Life course socioeconomic factors on self-report health outcomes in African americans with rheumatoid arthritis

Introduction: African Americans (AAs) have been markedly underrepresented in research on rheumatoid arthritis (RA). The strong association between lower levels of individual socioeconomic status (SES) with poorer health outcomes in RA is well-established in whites, but less so in AAs. Socioeconomic conditions in early life may have implications for racial differences in disability between older AAs and whites. No studies have looked at the effect of life course social position on arthritis outcomes in RA. Methods: A cross-sectional analysis was carried out on 371 AA with RA using data collected through the Consortium for the Longitudinal Evaluation of African Americans with Early RA (CLEAR) registry and network. Childhood socioeconomic position (SEP) was defined based on mother and father's educational attainment, parental homeownership and occupation type. Similar measures were used to define current SEP (i.e. educational attainment, current homeownership, occupation type). Self-report measures included Fatigue and Pain Visual Analogue Scales, disability as measured by the Health Assessment Questionnaire, helplessness as measured by the Rheumatology Attitudes Index, as well as measures of limited activity, mentally and physically unhealthy days. Results: In covariate-adjusted means of disease severity measures for childhood-adult pairs according to individual SES measures, disability was associated with current educational attainment, home ownership and non-managerial position. Pain and helplessness were associated with current educational attainment and current homeownership. Parental homeownership was associated with fatigue and physically unhealthy days. Conclusion: In AAs with RA, current SEP appears to have a stronger association with current health outcomes as compared to childhood SEP.