Psychosocial Epidemiology of Rheumatoid Arthritis in a Rural Population

Most studies of rheumatoid arthritis by epidemiologists or by health psyd~ologists have been conducted in urban setrings. Furthermore, previous studies have rarely attempted to obtain a control group which was clearly representative of the general community. This study attempts, on a small scale, ro overcome both these deficiencies in the existing literature. Fifty-two confirmed cases of rheumatoid arthritis were identified through a survey of physicians in three rural Illinois counties. Random telephone numbers were dialed until 26 volunteer controls of similar ages were identified. Both groups were predominately (82.3% and 84.6%) female. Subject loss resulted in final analyses for 51 cases (42 women and 6 men) versus 23 controls (22 women and 1 man). Cases and controls did not differ significantly in terms of age, occupational group, jncolne, or education. The mesn age was 47 yr., with the most frequent occupation being housewife and the mode for education being less than high school graduation. Age onset for the cases showed definite clustering between the ages of 25 and 35 yr., then again bemeen the ages of 43 and 53 yr. These clusters coincide with reported clusters for the onset of many allergic disorders (Gel1 & Coombs, 1968). The greatest difference found between cases and controls was in social support. The mean number of close friends reported by cases was 7.15, while controls reported a mean of 11.03 close friends. Relative odds indicated char persons with fewer than 11 close friends were 2.3 times as likely to have rheumatoid arthritis as persons with 11 or more close friends. When the number of close friends was compared to number of relatives reported, 51.1% of the cases and 21.7% of the controls reported having fewer clcse friends than relatives. These differences were significant (p = .05) by chi-squared. Cases were also less mobile than controls. Gses had resided at their current address an average of 15.5 yr. and controls an average of 8.7 yr. (p < .05). Persons who had not moved in the past 10 yr. were 2.7 times more likely to have rheumatoid arthritis than persons who had moved in the past 10 yr. Stressful events consistently occurred to a larger proportion of the cases than of the controls; however, these differences were nonsignificant (p = .05). Because the sample was small, the power of the tests applied was relatively low, so it is possible that these differences might have proven significant had the sample been larger. An additional finding of note was that 23 of the 51 cases (45.1%) wrote in the lnergins and on the backs of pages to provide precise details and minute explanations which were not requested in the questionnaire. For instance, one case answered a question about number of siblings by giving the names, ages, occupations, residences, spouses names, and children's names for each of her siblings. This compulsive-appearing behavior was not shown by any of the controls. This supports Cobb and Kasl's position (1968) regarding a possible link between neuroticism and rheumatoid arthritis

Environmental health · Population · Psychiatry · Psychosocial · Rheumatoid arthritis · Rural population · Clinical Psychology · Epidemiology · Internal Medicine · Medicine · Psychology · Rheumatoid Arthritis Research and Therapies

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  Ruby S C Phillips, Ruby Phillips•Family & Community Health•2000

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