CHICAGO, Illinois—Three new studies focus on the relationship between race, ethnicity, and arthritis. Two studies showed that African-American and Hispanic rheumatoid arthritis (RA) patients are more adversely affected and feel worse than their Caucasian counterparts; a third study found that African-American patients actually had fewer subcutaneous rheumatoid nodules and tender joint counts than did Caucasians patients, but this did not seem make any differences in disease expression.

Comorbid conditions, functional limitations, activity, weight, insurance play key roles

In one study, researchers found that African-American and Hispanic arthritis patients are more than twice as likely as Caucasian patients to report some level of disability in regard to performing activities of daily living. These findings appear in the August issue of Arthritis & Rheumatism.¹ These differences were related to the presence of comorbid conditions, functional limitations, unhealthful behaviors, and lack of health insurance, the study showed.

"At the clinical level, treatment of comorbid conditions, functional limitations, and promotion of physical activity and weight maintenance should be a priority to prevent the development of disability, especially in minority populations," report researchers led by Jing Song, MS, of Northwestern University Feinberg School of Medicine, in Chicago.

The researchers reviewed 1998-2004 data from the Health and Retirement Study, which included 7257 RA patients who were initially free of disability. The respondents included nonHispanics, African-Americans, Hispanics/English-speaking, and Hispanics/Spanish-speaking who were asked about difficulty with dressing, walking across the room, getting out of bed, bathing, eating, and use of the toilet.

Over all, one in six respondents reported disability in at least one daily activity during the 6-year follow-up period. African-Americans and English- and Spanish-speaking Hispanics had twice the rate of disability as their nonHispanic counterparts.
 
Second study finds less pain, disability among Caucasian patients
with RA

A second study appearing in the July issue of the Journal of Rheumatology² showed some minority health disparities among African-American and Hispanic RA patients compared with their Caucasian counterparts.

In this study, Caucasian patients scored better on measures of pain, disability, and global health than did African-American and Hispanic patients. Specifically, pain was worse in both African-American and Hispanic groups (P <0.01) and global health worse in Hispanics (P <0.05). African Americans had the poorest outcomes in all three measures after the researchers adjusted for covariates, although only pain in African Americans (P <0.05) was statistically different from Caucasians.

"Additional study and longitudinal research with larger numbers of patients are needed to improve our understanding of these differences and to assess potential causal roles," conclude the researchers led by Bonnie Bruce, DrPH, MPH, RD, of Stanford University, in Palo Alto, California.

But African-American RA patients have fewer rheumatoid nodules, fewer tender joints

A third study in the July issue of the Journal of Rheumatology³ found that although African-American RA patients may have lower rates of subcutaneous rheumatoid nodules and lower tender joint counts than Caucasians, there does not appear to be any important racial/ethnic differences in disease expression between the two ethnic groups, report researchers led by Ted. R. Mikuls, MD, rheumatologist at the University of Nebraska Medical Center, in Omaha.

"Whether this finding translates into a clinically meaningful difference in disease outcomes with an increased duration of follow-up remains unknown," the researchers write. Over all, "there was limited evidence to support the existence of important racial/ethnic differences in other RA-related disease criteria or patient reported outcomes."

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