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Racial differences in osteoarthritis pain and function: potential explanatory factors.

K D Allen1, E Z Oddone, C J Coffman

  • 1Health Services Research and Development Service, Durham VA Medical Center, Durham, NC 27705, USA. kelli.allen@duke.edu

Osteoarthritis and Cartilage
|October 15, 2009
PubMed
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Racial differences in osteoarthritis pain and function are explained by psychological factors like self-efficacy and coping, not race itself. Interventions targeting these factors can reduce disparities.

Area of Science:

  • Rheumatology
  • Health Disparities Research
  • Psychosocial Aspects of Chronic Disease

Background:

  • Hip and knee osteoarthritis (OA) disproportionately affects minority populations.
  • Understanding racial disparities in OA pain and function is crucial for equitable care.

Purpose of the Study:

  • To investigate the psychological and behavioral factors contributing to racial differences in pain and function among OA patients.
  • To identify key variables that mediate the relationship between race and OA outcomes.

Main Methods:

  • A cohort of 491 African American and Caucasian patients with hip/knee OA participated in a telephone-based self-management trial.
  • Arthritis Impact Measurement Scales-2 (AIMS2) pain and function subscales were assessed, along with psychological variables.

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  • Multivariable regression models identified factors reducing the race-outcome association by at least 10%.

    • Main Results:

    • Initially, African Americans reported worse OA pain and function scores than Caucasians.
    • After accounting for covariates, race was no longer significantly associated with pain or function.
    • Lower arthritis self-efficacy, poorer affect scores, greater emotion-focused coping, and self-reported fair/poor health were linked to worse pain and function.

    Conclusions:

    • Psychological factors, including arthritis self-efficacy, affect, and emotion-focused coping, explain racial disparities in OA pain and function.
    • Self-management and psychological interventions addressing these factors are vital for reducing health inequities.
    • Targeted dissemination of these interventions among African Americans may help close the gap in OA outcomes.