{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T03:22:01Z","timestamp":1793762521810,"version":"4.6.1"},"reference-count":30,"publisher":"Springer Science and Business Media LLC","issue":"5","license":[{"start":{"date-parts":[[2011,10,19]],"date-time":"2011-10-19T00:00:00Z","timestamp":1318982400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/2.0\/"},{"start":{"date-parts":[[2011,10,19]],"date-time":"2011-10-19T00:00:00Z","timestamp":1318982400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/2.0\/"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Arthritis Res Ther"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                        <jats:title>Introduction<\/jats:title>\n                        <jats:p>The purpose of this study was to examine data from the Johnston County Osteoarthritis (OA) Project for independent associations of educational attainment, occupation and community poverty with tibiofemoral knee OA.<\/jats:p>\n                     <\/jats:sec><jats:sec>\n                        <jats:title>Methods<\/jats:title>\n                        <jats:p>A cross-sectional analysis was conducted on 3,591 individuals (66% Caucasian and 34% African American). Educational attainment (&lt; 12 years or \u226512 years), occupation (non-managerial or not), and Census block group household poverty rate (&lt; 12%, 12 to 25%, &gt; 25%) were examined separately and together in logistic models adjusting for covariates of age, gender, race, body mass index (BMI), smoking, knee injury and occupational activity score. Outcomes were presence of radiographic knee OA (rOA), symptomatic knee OA (sxOA), bilateral rOA and bilateral sxOA.<\/jats:p>\n                     <\/jats:sec><jats:sec>\n                        <jats:title>Results<\/jats:title>\n                        <jats:p>When all three socioeconomic status (SES) variables were analyzed simultaneously, low educational attainment was significantly associated with rOA (odds ratio (OR) = 1.44, 95% confidence interval (CI) 1.20, 1.73), bilateral rOA (OR = 1.43, 95% CI 1.13, 1.81), and sxOA (OR = 1.66, 95% CI 1.34, 2.06), after adjusting for covariates. Independently, living in a community of high household poverty rate was associated with rOA (OR = 1.83, 95% CI 1.43, 2.36), bilateral rOA (OR = 1.56, 95% CI 1.12, 2.16), and sxOA (OR = 1.36, 95% CI 1.00, 1.83). Occupation had no significant independent association beyond educational attainment and community poverty.<\/jats:p>\n                     <\/jats:sec><jats:sec>\n                        <jats:title>Conclusions<\/jats:title>\n                        <jats:p>Both educational attainment and community SES were independently associated with knee OA after adjusting for primary risk factors for knee OA.<\/jats:p>\n                     <\/jats:sec>","DOI":"10.1186\/ar3492","type":"journal-article","created":{"date-parts":[[2011,10,19]],"date-time":"2011-10-19T18:18:54Z","timestamp":1319048334000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":59,"title":["Associations of educational attainment, occupation and community poverty with knee osteoarthritis in the Johnston County (North Carolina) osteoarthritis project"],"prefix":"10.1186","volume":"13","author":[{"given":"Leigh F","family":"Callahan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca J","family":"Cleveland","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jack","family":"Shreffler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Todd A","family":"Schwartz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Britta","family":"Schoster","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Randy","family":"Randolph","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jordan B","family":"Renner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanne M","family":"Jordan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2011,10,19]]},"reference":[{"key":"3248_CR1","first-page":"1","volume-title":"A National Public Health Agenda for Osteoarthritis","author":"Arthritis Foundation Centers for Disease Control and Prevention 2010","year":"2010","unstructured":"Arthritis Foundation Centers for Disease Control and Prevention 2010: A National Public Health Agenda for Osteoarthritis. 2010, 1-52."},{"key":"3248_CR2","first-page":"1","volume-title":"Adv Data","author":"CJ DeFrances","year":"2006","unstructured":"DeFrances CJ, Podgornik MN: 2004 National Hospital Discharge Survey. Adv Data. 2006, 1-19."},{"key":"3248_CR3","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1093\/oxfordjournals.aje.a114939","volume":"128","author":"JJ Anderson","year":"1988","unstructured":"Anderson JJ, Felson DT: Factors associated with osteoarthritis of the knee in the first national Health and Nutrition Examination Survey (HANES I). Evidence for an association with overweight, race, and physical demands of work. Am J Epidemiol. 1988, 128: 179-89.","journal-title":"Am J Epidemiol"},{"key":"3248_CR4","doi-asserted-by":"publisher","first-page":"R46","DOI":"10.1186\/ar2956","volume":"12","author":"L Callahan","year":"2010","unstructured":"Callahan L, Shreffler J, Siaton B, Helmick C, Schoster B, Schwartz T, et al: Limited educational attainment and radiographic and symptomatic knee osteoarthritis: a cross-sectional analysis using data from the Johnston County (North Carolina) Osteoarthritis Project. Arthritis Research & Therapy. 2010, 12: R46-10.1186\/ar2956.","journal-title":"Arthritis Research & Therapy"},{"key":"3248_CR5","first-page":"172","volume":"34","author":"JM Jordan","year":"2007","unstructured":"Jordan JM, Helmick CG, Renner JB, Luta G, Dragomir A, Woodard J, et al: Prevalence of knee symptoms and radiographic and symptomatic knee osteoarthritis in African-Americans and Caucasians: The Johnston County Osteoarthritis Project. J Rheumatol. 2007, 34: 172-80.","journal-title":"J Rheumatol"},{"key":"3248_CR6","doi-asserted-by":"publisher","first-page":"139","DOI":"10.1016\/0895-4356(92)90006-9","volume":"45","author":"MT Hannan","year":"1992","unstructured":"Hannan MT, Anderson JJ, Pincus T, Felson DT: Educational attainment and osteoarthritis: differential associations with radiographic changes and symptom reporting. J Clin Epidemiol. 1992, 45: 139-47. 10.1016\/0895-4356(92)90006-9.","journal-title":"J Clin Epidemiol"},{"key":"3248_CR7","doi-asserted-by":"publisher","first-page":"122","DOI":"10.1002\/anr.1790020406","volume":"2","author":"LF Callahan","year":"1989","unstructured":"Callahan LF, Smith WJ, Pincus T: Self-report questionnaires in five rheumatic diseases: comparisons of health status constructs and associations with formal education level. Arthritis Care Res. 1989, 2: 122-31. 10.1002\/anr.1790020406.","journal-title":"Arthritis Care Res"},{"key":"3248_CR8","doi-asserted-by":"publisher","first-page":"1017","DOI":"10.1136\/ard.61.11.1017","volume":"61","author":"J Thumboo","year":"2002","unstructured":"Thumboo J, Chew LH, Lewin-Koh SC: Socioeconomic and psychosocial factors influence pain or physical function in Asian patients with knee or hip osteoarthritis. Ann Rheum Dis. 2002, 61: 1017-20. 10.1136\/ard.61.11.1017.","journal-title":"Ann Rheum Dis"},{"key":"3248_CR9","doi-asserted-by":"publisher","first-page":"147","DOI":"10.1097\/01.bor.0000151403.18651.de","volume":"17","author":"J Odutola","year":"2005","unstructured":"Odutola J, Ward MM: Ethnic and socioeconomic disparities in health among patients with rheumatic disease. Curr Opin Rheumatol. 2005, 17: 147-52. 10.1097\/01.bor.0000151403.18651.de.","journal-title":"Curr Opin Rheumatol"},{"issue":"5","key":"3248_CR10","doi-asserted-by":"publisher","first-page":"401","DOI":"10.1136\/jech.2006.048306","volume":"61","author":"P Sainio","year":"2007","unstructured":"Sainio P, Martelin T, Koskinen S, Heliovaara M: Educational differences in mobility: the contribution of physical workload, obesity, smoking and chronic conditions. J Epidemiol Community Health. 2007, 61 (5): 401-8. 10.1136\/jech.2006.048306. PMCID: PMC2465686","journal-title":"J Epidemiol Community Health"},{"key":"3248_CR11","doi-asserted-by":"publisher","first-page":"316","DOI":"10.1093\/ije\/dyh386","volume":"34","author":"JA Dalstra","year":"2005","unstructured":"Dalstra JA, Kunst AE, Borrell C, Breeze E, Cambois E, Costa G, et al: Socioeconomic differences in the prevalence of common chronic diseases: an overview of eight European countries. Int J Epidemiol. 2005, 34: 316-26. 10.1093\/ije\/dyh386.","journal-title":"Int J Epidemiol"},{"key":"3248_CR12","doi-asserted-by":"publisher","first-page":"1002","DOI":"10.1002\/art.23834","volume":"59","author":"LF Callahan","year":"2008","unstructured":"Callahan LF, Shreffler J, Mielenz T, Schoster B, Kaufman JS, Xiao C, et al: Arthritis in the Family Practice Setting: Associations with Education and Community Poverty. Arthritis Care Res. 2008, 59: 1002-8. 10.1002\/art.23834.","journal-title":"Arthritis Care Res"},{"key":"3248_CR13","doi-asserted-by":"publisher","first-page":"48","DOI":"10.1093\/oxfordjournals.aje.a009191","volume":"146","author":"AV Diez-Roux","year":"1997","unstructured":"Diez-Roux AV, Nieto FJ, Muntaner C, Tyroler HA, Comstock GW, Shahar E, et al: Neighborhood environments and coronary heart disease: a multilevel analysis. Am J Epidemiol. 1997, 146: 48-63.","journal-title":"Am J Epidemiol"},{"key":"3248_CR14","doi-asserted-by":"publisher","first-page":"489","DOI":"10.1146\/annurev.soc.25.1.489","volume":"25","author":"SA Robert","year":"1999","unstructured":"Robert SA: Socioeconomic position and health: the independent contribution of community socioeconomic context. Annu Rev Sociol. 1999, 25: 489-516. 10.1146\/annurev.soc.25.1.489.","journal-title":"Annu Rev Sociol"},{"key":"3248_CR15","doi-asserted-by":"publisher","first-page":"99","DOI":"10.1056\/NEJM200107123450205","volume":"345","author":"AV Diez-Roux","year":"2001","unstructured":"Diez-Roux AV, Merkin SS, Arnett D, Chambless L, Massing M, Nieto FJ, et al: Neighborhood of residence and incidence of coronary heart disease. N Engl J Med. 2001, 345: 99-106. 10.1056\/NEJM200107123450205.","journal-title":"N Engl J Med"},{"key":"3248_CR16","first-page":"126","volume":"30","author":"PP Wang","year":"2003","unstructured":"Wang PP, Badley EM: Consistent low prevalence of arthritis in Quebec: findings from a provincial variation study in Canada based on several Canadian population health surveys. J Rheumatol. 2003, 30: 126-31.","journal-title":"J Rheumatol"},{"key":"3248_CR17","doi-asserted-by":"publisher","first-page":"399","DOI":"10.1002\/art.23316","volume":"59","author":"M Canizares","year":"2008","unstructured":"Canizares M, Power JD, Perruccio AV, Badley EM: Association of regional racial\/cultural context and socioeconomic status with arthritis in the population: a multilevel analysis. Arthritis Rheum. 2008, 59: 399-407. 10.1002\/art.23316.","journal-title":"Arthritis Rheum"},{"key":"3248_CR18","volume-title":"Arthritis Care & Research","author":"AE Nelson","year":"2010","unstructured":"Nelson AE, Renner JB, Shi XA, Shreffler JH, Schwartz TA, Jordan JM: Cross-sectional comparison of extended anteroposterior and posteroanterior fixed-flexion positioning to assess radiographic osteoarthritis at the knee: The Johnston County Osteoarthritis Project. Arthritis Care & Research. 2010, 62:"},{"key":"3248_CR19","volume-title":"1990 census of population and housing","author":"US Department of Commerce - Bureau of the Census","year":"1990","unstructured":"US Department of Commerce - Bureau of the Census: 1990 census of population and housing. 1990, Washington: US GPO"},{"key":"3248_CR20","doi-asserted-by":"publisher","first-page":"147","DOI":"10.1037\/1082-989X.7.2.147","volume":"7","author":"JL Schafer","year":"2002","unstructured":"Schafer JL, Graham JW: Missing data: Our view of the state of the art. Psychological methods. 2002, 7: 147-","journal-title":"Psychological methods"},{"issue":"3 Suppl","key":"3248_CR21","doi-asserted-by":"publisher","first-page":"42","DOI":"10.1016\/0049-0172(90)90046-I","volume":"20","author":"DT Felson","year":"1990","unstructured":"Felson DT: The epidemiology of knee osteoarthritis: results from the Framingham Osteoarthritis Study. Semin Arthritis Rheum. 1990, 20 (3 Suppl): 42-50.","journal-title":"Semin Arthritis Rheum"},{"key":"3248_CR22","first-page":"93","volume":"20","author":"DJ Hunter","year":"2002","unstructured":"Hunter DJ, March L, Sambrook PN: Knee osteoarthritis: the influence of environmental factors. Clin Exp Rheumatol. 2002, 20: 93-100.","journal-title":"Clin Exp Rheumatol"},{"key":"3248_CR23","doi-asserted-by":"publisher","first-page":"R127","DOI":"10.1186\/ar2016","volume":"8","author":"L Ameye","year":"2006","unstructured":"Ameye L, Chee W: Osteoarthritis and nutrition. From nutraceuticals to functional foods: a systematic review of the scientific evidence. Arthritis Research & Therapy. 2006, 8: R127-10.1186\/ar2016.","journal-title":"Arthritis Research & Therapy"},{"key":"3248_CR24","doi-asserted-by":"crossref","first-page":"1107","DOI":"10.1093\/ajcn\/87.5.1107","volume":"87","author":"N Darmon","year":"2008","unstructured":"Darmon N, Drewnowski A: Does social class predict diet quality?. Am J Clin Nutr. 2008, 87: 1107-17.","journal-title":"Am J Clin Nutr"},{"key":"3248_CR25","doi-asserted-by":"publisher","first-page":"1351","DOI":"10.1002\/art.1780381002","volume":"38","author":"E Yelin","year":"1995","unstructured":"Yelin E, Callahan LF: The economic cost and social and psychological impact of musculoskeletal conditions. Arthritis Rheum. 1995, 38: 1351-62. 10.1002\/art.1780381002.","journal-title":"Arthritis Rheum"},{"key":"3248_CR26","volume-title":"Journal of Applied Gerontology","author":"KR Martin","year":"2011","unstructured":"Martin KR, Schoster B, Woodard JC, Callahan LF: What community resources do older community-dwelling adults use to manage their osteoarthritis? A formative examination. Journal of Applied Gerontology. 2011, \nhttp:\/\/jag.sagepub.com\/content\/early\/2011\/02\/06\/0733464810397613\n, ,"},{"key":"3248_CR27","first-page":"404","volume":"68","author":"KR Martin","year":"2007","unstructured":"Martin KR, Schoster B, Shreffler J, Meier A, Callahan LF: Perceived Barriers to Physical Activity Among North Carolinians with Arthritis: Findings from a Mixed-Methodology Approach. N C Med J. 2007, 68: 404-12.","journal-title":"N C Med J"},{"key":"3248_CR28","volume-title":"Arthritis Basics. Key Public Health Messages","author":"Centers for Disease Control and Prevention (CDC)","year":"2007","unstructured":"Centers for Disease Control and Prevention (CDC): Arthritis Basics. Key Public Health Messages. 2007, [http:\/\/www.cdc.gov\/arthritis\/arthritis\/key.htm]"},{"key":"3248_CR29","doi-asserted-by":"publisher","first-page":"R37","DOI":"10.1186\/ar3270","volume":"13","author":"A Nelson","year":"2011","unstructured":"Nelson A, Shi X, Schwartz T, Chen JC, Renner J, Caldwell K, et al: Whole blood lead levels are associated with radiographic and symptomatic knee osteoarthritis: a cross-sectional analysis in the Johnston County Osteoarthritis Project. Arthritis Research & Therapy. 2011, 13: R37-10.1186\/ar3270.","journal-title":"Arthritis Research & Therapy"},{"key":"3248_CR30","doi-asserted-by":"publisher","first-page":"643","DOI":"10.1002\/acr.20428","volume":"63","author":"LF Callahan","year":"2011","unstructured":"Callahan LF, Martin KR, Shreffler J, Kumar D, Schoster B, Kaufman JS, et al: Independent and combined influence of homeownership, occupation, education, income and community poverty on physical health in persons with arthritis. Arthritis Care & Research. 2011, 63: 643-53. 10.1002\/acr.20428.","journal-title":"Arthritis Care & Research"}],"container-title":["Arthritis Research &amp; Therapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/ar3492.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/ar3492\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/ar3492.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,10,8]],"date-time":"2024-10-08T10:22:34Z","timestamp":1728382954000},"score":1,"resource":{"primary":{"URL":"https:\/\/arthritis-research.biomedcentral.com\/articles\/10.1186\/ar3492"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2011,10,19]]},"references-count":30,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2011,10]]}},"alternative-id":["3248"],"URL":"https:\/\/doi.org\/10.1186\/ar3492","relation":{},"ISSN":["1478-6354"],"issn-type":[{"value":"1478-6354","type":"electronic"}],"subject":[],"published":{"date-parts":[[2011,10,19]]},"assertion":[{"value":"11 April 2011","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"25 August 2011","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 October 2011","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 October 2011","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}}],"article-number":"R169"}}