Individual & Community Social Determinants of Osteoarthritis Outcomes

描述(申请人提供)：这项拟议项目的长期目标是更好地阐明个人和社区社会决定因素在4337名患有骨性关节炎的非西班牙裔非裔美国人和非西班牙裔高加索人中对健康结果的作用。这将在北卡罗来纳州以农村为主的约翰斯顿县进行一项独特的、前瞻性的、基于人群的膝盖骨和髋关节骨关节炎研究。这一目标将通过以下目的使用多种方法来实现：1)确定社区和个人SES与膝关节和髋关节骨关节炎患病率之间是否存在独立的关联；2)确定社区和个人SES与关节炎的严重程度和进展是否存在独立的关联；3)确定社区和个人的SES与残疾之间是否存在独立的关联；4)确定SES(社区和个人)与死亡率之间是否存在独立的关联；5)制定一种社区健康特征的观察性评估措施，并开发一种量表来评估参与者对这些特征的看法；6)检验个人和社区SES与膝关节和髋关节骨性关节炎患病率和预后之间关系的假设中介变量。与公共卫生相关：健康结果之间的差距是多因素的，不完全了解，而且可能很难完全纠正。然而，更好地了解影响种族和族裔群体健康结果的个人和社区因素，将为设计干预措施和制定缩小这些差距的政策提供宝贵的基础。

DESCRIPTION (provided by applicant): The long-term goal of this proposed project is to better clarify the role of both individual and community social determinants with health outcomes in 4337 non-Hispanic African-Americans and non-Hispanic Caucasians with OA. This will be accomplished in a unique, prospective, population-based study of knee and hip OA in Johnston County, a predominantly rural county in North Carolina. This goal will be accomplished using multi- methodology through the following aims: 1) to determine whether there is an independent association between community and individual SES with knee and hip OA prevalence; 2) to determine whether there is an independent association between community and individual SES with arthritis severity and progression; 3) to determine whether there is an independent association between community and individual SES with disability; 4) to determine whether there is an independent association between SES (community and individual) and mortality; 5) to develop a measure of observational assessment for community health characteristics and develop a scale to assess participants' perceptions of these characteristics; 6) to test hypothesized mediators of relationships between individual and community SES with knee and hip OA prevalence and outcomes. PUBLIC HEALTH RELEVANCE: The gap in health outcomes is multifactorial, incompletely understood, and potentially difficult to redress in its entirety. However, a better understanding of the individual and community factors that influence health outcomes in racial and ethnic groups will provide an invaluable foundation for designing interventions and creating policies to reduce these gaps.