{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T07:43:43Z","timestamp":1780472623439,"version":"3.54.1"},"reference-count":15,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,9,20]],"date-time":"2022-09-20T00:00:00Z","timestamp":1663632000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["Loan Repayment Program 9L40\u2010HD\u2010106442\u201002A1"],"award-info":[{"award-number":["Loan Repayment Program 9L40\u2010HD\u2010106442\u201002A1"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000133","name":"Agency for Healthcare Research and Quality","doi-asserted-by":"publisher","award":["K12HS026383"],"award-info":[{"award-number":["K12HS026383"]}],"id":[{"id":"10.13039\/100000133","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["KL2TR001870"],"award-info":[{"award-number":["KL2TR001870"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthritis Care &amp; Research"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Health disparities in juvenile idiopathic arthritis (JIA) remain poorly understood. Social disadvantage may have a cumulative impact on health, with recent analyses using combined scoring systems to measure their impact on outcomes. Our aim was to investigate cumulative social disadvantage on childhood arthritis by using a cumulative score to analyze its association with arthritis among a nationally representative sample of children.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A cross\u2010sectional analysis of the National Survey of Children's Health (2016\u20132019) was performed. A cumulative social disadvantage score was generated (1 point each, with a maximum score of 4): low guardian education (high school or less), low household income level (0\u2013199% of federal poverty level), underinsured status (public or uninsured), and high adverse childhood experience (ACE) score (\u22654). Univariate and multivariable (adjusting for age, sex, and race and ethnicity) logistic regression models were used to measure the association between cumulative social risk and the odds of an arthritis diagnosis and moderate\u2010to\u2010severe parent\u2010reported arthritis severity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 131,774 surveys completed, a total of 365 children reported current arthritis. Cumulative social disadvantage was associated with an arthritis diagnosis, with the highest odds among those with a score of 4 (adjusted odds ratio [OR<jats:sub>adj<\/jats:sub>] 12.4 [95% confidence interval (95% CI) 2.9\u201353.3]). Cumulative social disadvantage also was associated with increased odds of moderate\u2010to\u2010severe arthritis severity (OR<jats:sub>adj<\/jats:sub> 12.4 [95% CI 1.8\u201382.6]).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In this nationally representative sample, accumulated social disadvantage, measured via a cumulative social disadvantage score based on income level, guardian education, insurance status, and ACE exposure, was associated with an arthritis diagnosis and moderate\u2010to\u2010severe arthritis severity.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acr.24991","type":"journal-article","created":{"date-parts":[[2022,7,29]],"date-time":"2022-07-29T12:39:52Z","timestamp":1659098392000},"page":"3-8","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Cumulative Social Disadvantage Associated with Childhood Arthritis: A <scp>Cross\u2010Sectional<\/scp> Analysis of the National Survey of Children's Health"],"prefix":"10.1002","volume":"75","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1873-3520","authenticated-orcid":false,"given":"William Daniel","family":"Soulsby","sequence":"first","affiliation":[{"name":"University of California  San Francisco"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erica","family":"Lawson","sequence":"additional","affiliation":[{"name":"University of California  San Francisco"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew S.","family":"Pantell","sequence":"additional","affiliation":[{"name":"University of California  San Francisco"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,9,20]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2016.09.010"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.21991"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pedn.2017.08.023"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.131382"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.22466"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00296-018-4128-8"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2020.06.046"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2005-1647"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2019.3933"},{"key":"e_1_2_6_11_1","unstructured":"Child and adolescent health measurement initiative.National Survey of Children's Health: 2017\u20132018. Data resource center for child and adolescent health supported by the U.S. Department of Health and Human Services Health Resources and Services Administration (HRSA) Maternal and Child Health Bureau (MCHB). URL:www.childhealthdata.org."},{"key":"e_1_2_6_12_1","doi-asserted-by":"crossref","first-page":"761","DOI":"10.1136\/jech-2020-213847","article-title":"Advancing health equity by integrating intersectionality into epidemiological research: applications and challenges","volume":"74","author":"Mandelbaum J.","year":"2020","journal-title":"J Epidemiol Community Health"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2018.12.015"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2016.2521"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2020.6445"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2020-024406"}],"container-title":["Arthritis Care &amp; Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/acr.24991","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/acr.24991","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/acrjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/acr.24991","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,2]],"date-time":"2025-10-02T17:05:21Z","timestamp":1759424721000},"score":1,"resource":{"primary":{"URL":"https:\/\/acrjournals.onlinelibrary.wiley.com\/doi\/10.1002\/acr.24991"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,9,20]]},"references-count":15,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2023,1]]}},"alternative-id":["10.1002\/acr.24991"],"URL":"https:\/\/doi.org\/10.1002\/acr.24991","archive":["Portico"],"relation":{},"ISSN":["2151-464X","2151-4658"],"issn-type":[{"value":"2151-464X","type":"print"},{"value":"2151-4658","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,9,20]]},"assertion":[{"value":"2021-11-10","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-07-26","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-09-20","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}