Increased rheumatoid arthritis activity linked to diverse social and demographic factors

A recent study featured in BMC Rheumatology sheds light on the correlation between increased rheumatoid arthritis (RA) activity and a range of social  and demographic factors. These factors include age, income, gender, education, employment status, BMI, disease duration and retirement status.  

Utilizing data from The University of Pittsburgh Rheumatoid Arthritis Comparative Effectiveness Research (RACER) registry, Dr. Zhu et al. and colleagues conducted a comprehensive study involving 729 patients meeting the 1987 ACR criteria for RA and enrolled between 2010-2015. The analysis revealed noteworthy trends among patients with high RA disease activity (45% of the cohort), with a majority holding less than a college degree (70%), being not employed/retired/disabled (71%) and possessing an annual income below $50,000 (55%). The study identified key factors associated with RA disease activity, including BMI (OR = 1.04, 95% CI: 1.01-1.08), longer disease duration (>2 and <10 years vs. ≤2 years of disease) (OR = 0.45, 95% CI: 0.25-0.78), and retirement status (OR = 1.74, 95% CI: 1.02-2.98). 

Multiple surveys, including the National Health and Nutrition Examination Survey-III, and research studies carried out in the United States and Europe  indicate increased prevalence of RA among individuals with lower educational attainment and lower socioeconomic status (SES). Researchers have also revealed a significant impact of SES and health disparities on both the disease activity and clinical trajectory of RA. 

Enhanced awareness of the potential influence of SES and health disparities on disease outcomes can empower physicians to make informed clinical decisions and develop more targeted disease management strategies. The present study outcomes underscore notable variations in RA disease activity across diverse social groups, such as those with varying employment status. While causation cannot be definitively established in this study, social disparities may contribute to delayed treatment-seeking and inadequate early care among rheumatoid arthritis patients, ultimately leading to more severe and debilitating disease outcomes. 


Zhu L, Moreland LW, Ascherman D. Cross-sectional association between social and demographic factors and disease activity in rheumatoid arthritis. BMC Rheumatol. 2024 Jan 19;8(1):2.