This Project has concluded. The information below is for informational purposes only.
The Individual and Community Social Determinants of Arthritis Outcomes (SODE) study was a 5-year project sponsored by the National Institutes of Health.The long-term goal of our research is to better understand why people of lower socioeconomic status SES have poorer health status outcomes.
To test for a significant independent relationship between community level SES and prevalence of common chronic diseases, including arthritis, controlling for individual level SES , in a community-based cohort of individuals derived from a family practice network.
To test for a significant independent relationship between community level SES and health related quality of life (HRQOL) in persons from a community-based cohort, controlling for individual level SES. This relationship will be examined cross-sectionally and longitudinally.
To test hypothesized “individual-in-context” mediators of the relationship between community level SES and health outcomes in a cohort of family practice participants.
What did we learn?
As the most common chronic condition and a leading cause of disability, arthritis is the exemplar chronic condition and an ideal model in which to examine health outcomes.When chronic conditions were examined to determine which ones are associated with better or poorer QOL, as measured by the SF-36, musculoskeletal conditions are in the cluster of conditions that led to the most adverse sequelae.Arthritis health promotion efforts have been increased through the goals of Healthy People 2010and the National Arthritis Action Plan, and similar priority has been placed on reducing disparities in individuals with arthritis.
Developing effective prevention strategies requires establishing variables associated with outcomes and then evaluating putative mediating mechanisms.Targeted interventions and prevention strategies for arthritis could be improved by verification of associations between community socioeconomic context and individual health in people with arthritis, while adjusting for individual SES, followed by examination of potential mechanisms of SES effects on multiple levels.
This project established whether there are independent significant contextual effects of communities on the prevalence, severity and progression of arthritis.If these associations are found, potential mediators can be explored to establish the bridge between the observation of associations and implementing and designing prevention strategies.The results will channel the direction of future studies exploring these relationships and will guide health policies and the focus of prevention strategies, i.e., at the community and/or individual level.
Participants were enrolled through a family practice based research network at two time points; the original cohort in 2001 and an enrichment sample in the summer of 2004.The 22 practice sites from which the participants were recruited were selected to represent the geographic and racial/ethnic diversity of North Carolina.
What was Involved?
2491 participants completed our first telephone survey, and 1541 of these participants completed our follow-up telephone survey.The survey contained close-ended questions assessing health status, chronic health conditions, community and neighborhood characteristics, health attitudes and beliefs, and sociodemographic variables.To supplement the quantitative data, 7 focus groups and 11 in-depth individual interviews were conducted among a sample of the study participants who completed the telephone survey.The purpose of the qualitative data collection was to identify and examine the community-level factors that may influence the participants’ health.Focus group participants were also given disposable cameras to photograph their environment and community, in order to enhance the discussion.
01/01/03 – 12/31/07
Callahan LF, Mielenz T, Schoster B, Kaufman J, Randolph R, DeVellis R, Sloane P, Tudor G, Weinberger M.Individual and community social determinants of health status in people with arthritis.Arthritis Rheum 2004: 50;9, S38.
Callahan LF, Mielenz T, Remmes K, Schoster B, Kaufman J, Randolph R, DeVellis R, Sloane P, Weinberger M. Individual and Community Social Determinants of Health Status in People with Arthritis Followed in the Family Practice Setting (FPS).Arthritis Rheum 2005:52;9, S728.
Remmes K, Callahan LF, Mielenz T, Schoster B, DeVellis R.Comparison of Health Attitudes and Beliefs in Individuals with and without Arthritis. Arthritis Rheum 2005:52;9, S729.
Martin KR, Schoster BL, Meier A, Callahan LF. Community and personal barriers to physical activity for people with arthritis: a multi method approach.Arthritis Rheum 2006: 54;9, S768.