FRI0661 ASSOCIATIONS OF CURRENT AND CHILDHOOD SOCIOECONOMIC STATUS WITH PATIENT-REPORTED HEALTH OUTCOMES AMONG PATIENTS WITH KNEE OR HIP OSTEOARTHRITIS IN A FAMILY PRACTICE SETTING IN MEXICO CITY
Authors: Julio Pisanty Alatorre, Maria Victoria Goycochea Robles
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background</h3> The life-course approach is a useful framework to understanding socioeconomic inequalities in the prevalence and outcomes of chronic disease,<sup>1</sup> and in particular in osteoarthritis (OA).<sup>2</sup> Previous studies have measured Socioeconomic Status (SES) in 2 points of the life-course (childhood and current) and found consistent relationships between them and both prevalence and presence of worse outcomes,<sup>2-4</sup> but this relationship has been little explored in the Latin-American region where exposure to low SES throughout the life-course is higher than in developed countries. <h3>Objectives</h3> Our aim was to investigate the association of current and childhood SES with functional status, quality of life and disability among patients with knee or hip OA. <h3>Methods</h3> We recruited patients with self-reported doctor-diagnosed knee or hip OA in a social security family practice setting, excluding patients with other rheumatic diseases liable to causing secondary OA. We measured current SES by education, occupation type and estimated income using a validated tool;<sup>5</sup> and childhood SES by parental education and occupation type. We measured functional status, quality of life and disability using Spanish-language versions of the WOMAC,<sup>6</sup> AMICAL<sup>7</sup> and HAQ-DI<sup> 8</sup> tools. We used Spearman correlations, ANOVA and multiple linear regression to test for significance, with a p&lt;0.05 cutpoint. <h3>Results</h3> We recruited 146 patients with a mean age of 69.4 yr. 80% were female; 92%, 30% and 45% suffered from knee, hip and other joint OA, respectively, while 60% had incomes in the upper 2 quintiles of the general Mexican population. We found current income to be the best predictor of WOMAC (Spearman's ρ=-0.354, p&lt;0.01), AMICAL (ρ=-0.362, p&lt;0.01) and HAQ-DI scores (ρ=-0.335, p&lt;0.01), and education to be correlated with all three scores as well. Occupation type was significantly associated with AMICAL and HAQ-DI but not WOMAC scores. Paternal and maternal education, and maternal occupation type, were significantly associated only with AMICAL scores. In multiple linear regression models were income and maternal education were entered separately, after adjusting for age, sex, BMI and presence of Diabetes and Hypertension, both variables were significantly associated with WOMAC, AMICAL and HAQ-DI scores (adj r<sup>2</sup>0.076-0.157, p&lt;0.05). When both variables were entered into multiple linear regression models (adj r<sup>2</sup> 0.112 and 0.110), significant associations remained between current income level and WOMAC and AMICAL scores (p&lt;0.01), as well as between maternal education and AMICAL scores (p&lt;0.05). Associations between both variables and HAQ-DI scores did not reach statistical significance (p=0.07). <h3>Conclusion</h3> Among patients with knee or hip OA in our setting, current SES is a significant predictor of functional status, quality of life and disability, while childhood SES – best modeled by maternal education – is a significant predictor of quality of life. More research is needed to elucidate the relationship of SES throughout the life course with outcomes among patients with OA. <h3>References</h3> [1] Ben-Shlomo Y, Kuh D. Int J of Epidemiol. 2002; 31(2): 285–293. [2] Luong M-LN, et al. Aging Health. 2012;8(4):413-37. [3] Baldassari AR, et al. BMC Musculoskelet Disord. 2013;14(1). [4] Baldassari AR, et al. Arthritis Care Res. 2013;65(8):1334-42. [5] Gutiérrez JP, et al. Salud Pública México. 2015;57(4):298. [6] López Alonso SR, et al. Aten Primaria. 2009;41(11):613-20. [7] Espinoza-Cuervo G, et al. Reumatología Clínica. 2014;10(14):201-274. [8] González VM, et al. Arthritis Rheum. 1995;38(10):1429-46. <h3>Disclosure of Interests</h3> None declared