Mitchell J M, Burkhauser R V, Pincus T
Department of Health Policy Management, Johns Hopkins University, Baltimore, Maryland.
Arthritis Rheum. 1988 Mar;31(3):348-57. doi: 10.1002/art.1780310306.
A population-based survey designed to be representative of the entire US population of working age (18-64 years) includes data on pain and swelling of specific joints in each subject. We analyzed these data to estimate work status and disability status, as well as earnings losses, associated with Symmetric Polyarthritis. Subjects identified in the survey as having Symmetric Polyarthritis were similar in age, race, sex, and marital status to rheumatoid arthritis patients seen in clinical settings. Overall, 51% of women with Symmetric Polyarthritis and 47% of men with Symmetric Polyarthritis were severely disabled, compared with 4.5% of women and 3.7% of men with no arthritis. Earnings of women and men with Symmetric Polyarthritis were only 27% and 48%, respectively, of earnings of individuals without arthritis. The total earnings gap between the 2 groups was +17.6 billion (1986 dollars). Econometric regression analyses indicated that about one-third of this earnings gap was explained by the presence of Symmetric Polyarthritis. The remaining two-thirds was explained by differences in age, education, and comorbidity between individuals with Symmetric Polyarthritis and those without arthritis. The earnings of individuals with Symmetric Polyarthritis, therefore, would be expected to be considerably lower than those of the general population, even if these individuals were not affected by arthritis. Nonetheless, earnings losses of at least +6.5 billion annually are explained by Symmetric Polyarthritis.
一项旨在代表美国所有工作年龄(18至64岁)人口的基于人群的调查,收集了每位受试者特定关节疼痛和肿胀的数据。我们分析了这些数据,以估计与对称性多关节炎相关的工作状态、残疾状态以及收入损失。在调查中被确定患有对称性多关节炎的受试者,在年龄、种族、性别和婚姻状况方面与临床环境中所见的类风湿关节炎患者相似。总体而言,患有对称性多关节炎的女性中有51%、男性中有47%严重残疾,相比之下,无关节炎的女性和男性中这一比例分别为4.5%和3.7%。患有对称性多关节炎的女性和男性的收入分别仅为无关节炎个体收入的27%和48%。两组之间的总收入差距为176亿美元(1986年美元)。计量经济学回归分析表明,这一收入差距中约三分之一可归因于对称性多关节炎的存在。其余三分之二则可归因于患有对称性多关节炎的个体与无关节炎个体在年龄、教育程度和合并症方面的差异。因此,即使这些个体未受关节炎影响,患有对称性多关节炎的个体的收入预计也会大大低于普通人群。尽管如此,对称性多关节炎每年造成的收入损失至少为65亿美元。