Background: Social determinants of health (SDOH) such as sex, gender, race, and socioeconomic status, are associated with adverse outcomes among individuals with arthritis. However, evaluations of these associations have largely utilized variable-centered approaches that only consider independent factor effects, and critically do not count for relationships between factors.

Objectives: Guided by the Campbell and Cochrane Equity Methods Group’s PROGRESS-Plus framework on risk factors that lead to inequities in health ( P lace of residence; R ace, culture, ethnicity, language; O ccupation; G ender, sex; R eligion; E ducation; S ocioeconomic status; and S ocial capital), our objective was to understand how SDOH intersect and impact outcomes among adults with arthritis in Canada.

Methods: We leveraged rich data from the Canadian Longitudinal Survey on Aging (CLSA), a longitudinal study of 50,000 Canadians in the community aged 45 to 85 years. We applied latent class analysis (LCA) to identify distinct classes of people living with arthritis based on PROGRESS-Plus factors, using maximum likelihood estimation. We then conducted logistic regression on the selected LCA model to evaluate the association between class membership and health and arthritis related outcomes, of perceived health, limitations in activity, and pain or discomfort.

Results: Of 9,850 total respondents in the CLSA, 2,514 were living with arthritis (46% male, 54% female). We identified the 5-class solution as most optimal based on fit statistics (e.g., lower Akaike Information Criterion=176623 and Bayesian Information Criterion=181834) and overall model interpretability. There were notable characteristics of resultant classes according to some factors, specifically P lace of residence, S ocioeconomic status, and S ocial capital. In particular, those in Class 2 were more likely to be ( P ) born outside of Canada (18%), with ( S ) lower income (30%) and education (15%), and ( S ) unattached (single, divorced, separated, or widowed; 50%). Those in Class 3 had a high likelihood of being married (91%), born in Canada (87%), with some form of postgraduate education (90%) and higher income levels (68%). Compared to other classes, members in Class 2 tended to have the lowest odds of having better perceived health (odds ratio [OR] 0.53; 95% confidence interval [CI] 0.41-0.69; p-value<0.001) and the highest odds of experiencing pain or discomfort (OR 1.17; 95% CI, 0.88-1.55; p-value=0.284), and limitations in activity (OR 1.26; 95% CI, 0.96-1.65; p-value=0.094). Contrarily, compared to other classes, members in Class 3 tended to have better outcomes, with the highest odds of perceived general health (OR 1.57; 95% CI, 1.27-1.95; p-value<0.001), and better perceived mental health (OR 1.39; 95% CI, 1.12-1.72; p-value=0.003). Members of Class 3 also had the lowest odds of having limitations in activity (OR 0.56; 95% CI, 0.44-0.70; p-value<0.001) and experiencing pain or discomfort (OR 0.63; 95% CI, 0.50-0.80; p-value<0.001).

Conclusion: In identifying distinct classes of individuals with arthritis based on SDOH, our findings underscore the importance of applying an intersectionality lens to better understand outcomes in arthritis. Our findings suggest particular influence of key factors of P lace of residence, S ocioeconomic status and S ocial capital on health and arthritis-related outcomes in a nationally representative population of adults in Canada.

REFERENCES: NIL.

Acknowledgements: NIL.

Disclosure of Interests: None declared.

© The Authors 2025. This abstract is an open access article published in Annals of Rheumatic Diseases under the CC BY-NC-ND license ( http://creativecommons.org/licenses/by-nc-nd/4.0/ ). Neither EULAR nor the publisher make any representation as to the accuracy of the content. The authors are solely responsible for the content in their abstract including accuracy of the facts, statements, results, conclusion, citing resources etc.