The Social Gap Index and the prevalence of osteoarthritis in the community: a cross-sectional multilevel study in Mexico

Abstract

Multilevel studies have gained importance for highlighting social inequalities in health. These associations have been reported previously in diseases such as arthritis and chronic pain. We conducted a cross-sectional study using multilevel analysis to identify individual and contextual factors associated with the variation of prevalence of osteoarthritis (OA) in the Mexican population. The sample included 17,566 individuals of which 10,666 (60.7%) were women. The relationship between individual and contextual factors and OA were analyzed with a multilevel strategy. From the total population, 1,681 individuals had OA. Multilevel analysis showed that individual variables such as female gender (odds ratio (OR) = 1.3, 95% confidence interval (CI) 1.1, 1.4), age range 55-65 years (OR = 1.6, 95% CI 1.3, 2.0), musculoskeletal pain in the last 7 days (OR = 2.6, 95% CI 2.3, 3.0), and use of pain treatments (OR = 1.4, 95% CI 1.2, 1.7) were associated with OA. At the regional level, the Social Gap Index (SGIx) was associated with the diagnosis of OA (coefficient 0.5, 95% CI 0.2-1.1). The SGIx contextual variable was positively associated with the regional prevalence of OA and the variation in prevalence of OA in different regions. The larger the social gap, the greater the variation in OA prevalence. These factors were independently associated with the prevalence of OA: female gender, pain intensity, physical limitation, and the use of pain treatments were individual variables associated with OA. The association between OA prevalence and regional variations with SGIx reflects inequities in health provisions that should be considered in health programs.

Association of arthritis and vitamin D insufficiency with physical disability in Mexican older adults: findings from the Mexican Health and Aging Study

“…Data from the Health, Well-Being, and Aging in Latin America and the Caribbean Study (SABE) studies, showed that 23.8% to 55.6% of adults aged 60 years and above had self-reported arthritis and was significantly associated with limitation in activities of daily living (ADL) in all studied populations [3]. Data from The Community Oriented Program for the Control of Rheumatic Diseases (COPCORD) questionnaire showed a 9.5% prevalence of osteoarthritis in Mexico, the primary form of arthritis to affect middle and older adults, increasing to 21.4% in those 65 years and over [4]. Based on the 2010-2012 National Health Interview Survey in the U.S., by 2040 the prevalence of arthritis in adults is expected to increase to 25.9%, and the number of adults with activity limitation due to arthritis will increase to 11.4% [5].…”

The impact of arthritis on the physical function of a rural Maya-Yucateco community and factors associated with its prevalence: a cross sectional, community-based study

“…From a “social determinants of health” perspective, it seems that the conditions of social disadvantage faced by this rural community result in health inequities that condition the manifestation of arthritis. This social disparity has also been observed in a large Mexican multilevel epidemiological study where the prevalence of OA was clearly associated with higher social underdevelopment [ 42 ] and in a large Latin American study where the rheumatoid arthritis disabling effects were higher in people of low socioeconomic status [ 43 ].…”

We Got Your Back! Help Care Seeking and Caregiving in Mexican Indigenous Men With Ankylosing Spondylitis

“…Usually, back pain occurs at night, disrupting sleep. Aside from the fact that chronic diseases affect people during their productive years, limiting their earning potential, as treatments tend to be expensive, they further exacerbate the financial situation of those affected and their primary caretakers (Mould-Quevedo et al, 2008; Rodríguez-Amado et al, 2016).…”