Individual & Community Social Determinants of Osteoarthritis Outcomes

描述（由申请人提供）：本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例非西班牙裔非洲裔美国人和非西班牙裔白人OA患者中的作用。这将在约翰斯顿县（北卡罗来纳州的一个主要农村县）进行的一项独特的、前瞻性的、基于人群的膝关节和髋关节OA研究中完成。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OA患病率之间是否存在独立关联; 2）确定社区和个人SES与关节炎严重程度和进展之间是否存在独立关联; 3）确定社区和个人SES与残疾之间是否存在独立关联; 4）确定SES与残疾之间是否存在独立关联（社区和个人）和死亡率; 5）制定社区健康特征的观察性评估措施，并制定一个量表来评估参与者对这些特征的看法; 6）测试个人和社区SES与膝关节和髋关节OA患病率和结局之间关系的假设介质。公共卫生相关性：健康结果方面的差距是多因素的，人们对它的认识不完全，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.