Abstract

INTRODUCTION: Austria, a country with a high standard of living and a well-developed healthcare system, still experiences socioeconomic status (SES) disparities that impact health outcomes. Rheumatoid arthritis (RA) is a chronic autoimmune disease associated with significant disability and comorbidities. While SES has been linked to RA prevalence and disease severity, its role in a high-income country like Austria remains underexplored. This study investigates the association between SES factors-education, income, employment status and migration background-and RA prevalence and outcomes.

METHODS: This population-based study used data from the Paracelsus 10,000 cohort in Salzburg, Austria and a cross-sectional design. A total of 9,256 participants aged 40-77 years were analyzed, including 289 individuals diagnosed with RA based on the ACR/EULAR classification criteria. SES was assessed through self-reported education, income, employment status and country of birth. Logistic regression models were used to evaluate the association between SES and RA, adjusting for age, sex, metabolic syndrome, smoking and alcohol consumption.

RESULTS: RA prevalence was significantly lower among individuals with higher education (OR = 0.55, 95% CI: 0.37-0.82 for medium education; OR = 0.41, 95% CI: 0.25-0.68 for high education). Lower household income correlated with higher RA prevalence. Employment disparities were evident, with RA patients exhibiting higher rates of unemployment and work disability.

CONCLUSION: Despite Austria's high standard of living, SES remains a key determinant of RA prevalence. Lower levels of education, income and employment are associated with higher rates of RA, highlighting the need for targeted public health interventions. Strengthening healthcare access, promoting early screening and offering economic support to vulnerable groups could be important steps toward reducing these disparities. Further research should explore the underlying mechanisms of this association and examine whether socioeconomic disparities also influence disease progression and patient outcomes.