ArticleRMD open2026
Sustained exposure to low- and high-income status and risk of all-cause mortality in individuals with rheumatoid arthritis: a population-based retrospective cohort study from 2010 to 2020.
Article in RMD open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveAlthough socioeconomic status has been linked to various rheumatoid arthritis (RA)-related outcomes, evidence on the association of sustained income status with mortality among patients with RA remains limited.
methodsWe followed a nationally representative cohort of 50 600 Korean adults aged ≥40 years newly diagnosed with RA between 2010 and 2017 through 31 December 2020. Income status, based on monthly health insurance premiums, was tracked over the 5-year period preceding diagnosis. Primary exposure included the cumulative years in a low- or high-income status. The outcome was all-cause mortality. Cox proportional hazards models were used to estimate HRs after adjusting for sociodemographic, behavioural and clinical covariates. We conducted a comprehensive stratified analysis using a range of relevant factors.
resultsSustained low-income status was significantly associated with increased mortality in a dose-response manner among patients aged <65 years, even after adjusting for income status at diagnosis (p for trend=0.011 vs 0.374 in older patients). Sustained high-income status was associated with reduced mortality in both age groups, with a stronger association observed in younger patients (adjusted HR (95% CI) for 5-year high-income exposure: 0.50 (0.38-0.64) in patients aged <65 years versus 0.74 (0.62-0.88) in patients ≥65 years). Rural residence further amplified the adverse effects of prolonged low-income exposure.
conclusionsPersistent low-income status increases mortality risk among younger patients with RA, a group often overlooked by policy interventions. Policies that address the sustained economic disadvantages beyond short-term assistance are required.
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