isons. These findings further support observations that formal education level is ... Professions Association, Tampa, FL, December 1988. From the Division of ...
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BRIEF REPORT
ASSOCIATIONS BETWEEN CLINICAL STATUS QUESTIONNAIRE SCORES AND FORMAL EDUCATION LEVEL IN PERSONS WITH SYSTEMIC LUPUS ERYTHEMATOSUS LEIGH F. CALLAHAN and THEODORE PINCUS
In a study of 124 systemic lupus erythematosus patients, clinical status, according to 5 questionnaire scales, was poorer in patients with 511 years versus those with 2 1 2 years of formal education. These results were statisticallysignificant when adjusted for age, race, sex, and disease duration, though results on some scales were not significant when adjusted for multiple comparisons. These findings further support observations that formal education level is associated with clinical status in rheumatic and other chronic diseases. Formal education level has been reported to be associated with morbidity and mortality in individuals with rheumatoid arthritis (RA) (1,2), cardiovascular disease, and back pain (for review, see ref. 3). Furthermore, formal education level is associated with the prevalence rates of most common diseases in the US (4), Great Britain, and Italy, as well as mortality rates in the general population (for review, see ref. 3). Formal education level appears to be a useful surro-
Presented in part at the Southeastern Regional Meeting of the American College of Rheumatology and the Arthritis Health Professions Association, Tampa, FL, December 1988. From the Division of Rheumatology and Immunology, Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee. Supported in part by the Arthritis Foundation, the Maury County Lupus Foundation, the Jack C. Massey Foundation, and NIH grant AM-21393 to the American Rheumatism Association Medical Information System (ARAMIS). Leigh F. Callahan, BS; Theodore Pincus, MD. Address reprint requests to Leigh F. Callahan, BS, Division of Rheumatology and Immunology, T-3219 Medical Center North, Department of Medicine, Vanderbilt University, Nashville, TN 31232. Submitted for publication June 28, 1989; accepted in revised form October 16, 1989. Arthritis and Rheumatism, Vol. 33, No. 3 (March 1990)
gate for patient socioeconomic status, with a potential advantage over other socioeconomic variables such as occupation and income, which are more likely to be affected by disease that begins in adult life (1-4). Socioeconomic status has been reported to be associated with mortality rates in individuals with systemic lupus erythematosus (SLE) (5,6), consistent with the reports cited above. However, in a recent study of 78 SLE patients, associations between formal education level and disease outcome were not found (7). That prompted us to analyze possible associations between formal education level and clinical status according to 5 questionnaire scales, in a crosssectional sample of 124 consecutive SLE patients seen at our university rheumatology clinic. Patients. Data were collected on 124 consecutive patients, diagnosed by a rheumatologist as having SLE and seen at the clinic of the Division of Rheumatology and Immunology at Vanderbilt University. The mean age of the patients was 39.6 years, and the mean disease duration was 4.6 years (Table 1). Eighty-six percent of the patients were women, 74.8% were white, 29.6% were working full-time, and 57.3% were married (Table 1). The mean formal education level of the patients was 12.9 years. Twenty of the 124 patients (16.1%) had (11 years of formal education. Six of those individuals had completed only grade school, and the other 14 had completed some high school. No significant differences were seen in age, sex, race, marital status, or disease duration, between patients with I11 years versus those with 2 12 years of education (Table 1). The patients with 212 years of education were significantly more likely to be working full-time than those with 5 11 years of formal education.
BRIEF REPORTS
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Table 1. Comparisons of demographic measures in 124 systemic lupus erythematosus patients classified according to level of formal education
Demographic measure
Total group
5 1 I years of education (n = 20)
212 years of education (n = 104)
Age (years) % female % white % working full-time % married Disease duration (years)
39.6 86 75 30 57 4.6
45.5 90 75 0 58 5.5
39.8 86 77 37 61 4.5
P* 0.12 0.90 0.89
