Relations of Social Determinants of Health to Pain and Function in Individuals with Knee Osteoarthritis in a Hispanic-dominant Community.

Abstract

Background: Social determinants of health have been associated with knee osteoarthritis (OA) symptoms. However, there is a dearth of research on the influence of social determinants of health on knee OA among Hispanics despite Hispanics being disproportionately impacted by racial/ethnic disparities in pain and function. Thus, we sought to investigate the relations of social determinants of health to pain and function in individuals with knee OA in a Hispanic-dominant community.

Methods: We included participants residing in El Paso, Texas, a major Hispanic community in the US. We evaluated relations of income level, education level and perceived discrimination to The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) knee pain, quantitative sensory testing (QST) measures of pressure pain threshold (PPT), temporal summation (TS) and conditioned pain modulation (CPM), and WOMAC function using linear or logistic regression models adjusting for age, sex and BMI.

Results: Fifty-nine participants with knee OA were included (76% Hispanic). Higher income and education levels were associated with less knee pain and better function. Higher income and education levels had non-significant trends toward associations with non-facilitated TS and higher PPT, respectively. In contrast, perceived discrimination was not associated with any of the outcomes.

Conclusions: We found that income and education levels were associated with pain and function and showed non-significant associations with central pain sensitization assessed by PPT and TS. Perceived discrimination was not associated with any outcome. These findings underscore the importance of social determinants of health in precision pain management for Hispanic individuals with knee OA.