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

Summary Objective To determine the association between socio-economic status (SES) and risk of hand, hip or knee osteoarthritis (OA) at a population level. Design Retrospective ecological study using the System for the Development of Research in Primary Care (SIDIAP) database (primary care anonymize...

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Published in:Osteoarthritis and cartilage 2015-08, Vol.23 (8), p.1323-1329
Main Authors: 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, Prieto-Alhambra, D
Format: Article
Language:English
Subjects:
Adult
Age Factors
Alcohol Drinking - epidemiology
Databases, Factual
Female
Hand - physiopathology
Humans
Incidence
Male
Middle Aged
Obesity - epidemiology
Osteoarthritis
Osteoarthritis, Hip - epidemiology
Osteoarthritis, Hip - physiopathology
Osteoarthritis, Knee - epidemiology
Osteoarthritis, Knee - physiopathology
Prevalence
Primary health care
Retrospective Studies
Rheumatology
Risk Factors
Sex Factors
Smoking - epidemiology
Social Class
Socioeconomic status
Spain - epidemiology
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Summary:Summary Objective To determine the association between socio-economic status (SES) and risk of hand, hip or knee osteoarthritis (OA) at a population level. Design Retrospective ecological study using the System for the Development of Research in Primary Care (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 OA (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) vs 46.83 (18.49), years (Mean SD), had fewer women (49.1% vs 54.8%), a higher percentage of obese (16.2% vs 8.4%), smokers (16.9% vs 11.9%) and high-risk alcohol consumption subjects (1.5% vs 1.3%). Compared to the least deprived, the most deprived areas had an excess risk of OA: age-sex-adjusted Incidence Rate Ratio (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 OA (hand, hip, knee). Their increased prevalence of obesity accounts for a 50% of the excess risk of knee OA observed. Public health interventions to reduce the prevalence of obesity in this population could reduce health inequalities.
ISSN:1063-4584
1522-9653
DOI:10.1016/j.joca.2015.03.020