Jennifer Barton|Laura Trupin|Dean Schillinger|Stuart A. Gansky|Chris Tonner|Mary Margaretten|Vladimir Chernitskiy|Jonathan Graf|John B. Imboden|Edward Yelin
Racial and ethnic disparities in disease activity and function among persons with rheumatoid arthritis from university?affiliated clinics
abstract objective health outcomes rheumatoid arthritis ra improved significantly past 2 decades however research suggests disparities exist raceethnicity socioeconomic status certain vulnerable populations remaining understudied objective assess disparities disease activity function raceethnicity explore impact language immigrant status clinics serving diverse populations methods examined crosssectional study 498 adults confirmed ra 2 rheumatology clinics university hospital clinic public county hospital clinic outcomes included disease activity score 28 joints das28 components health assessment questionnaire haq measure function estimated multivariable linear regression models including interaction terms raceethnicity clinic site results adjusting age sex education disease duration rheumatoid factor status medication use clinically meaningful statistically significant differences das28 haq scores seen raceethnicity language immigrant status lower disease activity better function observed among whites compared nonwhites university hospital pattern observed disease activity language english compared nonenglish immigrant status usborn compared immigrant university clinic significant differences outcomes found county clinic conclusion relationship social determinants ra disease activity varied significantly across clinic setting pronounced variation university county clinic disparities may result events preceded access subspecialty care poor adherence health care delivery system differences