The association between low socioeconomic status with high physical limitations and low illness self-perception in patients with juvenile idiopathic arthritis: results from the Childhood Arthritis Prospective Study

Arthritis Care Res (Hoboken). 2015 Mar;67(3):382-9. doi: 10.1002/acr.22466.


Objective: To examine the association between socioeconomic status (SES) and delay to a pediatric rheumatology clinic, disease severity, and illness perception in patients with juvenile idiopathic arthritis in England.

Methods: Using the Index of Multiple Deprivation, 923 consecutive children from the Childhood Arthritis Prospective Study were assigned to SES groups: high-SES (19.1%), middle-SES (44.5%), or low-SES (36.4%). At baseline, disease activity was assessed, and the Childhood Health Assessment Questionnaire (C-HAQ), the Illness Perception Questionnaire, and the Child Health Questionnaire, version Parent Form 50, were completed. Linear median regression analyses or zero-inflated negative binominal (ZINB) regression analyses were used.

Results: Delay to first pediatric rheumatology consultation was the same between the 3 SES groups. Although disease activity scores assessed by the pediatric rheumatologist did not differ between the 3 SES groups, persons in the low-SES group recorded higher C-HAQ scores compared to the high-SES group (zero-inflated part of ZINB odds ratio 0.28 [95% confidence interval (95% CI) 0.14, 0.55], count part of ZINB β 0.26 [95% CI 0.05, 0.48]). Parents with low SES also reported more often that their children's school work or activities with friends had been limited. Furthermore, the low-SES group had a worse perception about the consequences of the disease and the effect of treatment than those in the high-SES group.

Conclusion: Patients from a low-SES background report more problems with daily activities and have a lower perception of the consequences of the disease than patients from a high-SES background, warranting special attention from a multidisciplinary team.

Publication types

  • Comparative Study
  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Activities of Daily Living
  • Adolescent
  • Arthritis, Juvenile / diagnosis*
  • Arthritis, Juvenile / economics*
  • Arthritis, Juvenile / physiopathology
  • Arthritis, Juvenile / psychology
  • Arthritis, Juvenile / therapy
  • Child
  • Child, Preschool
  • Cost of Illness
  • Cross-Sectional Studies
  • Disability Evaluation*
  • England
  • Female
  • Health Services Accessibility / economics
  • Health Status Disparities*
  • Humans
  • Linear Models
  • Male
  • Motor Activity*
  • Odds Ratio
  • Predictive Value of Tests
  • Prognosis
  • Prospective Studies
  • Referral and Consultation
  • Rheumatology / methods*
  • Self Concept*
  • Severity of Illness Index
  • Social Class*
  • Surveys and Questionnaires*