Background An individual focus is frequently used as a key determinant of health to evaluate the behavior of different diseases with important limitations for detecting the effect exerted by social and economic factors, and policy on the health-disease process.
Objectives To identify individual and ecological factors associated with the prevalence of osteoarthritis in Mexican population.
Methods Our data are from a cross-sectional, community-based study performed in four regions of México using the COPCORD methodology between August 2008 and August 2009. The total sample included 17,566 individuals of which 10,666 (60.7%) were women. The prevalence of osteoarthritis (OA) was determined in this population. The relationship between individual level (age, gender, income, education, type of work, housing facilities and access to healthcare) and ecological level (Human Development Index, inequality, level of urbanization, income, health services, migration, unemployment, Marginalization Index and Social Gap Index) with OA were analyzed with a multilevel strategy.
Results A total of 1,681 (62.1%) out of 2,706 individuals had OA. The prevalence of OA was 9.5% (95% CI 9.1, 10.0) and this was higher in women (6.6% vs. 2.9%, P <0.01). The prevalence in individuals under 45 years was 4.8% (95% CI 4.4, 5.2); in the 46 to 65 years group, it was 14.0% (95% CI 10.0, 15.0), and in those over 66 years 21.4% (95% CI 19.7, 23.2). Multilevel analysis showed that the individual variables associated with the presence of OA were female gender (OR = 1.2, 95% CI 1.1, 1.4), age range 55-65 years (OR = 0.6, 95% CI 0.5, 0.8), musculoskeletal pain in the last 7 days (OR = 2.6 95% CI 2.2, 3.0), use of pain treatments (OR = 1.4, 95% CI 1.2, 1.7). At the regional level, the Social Gap Index was associated with the diagnosis of OA (coefficient: 0.4, 95% CI 0.1-1.1).
Conclusions The Social Gap index was the only ecological variable associated with significant variance of the prevalence of OA. Female gender, pain intensity, physical limitation, and the use of pain treatments are individual variables that are associated with the presence of OA.
Disclosure of Interest None Declared
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