Minorities at higher risk of arthritis disability

NEW YORK (Reuters Health) - Black and Hispanic adults with arthritis are more likely than whites to become disabled from the joint disease, new research findings suggest.

In a study that followed nearly 7,300 Americans with arthritis for six years, researchers found that African-American patients were twice as likely to develop a disability as their white counterparts. The same was true of Hispanic adults who spoke Spanish as their primary language, but not primarily English-speaking Hispanic patients.

A range of factors -- from poorer overall health to lack of insurance to less-healthy lifestyles -- together explained the racial disparity, the study found.

Jing Song and colleagues at Northwestern University in Chicago report the findings in the journal Arthritis & Rheumatism. The results are based on a national survey of 7,257 adults age 51 and up who had arthritis but were free of major disabilities at the outset. Participants were interviewed every two years between 1998 and 2004.

During that time, 28 percent of both African-Americans and Spanish-speaking Hispanic adults developed at least one disability in "activities of daily living," such as problems with getting out of bed, dressing or bathing.

That compared with 16 percent of white adults and 19 percent of English-speaking Hispanic study participants.

About half of the racial disparity could be explained by health factors, according to Song's team. Minorities were more likely to have co-existing health conditions like high blood pressure and diabetes, and they tended to have higher rates of obesity and lower rates of regular exercise.

Access to medical care was also a prime factor, the study found. Minorities had lower incomes and less wealth, and lack of health insurance was "particularly problematic," the researchers conclude.

Spanish-speaking Hispanic adults were worst off when it came to insurance, with 20 percent having no coverage and more than one-third relied on Medicaid, the government program for low-income Americans.

In contrast, less than 4 percent of white arthritis sufferers were uninsured, and 58 percent had private insurance.

According to Song's team, black and Hispanic arthritis sufferers need better treatment of their co-existing conditions, and more encouragement to make lifestyle changes, like taking up regular exercise.

Future studies, the researchers add, should test ways to reach minority arthritis patients more effectively.

SOURCE: Arthritis & Rheumatism, August 2007.