseline self-reported occupation. Differences in the Health Assessment Questionnaire (HAQ) score at baseline and 3 years by IMD or social class were tested. The mean 3-year change in HAQ score was compared by IMD and social class, and interactions between these measures examined. Results Patients from more deprived areas had poorer 3-year HAQ outcome than those from less deprived areas (P = 0.019, adjusted for baseline HAQ score, age, sex, and symptom duration). The mean difference in HAQ change was most notable between the most deprived (IMD4) and least deprived areas (IMD1) (0.22; 95% confidence interval [95% CI] 0.11, 0.34). There was also a significant difference in HAQ score change between patients of the highest (SCI and II) and lowest social class (SCIV and V) (0.11; 95% CI 0.02, 0.20). For the mean (95% CI) 3-year change in HAQ score, a significant interaction exists between IMD score and social class and their association with HAQ scores (P = 0.001) to modify outcome: IMD1/SC I and II -0.23 (95% CI -0.40, -0.06) versus IMD 4/SC IV and V 0.15 (95% CI -0.05, 0.34). Conclusion Person- and area-level inequalities combine to modify outcome for rheumatoid arthritis. A person's social circumstance and residential environment have independent effects on outcome and are not just alternative measures of the same exposure.
Item Type: | Article |
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Faculty \ School: | Faculty of Medicine and Health Sciences > Norwich Medical School |
UEA Research Groups: | Faculty of Medicine and Health Sciences > Research Groups > Health Promotion Faculty of Social Sciences > Research Centres > Water Security Research Centre Faculty of Medicine and Health Sciences > Research Centres > Lifespan Health |
Depositing User: | Rhiannon Harvey |
Date Deposited: | 07 Mar 2012 12:17 |
Last Modified: | 19 Oct 2023 00:37 |
URI: | https://ueaeprints.uea.ac.uk/id/eprint/38015 |
DOI: | 10.1002/art.24830 |
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