| Title: | Association of Socioeconomic Status and Health Lifestyles with Incident Early-onset and Late-onset Rheumatoid Arthritis: A Prospective Cohort Study in the UK |
| Journal: | Asian Journal of Social Health and Behavior |
| Published: | 10 Aug 2026 |
| DOI: | https://doi.org/10.4103/shb.shb_477_25 |
Publication 21191
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Abstract
Abstract Introduction: Socioeconomic status (SES) and lifestyle behaviors are recognized determinants of chronic disease risk, but their relative contributions to early-onset and late-onset rheumatoid arthritis (RA) remain uncertain. Methods: This cohort study comprised 35,360 participants from the UK Biobank. SES was derived from education, income, and employment using latent class analysis, and lifestyle was assessed through a four-component score (smoking, alcohol, physical activity, and diet). Incident RA was identified through hospital and mortality records. Cox models estimated hazard ratios (HRs) for early-onset (<65 years) and late-onset (≥65 years) RA, with subgroup and sensitivity analyses performed to test robustness. Results: During follow-up, 997 incident RA cases were identified (318 early-onset, 679 late-onset). Lower SES was strongly associated with a higher risk of RA in both groups, with a greater relative effect in early-onset disease (low vs. high SES, HR: 2.31, 95% confidence interval [CI]: 1.66-3.22) than in late-onset disease (HR: 1.99, 95% CI: 1.63-2.43). A healthy lifestyle was associated with reduced RA risk, particularly in late-onset RA (HR: 0.62, 95% CI: 0.50-0.75 for lifestyle score 3-4 vs. 0-1), while the effect was more modest in early-onset RA (HR: 0.74, 95% CI: 0.55-0.98). Joint analyses showed the highest risks among individuals with both low SES and poor lifestyle, with HRs of 3.42 (95% CI: 1.93-6.07) for early-onset and 3.24 (95% CI: 2.29-4.60) for late-onset RA. Conclusion: Socioeconomic disadvantage is a predominant driver of early-onset RA, whereas lifestyle factors are more influential for late-onset disease. Healthy lifestyles can attenuate but not fully offset the risk associated with low SES. </p>
5 Authors
- Chenye Jin
- Siying Liu
- Bingxin You
- Zhifeng Wen
- Yongze Li
1 Application
| Application ID | Title |
|---|---|
| 206612 | Social, Economic, Lifestyle, and Environmental Factors in the Early and Late Onset of Chronic Non-Communicable Diseases |
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