Department of Psychology, University of Alabama at Birmingham, 1300 University Boulevard, Campbell Hall, Room 237E, Birmingham, AL, 35294, USA.
Pain Research and Intervention Center of Excellence (PRICE), University of Florida, Gainesville, FL, USA.
J Racial Ethn Health Disparities. 2019 Dec;6(6):1131-1143. doi: 10.1007/s40615-019-00615-7. Epub 2019 Jul 10.
Knee osteoarthritis (OA) disproportionately affects racial and ethnic minorities. Non-Hispanic Blacks (NHB) report a higher prevalence and severity of knee OA symptoms than their non-Hispanic White (NHW) counterparts. The role of poverty in explaining this disparity remains unclear.
The overall aim of this cross-sectional study was to determine whether ethnic/racial differences in knee pain and physical function varied according to poverty status.
NHB and NHW adults with or at risk of knee OA self-reported sociodemographic information, and completed the Western Ontario & McMaster Universities Osteoarthritis Index (WOMAC) and the Short Physical Performance Battery (SPPB). Annual income was adjusted for number of household occupants to determine poverty status (i.e., living above versus below poverty line).
Findings revealed 120 individuals living above the poverty line (49% NHB, 77% NHW) and 71 individuals living below the poverty line (51% NHB, 23% NHW). Adjusted multivariable models revealed significant ethnic/race by poverty status interactions for knee pain (p = 0.036) and physical function (p = 0.032) on the WOMAC, as well as physical function on the SPPB (p = 0.042). Post hoc contrasts generally revealed that NHW adults living above the poverty line experienced the least severe knee pain and best physical function, while NHB adults living below the poverty line experienced the most severe knee pain and poorest physical function.
Results of the present study add to the literature by emphasizing the importance of considering poverty and/or other indicators of socioeconomic status in studies examining ethnic/racial disparities in pain and physical function.
膝骨关节炎（OA）在不同种族和民族中的发病率不成比例。与非西班牙裔白人（NHW）相比，非西班牙裔黑人（NHB）报告膝 OA 症状的患病率和严重程度更高。贫困在解释这种差异中的作用尚不清楚。
本横断面研究的总体目的是确定在膝痛和身体功能方面，种族/民族差异是否根据贫困状况而有所不同。
患有或有膝 OA 风险的 NHB 和 NHW 成年人自我报告社会人口统计学信息，并完成了西部安大略省和麦克马斯特大学骨关节炎指数（WOMAC）和简短身体表现电池（SPPB）。年收入根据家庭人数进行调整，以确定贫困状况（即生活在贫困线以上或以下）。
研究结果显示，有 120 人生活在贫困线以上（49%为 NHB，77%为 NHW），71 人生活在贫困线以下（51%为 NHB，23%为 NHW）。调整后的多变量模型显示，在 WOMAC 上，膝痛（p=0.036）和身体功能（p=0.032）以及 SPPB 上的身体功能（p=0.042）方面，存在显著的种族/民族与贫困状况之间的相互作用。事后对比一般表明，生活在贫困线以上的 NHW 成年人经历的膝痛最不严重，身体功能最好，而生活在贫困线以下的 NHB 成年人经历的膝痛最严重，身体功能最差。
本研究的结果通过强调在研究疼痛和身体功能方面的种族/民族差异时考虑贫困和/或其他社会经济地位指标的重要性，为文献增添了新的内容。
