ARTHRITIS AMONG LATINOS: A STUDY BASED ON NATIONAL DATA

这项研究的广泛目的是帮助揭示拉丁裔(拉美裔)和非拉丁裔在关节炎患病率和相关残疾水平方面存在差异的原因。这些信息最终可以指导政策和干预计划，以减少身体残疾并促进这一人群的健康。根据最近的国家数据，拉丁裔关节炎患病率较高，但在关节炎患者中，报告活动受限的拉丁裔比非拉丁裔白人更多(CDC，1996a)。这些差异的原因尚不清楚，但可能包括社会人口因素、获得卫生保健的机会和文化适应因素的差异。因此，拟议研究的目的是：(1)检查社会经济因素(如收入、教育)和医疗保险覆盖范围是否能解释拉美裔和非拉美裔白人关节炎患病率的差异；(2)记录患有关节炎的拉美裔和非拉美裔白人在日常生活活动和工作能力方面的残疾程度，并确定预测不同群体残疾的社会人口因素(如收入、教育、职业类型)和保健因素(如缺乏医疗保险、保健质量)；在控制了社会人口变量后，检查医疗保健因素是否解释了拉美裔和非拉美裔白人残疾水平的差异，(3)检验出生状态(美国与外国出生)和在美国的时间长短(文化适应)对关节炎患病率和残疾的影响。这些问题将使用1994年全国残疾健康访谈调查(NHIS)的数据进行审查，第一阶段：个人和条件数据。拟议的研究将控制不同种族之间的年龄和SES差异，并按拉丁裔群体进行详细分析。因此，这项研究将有助于一个系统的研究计划，试图了解在研究不足的人群中关节炎的患病率和残疾。

The broad aim of this study is to assist in uncovering factors underlying the observed differences between Latinos (Hispanics) and non-Latinos in the prevalence rate of arthritis and associated levels of disability. This information can ultimately guide policy and intervention programs to reduce physical disability and promote health in this population. According to recent national data, Latinos arthritis have a higher arthritis prevalence rate, but among those with arthritis, more Latinos than non-Latino whites report activity limitations (CDC, 1996a). Reasons for these differences are unknown, but may include disparities in sociodemographic factors, access to health care, and acculturation factors. Therefore, the aims of the proposed study are to: (1) examine whether socioeconomic factors (e.g., income, education) and health insurance coverage account for differences in the prevalence of arthritis among Latinos and non-Latino whites, (2) document levels of disability, both in activities of daily living and inability to work, among Latinos and non-Latino whites with arthritis, and identify sociodemographic (e.g., income, education, type of occupation) and health care factors (e.g., lack of health insurance, quality of health care) that predict disability in the different groups; and examine whether health care factors explain the differences in disability levels of Latinos vs. non-Latino whites after controlling for sociodemographic variables, (3) examine the effects of nativity status (U.S. vs. foreign-born) and length of time in the U.S. (acculturation) on arthritis prevalence and disability. These issues will be examined using data from the National Health Interview Survey (NHIS) on Disability, Phase I: Person and Condition Data, 1994. The proposed study will control for age and SES differences between the various ethnic groups, and conduct detailed analyses by Latino groups. This study will, therefore, contribute to a systematic program of research attempting to understand arthritis prevalence and disability among under-studied populations.