The Influence of Neighbourhood Deprivation in Advanced Arthritis

Arthritis is a growing aging and public health concern in Canada and elsewhere. As with many other chronic health conditions, arthritis occurs more often and has a higher impact on functioning for people who have lower incomes... [ view full abstract ]

Arthritis is a growing aging and public health concern in Canada and elsewhere. As with many other chronic health conditions, arthritis occurs more often and has a higher impact on functioning for people who have lower incomes or live in an impoverished environment. There is a large body of research that supports a gradient between socioeconomic status and health and between area level poverty and decreased quality of life. Although this relationship is widely acknowledged, less is known about the influence of broader social conditions at the neighbourhood level on health outcomes. I provide an analysis of the direct impact of material and social deprivation on health related quality of life, as well as the impact considering the influence of age, body weight, physical functioning, sex, and co-existing health conditions. I also examine interaction effects between neighbourhood deprivation and individual characteristics.

An explanatory three-level multilevel model supported a substantial relationship between individual factors, deprivation at the neighbourhood level, and reduced mental and physical HRQoL. The impact of neighbourhood deprivation was more pronounced for mental health related life quality, with having a history of another health condition making the largest contribution to the model. Physical HRQoL was impacted by sex in interaction with material deprivation and body weight in interaction with social deprivation. I will discuss implications for practice, service delivery, and policy and make suggestions for further research.