Annual income, age, marital status, and smoking influence healthcare access among American minorities and Caucasians with knee osteoarthritis

ABSTRACT

This study examined the associations between annual income, age, marital status, smoking status, and healthcare access in American minority and Caucasian populations with or at high risk for knee osteoarthritis (KOA). The Osteoarthritis Initiative provided data on 4674 Americans aged between 45 and 79 years with or at increased risk for KOA. We categorized the participants into American minorities (such as African Americans, Asians, or other non-whites) and Caucasians based on racial and ethnic backgrounds. A multinomial regression analysis revealed that American minorities having an annual income of <$50,000 and who were single, divorced, or widowed were 3.82- and 2.19-times more likely not to have healthcare access, respectively. For Caucasians, age ≥65, annual household income <$50,000, and present or past smoking habit were 2.34-, 1.93-, and 1.50-times more likely not to access healthcare, respectively. American minorities and Caucasians who either had KOA or were at high risk for developing it and had lower annual income had a greater likelihood of not accessing healthcare. Age ≥65 years and smoking history impacted healthcare access in Caucasians, whereas American minorities were more affected by being single, divorced, or widowed.

KEYWORDS:

• Annual income
• healthcare coverage
• osteoarthritis
• race
• ethnicity
• knee
• Caucasians
• American minorities

Acknowledgements

The OAI is a public-private partnership comprising five contracts (N01-AR-2-2258, N01-AR-2-2259, N01-AR-2-2260, N01-AR-2-2261, and N01-AR-2-2262) funded by the National Institutes of Health, a branch of the Department of Health and Human Services, and conducted by the OAI Study Investigators. Private funding partners include Merck Research Laboratories, Novartis Pharmaceuticals Corporation, GlaxoSmithKline, and Pfizer Inc. The Foundation for the National Institutes of Health manages private-sector funding for OAI. This manuscript was prepared using an OAI public use dataset and does not necessarily reflect the opinions or views of OAI investigators, the NIH, or private funding partners. The authors extend their appreciation for support to the Research Center, College of Applied Medical Sciences, and the Deanship of Scientific Research at King Saud University.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Contributors: Sadd M. Bindawas and Vishal Vennu conceived and designed the study and interpreted the data. Sadd M. Bindawas performed a critical review. Vishal Vennu performed data collection and analysis. Vishal Vennu, Tarig A. Abdulrahaman, and Aqeel M. Alenazi drafted this manuscript. All authors have read and approved the final manuscript.

Ethics approval: The OAI study protocol was approved by the Institutional Review Board (IRB) of the University of California (Coordinating Center), San Francisco (approval number: FWA00000068). Written informed consent was obtained from all patients and volunteers to participate in this study in accordance with the Declaration of Helsinki.

Data availability statement

The data supporting this study's findings are freely available at the National Institutes of Health at https://nda.nih.gov/oai/about-oai.html.

Additional information

Funding

None.

Notes on contributors

Vishal Vennu

Vishal Vennu, MSc, Ph.D., is a Researcher in the Department of Rehabilitation Sciences at King Saud University, Riyadh, Saudi Arabia. He is an active academic researcher for more than 11 years and authored more than 35 peer-reviewed high-impact journal papers. His current research interests include public health, epidemiology, and clinical trial.

Tariq A. Abdulrahman

Tariq A. Abdulrahman received his MBBS from Khartoum University in Khartoum, Sudan. He received a PhD and DTMH from the University of London, United Kingdom. Currently, he is a physiology professor at the College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia. He has numerous scientific studies related to autonomic cardiovascular and thermoregulatory dysfunctions in the elderly, measurement of energy expenditure in patients and healthy subjects, investigation of postural and post-prandial hypotension in diabetic patients and healthy elderly. He supervised PhD and MSc students.

Aqeel M. Alenazi

Aqeel M. Alenazi is an assistant professor in health and rehabilitation sciences at Prince Sattam Bin Abdulaziz University, Saudi Arabia. His research interests include rehabilitation outcomes, osteoarthritis, diabetes, physical functions, the risk of falling in older adults, and the clinical utility of predictors of falling.

Saad M. Bindawas

Saad M. Bindawas, PT, PhD, FHEA, is a professor and consultant at King Saud University. He was the chair of the department of rehabilitation sciences and the former director of the research center in the college of applied medical sciences at King Saud University. His current research work is focused on the design, coordination, and analysis of rehabilitation and aging studies.