Racial differences in osteoarthritis pain and function: potential explanatory factors

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.
• 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.