Associations of educational attainment, occupation and community poverty with knee osteoarthritis in the Johnston County (North Carolina) osteoarthritis project

Leigh F Callahan,Randy Randolph,Rebecca J Cleveland,Britta Schoster,Jack Shreffler,Joanne M Jordan,Todd A Schwartz,Jordan B Renner

doi:10.1186/ar3492

Leigh F Callahan, Randy Randolph + Show 6 more

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https://doi.org/10.1186/ar3492

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Abstract

IntroductionThe purpose of this study was to examine data from the Johnston County Osteoarthritis (OA) Project for independent associations of educational attainment, occupation and community poverty with tibiofemoral knee OA.MethodsA cross-sectional analysis was conducted on 3,591 individuals (66% Caucasian and 34% African American). Educational attainment (< 12 years or ≥12 years), occupation (non-managerial or not), and Census block group household poverty rate (< 12%, 12 to 25%, > 25%) were examined separately and together in logistic models adjusting for covariates of age, gender, race, body mass index (BMI), smoking, knee injury and occupational activity score. Outcomes were presence of radiographic knee OA (rOA), symptomatic knee OA (sxOA), bilateral rOA and bilateral sxOA.ResultsWhen all three socioeconomic status (SES) variables were analyzed simultaneously, low educational attainment was significantly associated with rOA (odds ratio (OR) = 1.44, 95% confidence interval (CI) 1.20, 1.73), bilateral rOA (OR = 1.43, 95% CI 1.13, 1.81), and sxOA (OR = 1.66, 95% CI 1.34, 2.06), after adjusting for covariates. Independently, living in a community of high household poverty rate was associated with rOA (OR = 1.83, 95% CI 1.43, 2.36), bilateral rOA (OR = 1.56, 95% CI 1.12, 2.16), and sxOA (OR = 1.36, 95% CI 1.00, 1.83). Occupation had no significant independent association beyond educational attainment and community poverty.ConclusionsBoth educational attainment and community SES were independently associated with knee OA after adjusting for primary risk factors for knee OA.

Highlights

The purpose of this study was to examine data from the Johnston County Osteoarthritis (OA) Project for independent associations of educational attainment, occupation and community poverty with tibiofemoral knee OA
We found that after adjustment for known risk factors, educational attainment was associated with increased presence of symptomatic knee OA in both men and women and with radiographic knee OA in women [4]
In terms of our main variables of interest, socioeconomic status (SES) variables, 33.7% had low educational attainment, 56.2% had non-managerial occupations at their longest job, and 22.4% lived in block groups with household poverty rates over 25%

Summary

Introduction

The purpose of this study was to examine data from the Johnston County Osteoarthritis (OA) Project for independent associations of educational attainment, occupation and community poverty with tibiofemoral knee OA. Associations between lower levels of educational attainment and both OA presence and poorer health status outcomes have been noted in a number of studies [4,6,7,8,9,10,11,12]. Two of these studies, examined radiographic OA [4,6]. We found that after adjustment for known risk factors, educational attainment was associated with increased presence of symptomatic knee OA in both men and women and with radiographic knee OA in women [4]

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