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Socioeconomic inequities in perceived health among patients with musculoskeletal disorders compared with other chronic disorders: results from a cross-sectional Dutch study.

Putrik P, Ramiro S, Chorus AM, Keszei AP, Boonen A - RMD Open (2015)

Bottom Line: In patients with MSKDs, (primary school vs university education (-5.3 (PCS) and -3.3 (MCS)) and having a state subsidy vs paid work (-5.3 (PCS) and -4.7 (MCS)) were consistently associated with worse physical and mental health.Education and social status in MSKD have the same strong and independent association with health as in other chronic diseases.These health gradients are unfair and partly avoidable, and require consorted attention and action in and outside healthcare.

View Article: PubMed Central - PubMed

Affiliation: Department of Rheumatology , Maastricht University Medical Center , CAPHRI School for Public Health and Primary care, Maastricht , The Netherlands ; Department of Health Promotion, Maastricht University , CAPHRI School for Public Health and Primary care , Maastricht , The Netherlands.

ABSTRACT

Objectives: To explore the impact of socioeconomic factors on physical and mental health of patients with musculoskeletal disorders (MSKDs) and compare it across patients with other disorders.

Methods: A representative sample of the Dutch population (n=8904) completed a survey on sociodemographics, physician-diagnosed (co-) morbidities, and physical (physical component summary, PCS) and mental (mental component summary, MCS) subscales of SF-12 (outcome variables). Regression models were computed first in the total group of patients with MSKDs, with education, age, gender, origin and place of residence as independent variables, and, second, in individuals expected to have paid work, adding a variable on social status. Models were repeated for five other subgroups of chronic disorders (cardiovascular (CVD), diabetes, cancer, mental and respiratory) and for healthy individuals.

Results: MSKDs confirmed by a physician were reported by 1766 (20%) participants (mean age 59 years, 38% male), 547 (6%) respondents reported to have diabetes, 1855 (21%) CVD, 270 (3%) cancer, 526 (6%) mental disorders, 679 (8%) respiratory disorders and 4525 (51%) did not report any disease. In patients with MSKDs, (primary school vs university education (-5.3 (PCS) and -3.3 (MCS)) and having a state subsidy vs paid work (-5.3 (PCS) and -4.7 (MCS)) were consistently associated with worse physical and mental health. Gender was only relevant for PCS (female vs male -2.1). Comparable differences in health by education and social status were observed in the other diseases, except for cancer.

Conclusions: Education and social status in MSKD have the same strong and independent association with health as in other chronic diseases. These health gradients are unfair and partly avoidable, and require consorted attention and action in and outside healthcare.

No MeSH data available.


Related in: MedlinePlus

Relative impact of social status on the physical and mental components of SF-12 across the different chronic disorders in patients expected to have paid work. Paid work was always considered the reference category, that is, the impact of the other social status categories on physical and mental components of SF-12 is considered in comparison to paid work (SF-12, 12-item Short-Form Health Survey).
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RMDOPEN2014000045F2: Relative impact of social status on the physical and mental components of SF-12 across the different chronic disorders in patients expected to have paid work. Paid work was always considered the reference category, that is, the impact of the other social status categories on physical and mental components of SF-12 is considered in comparison to paid work (SF-12, 12-item Short-Form Health Survey).

Mentions: In the total group (model I), a health gradient by education in relation to mental health was present across MSKD and patients with CVD in comparable magnitude; mental health in persons with the lowest educational attainment (vs the highest) was on average 3.8 points lower in those with a CVD and 3.3 lower in those with an MSKD. In all other diseases, a trend to have worse mental health in lower educated individuals was present but did not reach statistical significance (figure 1B). Older age was associated with better mental health outcomes in all groups of diseases except cancer (where the effect of age was not statistically significant) but the effect never exceeded 0.13 points per year (table 3). In those expected to be in paid employment (model II), the gradient in mental health by social status in patients with MSKD was less strong compared to patients with CVD, diabetes and respiratory disorders, and in healthy individuals. In patients with MSKD, the average difference between a person with a paid job and a person who received state living allowance was 4.7 points, and this difference mounted to be 7.3, 10.0, 7.2 and 9.8 points in patients with CVD, diabetes and respiratory disorder, and in the healthy population, respectively (table 3 and figure 2B). Social status did not appear to be significantly related to mental health in patients with cancer and those with mental disorders.


Socioeconomic inequities in perceived health among patients with musculoskeletal disorders compared with other chronic disorders: results from a cross-sectional Dutch study.

Putrik P, Ramiro S, Chorus AM, Keszei AP, Boonen A - RMD Open (2015)

Relative impact of social status on the physical and mental components of SF-12 across the different chronic disorders in patients expected to have paid work. Paid work was always considered the reference category, that is, the impact of the other social status categories on physical and mental components of SF-12 is considered in comparison to paid work (SF-12, 12-item Short-Form Health Survey).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4612684&req=5

RMDOPEN2014000045F2: Relative impact of social status on the physical and mental components of SF-12 across the different chronic disorders in patients expected to have paid work. Paid work was always considered the reference category, that is, the impact of the other social status categories on physical and mental components of SF-12 is considered in comparison to paid work (SF-12, 12-item Short-Form Health Survey).
Mentions: In the total group (model I), a health gradient by education in relation to mental health was present across MSKD and patients with CVD in comparable magnitude; mental health in persons with the lowest educational attainment (vs the highest) was on average 3.8 points lower in those with a CVD and 3.3 lower in those with an MSKD. In all other diseases, a trend to have worse mental health in lower educated individuals was present but did not reach statistical significance (figure 1B). Older age was associated with better mental health outcomes in all groups of diseases except cancer (where the effect of age was not statistically significant) but the effect never exceeded 0.13 points per year (table 3). In those expected to be in paid employment (model II), the gradient in mental health by social status in patients with MSKD was less strong compared to patients with CVD, diabetes and respiratory disorders, and in healthy individuals. In patients with MSKD, the average difference between a person with a paid job and a person who received state living allowance was 4.7 points, and this difference mounted to be 7.3, 10.0, 7.2 and 9.8 points in patients with CVD, diabetes and respiratory disorder, and in the healthy population, respectively (table 3 and figure 2B). Social status did not appear to be significantly related to mental health in patients with cancer and those with mental disorders.

Bottom Line: In patients with MSKDs, (primary school vs university education (-5.3 (PCS) and -3.3 (MCS)) and having a state subsidy vs paid work (-5.3 (PCS) and -4.7 (MCS)) were consistently associated with worse physical and mental health.Education and social status in MSKD have the same strong and independent association with health as in other chronic diseases.These health gradients are unfair and partly avoidable, and require consorted attention and action in and outside healthcare.

View Article: PubMed Central - PubMed

Affiliation: Department of Rheumatology , Maastricht University Medical Center , CAPHRI School for Public Health and Primary care, Maastricht , The Netherlands ; Department of Health Promotion, Maastricht University , CAPHRI School for Public Health and Primary care , Maastricht , The Netherlands.

ABSTRACT

Objectives: To explore the impact of socioeconomic factors on physical and mental health of patients with musculoskeletal disorders (MSKDs) and compare it across patients with other disorders.

Methods: A representative sample of the Dutch population (n=8904) completed a survey on sociodemographics, physician-diagnosed (co-) morbidities, and physical (physical component summary, PCS) and mental (mental component summary, MCS) subscales of SF-12 (outcome variables). Regression models were computed first in the total group of patients with MSKDs, with education, age, gender, origin and place of residence as independent variables, and, second, in individuals expected to have paid work, adding a variable on social status. Models were repeated for five other subgroups of chronic disorders (cardiovascular (CVD), diabetes, cancer, mental and respiratory) and for healthy individuals.

Results: MSKDs confirmed by a physician were reported by 1766 (20%) participants (mean age 59 years, 38% male), 547 (6%) respondents reported to have diabetes, 1855 (21%) CVD, 270 (3%) cancer, 526 (6%) mental disorders, 679 (8%) respiratory disorders and 4525 (51%) did not report any disease. In patients with MSKDs, (primary school vs university education (-5.3 (PCS) and -3.3 (MCS)) and having a state subsidy vs paid work (-5.3 (PCS) and -4.7 (MCS)) were consistently associated with worse physical and mental health. Gender was only relevant for PCS (female vs male -2.1). Comparable differences in health by education and social status were observed in the other diseases, except for cancer.

Conclusions: Education and social status in MSKD have the same strong and independent association with health as in other chronic diseases. These health gradients are unfair and partly avoidable, and require consorted attention and action in and outside healthcare.

No MeSH data available.


Related in: MedlinePlus