Background/Purpose: Musculoskeletal conditions, including osteoarthritis (OA), osteoporosis (OP), rheumatoid arthritis (RA), and chronic pain, significantly burden individuals’ health and well-being. These conditions often lead to physical disabilities, reduced quality of life, and substantial healthcare costs. Despite their prevalence and impact, individuals with these conditions frequently face healthcare discrimination, exacerbating their conditions and hindering access to appropriate care. This study aims to understand the extent and nature of health discrimination among those with musculoskeletal conditions using a retrospective cross-sectional design focused on secondary data analysis from a 2022 community survey conducted by Hospital for Special Surgery (HSS).

Methods: The study sample comprises 18,248 participants >18 years, residing in New York, New Jersey and Florida. The research aimed to assess if there is a difference in the perceived level of healthcare discrimination experienced by individuals with OA, RA, chronic pain, and OP compared to those without these conditions. A multivariable linear regression was employed to analyze the relationship between perceived discrimination (dependent variable) and multiple independent variables, including the presence of OA, RA, OP, chronic pain, and demographic factors. Statistical significance was assessed using a two-sided test with a p-value threshold of < 0.05. Data were analyzed using SPSS.

Results: The analysis revealed significant associations between perceived healthcare discrimination and musculoskeletal conditions. OA was associated with a slight increase in perceived discrimination (OR: 1.04, p=0.140), while RA showed a statistically significant effect (OR: 1.39, p< 0.001). OP was also significant (OR: 1.13, p=0.002), and chronic pain had the highest association (OR: 1.36, p< 0.001). Age negatively correlated with perceived discrimination (OR: 0.97, p< 0.001), indicating younger individuals reported higher discrimination. Gender was positively associated (OR: 1.07, p=0.003), and being Hispanic was linked to lower perceived discrimination (OR: 0.82, p< 0.001). Race also influenced outcomes, with non-White individuals reporting lower discrimination (OR: 0.95, p< 0.001).

Conclusion: The findings reveal that patients with RA and chronic pain experience higher levels of perceived healthcare discrimination compared to those without these conditions. OP was also significantly associated with higher perceived discrimination, though to a lesser extent. Age, gender, and ethnicity also play crucial roles, indicating that younger patients and females feel more discriminated against. These results align with existing literature indicating that patients with musculoskeletal conditions often face biases and stigmatization, which can hinder their access to appropriate care and exacerbate their health issues. The study emphasizes the need for targeted interventions to address these disparities. Improving provider awareness and enhancing training programs are crucial steps toward reducing discrimination and ensuring equitable care for all patients, particularly those with chronic musculoskeletal conditions.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/perceived-healthcare-discrimination-among-individuals-with-musculoskeletal-conditions-a-retrospective-cross-sectional-analysis/