Socioeconomic status is a known strong correlate of arthritis prevalence and severity, disability, and frailty.. But there are two gaps in our knowledge of the correlation. First, few studies have investigated the strength of the association among minority (Black, Hispanic) seniors and drawn comparisons to Whites. Second, only one study (Leigh, Fries, Arthritis and Rheumatism, in press) with which I am familiar has investigated the three components of socioeconomic status--education, occupation, and income--as separate covariates of frailty. If causation runs from socioeconomic status to frailty then this is unfortunate, since from a prevention point of view, education, occupation, and income are separate entities. If income is the most important of the three, then implications might be drawn concerning, for example, the relation between Social Security benefits and frailty. If occupation, or main occupation prior to retirement, is the most important, then implications might be drawn for Occupational Safety and Health regulations. If, finally, education is the most important, and if, again, education is presumed to influence frailty rather than vice versa, investments in education may be potent preventive medicine. While occupation and income will be considered, the proposed research will devote the greatest attention to education since education has received the most prior research attention. Four data sets will be analyzed: the National Health and Nutrition Examination Survey 1 1971-75 (NHANES 1); II 1976-86 (NHANES 11); Epidemiological Follow-up to NHANES I (NHEFS), and the Hispanic Health and Nutrition Examination Survey (HHANES). Dependent variables will include self-reported arthritis, self-reported doctors' diagnoses of arthritis, selfreported health limitations from working or daily activities, a disability scale based on 25 questions; self-reports on pain in joints, back, neck, and knees. Independent variables will include gender, age, square of age, marital status, years of schooling completed, main lifetime occupation, current occupation, and income. Methods will include Ordinary Least Squares, Weighted Least Squares, Logistic, Weighted Logistic, and Instrumental Variables to account for selection bias. Blacks and Whites will be analyzed with data from the NHANES 1, 11, and NHEFS. Hispanics will be analyzed with data from the HHANES. Attention will be restricted to persons 65 years of age and older.
| Leigh, J P; Fries, J F (1994) Correlations between education and arthritis in the 1971-1975 NHANES I. Soc Sci Med 38:575-83 |
