Independent Influences of Current and Childhood Socioeconomic Status on Health Outcomes in a North Carolina Family Practice Sample of Arthritis Patients


  • Antoine R. Baldassari,

    1. University of North Carolina at Chapel Hill
    Search for more papers by this author
  • Rebecca J. Cleveland,

    1. University of North Carolina at Chapel Hill
    Search for more papers by this author
  • Leigh F. Callahan

    Corresponding author
    1. University of North Carolina at Chapel Hill
    • University of North Carolina at Chapel Hill, 3300 Thurston Building, CB #7280, Chapel Hill, NC 27599. E-mail:

    Search for more papers by this author
    • Dr. Callahan has received consultant fees, speaking fees, and/or honoraria (less than $10,000 each) from the NIH, the Canadian Arthritis Network, the University of Washington Pain Behaviors Study, and the National Association of Chronic Disease Directors.



Compelling evidence suggests that socioeconomic status (SES) is a determinant of health outcomes among persons with arthritis. SES in early life has likewise been associated with various aspects of health, but the connection between childhood SES and health among people with arthritis remains to be investigated. The purpose of this study was to determine the influences of current and childhood SES on self-reported disability, depression, and physical and mental health among people with self-reported doctor-diagnosed arthritis.


Data originated from a North Carolina network of primary care centers. Participants with self-reported arthritis with complete sociodemographic and relevant health information were retained in our sample (n = 782). We created summary measures for current and childhood SES from indicators of education, occupation, and homeownership, using parental SES as a proxy for participants' childhood SES. Linear regression models were used to assess the associations between health outcomes and SES variables separately and together, adjusting for key covariates.


Lower childhood and current SES scores were associated with worse disability and physical health. Current SES was furthermore associated with mental health and depressive symptoms. Associations of low current and childhood SES with health outcomes remained significant when concurrently included in a linear model.


Childhood and current SES are both determinants of health among persons with arthritis. This underscores the importance of childhood SES as a determinant of adult health among individuals with arthritis. Further studies should focus on these associations in different populations and across different types of arthritis.