Social epidemiology and rheumatic disease

Social epidemiology, a subdiscipline of epidemiology, aims to identify socioenvironmental exposures that may be related to a broad range of health status outcomes. The strong association throughout the developed world between lower levels of individual socioeconomic status and poorer health outcomes from many diseases, including arthritis, is well established. Although not yet well studied in arthritis, recent data suggest that community social determinants, eg, the socioeconomic environment of an individual's neighborhood, may be operant in this regard as well. It is of considerable interest that the association of community social determinants with health outcomes appears to be independent of an individual's socioeconomic status, at least in some clinical situations. Both Healthy People 2010 and the National Arthritis Action Plan place high priority on reducing disparities in health outcomes in the United States. Development of effective prevention strategies will require (1) precise recognition of individual and community variables that are associated with health outcomes and (2) evaluation of the putative mediating mechanisms. (C) 2003 Lippincott Williams Wilkins.