Socioeconomic status and the risk for being diagnosed with spondyloarthritis and chronic pain: a nested case-control study

Joud, Anna; Petersson, Ingemar F.; Jordan, Kelvin P.; Lofvendahl, Sofia; Grahn, Birgitta; Englund, Martin

Abstract

Socioeconomic status could potentially impact on which type of rheumatic diagnosis a patient receives. We determined whether different socioeconomic status is a risk factor for being diagnosed with spondyloarthritis (SpA) or chronic pain. In a nested case–control study, we identified two sets of adult cases diagnosed with (i) SpA (n = 1,194) and (ii) chronic pain (n = 3,730) during 2010–2012 in Skåne region, Sweden. We randomly sampled controls matched for age and sex. Level of education, marital status, and income were identified in national registers 4 years before inclusion. We also studied health-care utilization, prescribed pharmaceuticals, and work status. We used conditional logistic regressions and included socioeconomic variables and geographic area in the models. Low (odds ratio [OR] 1.69 95 % CI 1.50–1.91) or moderate education (OR 1.43 95 % CI 1.30–1.57), and low (OR 1.40 95 % CI 1.25–1.57) or moderate income (OR 1.24 95 % CI 1.10–1.38) were associated with a chronic pain diagnosis. For a SpA diagnosis, moderate income (OR 1.25 95 % CI 1.04–1.50) was the only significant factor identified. Both case groups had a larger proportion that did not work (P < 0.001), used more health care (P < 0.001), and were more frequently prescribed NSAIDs (P < 0.001) 4 years before diagnosis than controls. We confirmed that lower levels of education and income are associated with a chronic pain diagnosis. This association may reflect a true higher incidence of chronic pain and/or increased consultation propensity for such pain in people with socioeconomic status. We found no such association for SpA.

Citation

Joud, A., Petersson, I. F., Jordan, K. P., Lofvendahl, S., Grahn, B., & Englund, M. (2014). Socioeconomic status and the risk for being diagnosed with spondyloarthritis and chronic pain: a nested case-control study. Rheumatology International, 34(9), 1291-1298. https://doi.org/10.1007/s00296-014-3039-6

• Journal Article Type: Article
• Acceptance Date: May 3, 2014
• Online Publication Date: May 14, 2014
• Publication Date: 2014-09
• Deposit Date: Sep 19, 2023
• Journal: RHEUMATOLOGY INTERNATIONAL
• Print ISSN: 0172-8172
• Publisher: Springer Verlag
• Peer Reviewed: Peer Reviewed
• Volume: 34
• Issue: 9
• Pages: 1291-1298
• DOI: https://doi.org/10.1007/s00296-014-3039-6
• PMID: 24825253