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| Content Provider | World Health Organization (WHO)-Global Index Medicus |
|---|---|
| Author | Harrison, Mark J. Farragher, Tracey M. Clarke, Alexandra M. Manning, Stephanie C. Bunn, Diane K. Symmons, Deborah P. M. |
| Description | Country affiliation: United kingdom Author Affiliation: Harrison MJ ( University of Manchester, Manchester, UK.) |
| 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. |
| File Format | HTM / HTML |
| ISSN | 00043591 |
| e-ISSN | 15290131 |
| DOI | 10.1002/art.24830 |
| Journal | Arthritis & Rheumatism |
| Issue Number | 10 |
| Volume Number | 61 |
| Language | English |
| Publisher | Wiley-Blackwell |
| Publisher Date | 2009-10-15 |
| Publisher Place | United States |
| Access Restriction | Open |
| Subject Keyword | Disability Evaluation Therapy Health Status Disparities Arthritis, Rheumatoid Social Class Physiopathology Recovery Of Function Questionnaires Severity Of Illness Index Discipline Rheumatic Diseases Cohort Studies |
| Content Type | Text |
| Resource Type | Article |
| Subject | Immunology and Allergy Immunology Pharmacology (medical) Rheumatology |
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