Rheumatoid arthritis patients with lower socioeconomic statuses are more depressed and have more severe depression symptoms than people with higher socioeconomic statuses, according to a study in the February 2011 issue of Arthritis Care & Research.

“If two patients have the same amount of functional limitation [for instance, difficulty tying their shoes or combing their hair] but one patient is less educated and has less income, that patient will have more depression than another patient that has higher socioeconomic factors,” explains lead study author Mary Margaretten, MD, an assistant professor of medicine in the division of rheumatology at the University of California, San Francisco.

Researchers analyzed data from more than 800 medical appointments involving 466 patients. About half went to an urban county public hospital, while the other half went to a university medical center. The same doctors treated patients at both sites and all patients filled out questionnaires that assessed their levels of depression.

Compared with patients who went to the university medical center, patients at the public hospital had less education, lower household incomes, less access to health care and were more likely to be female, immigrants and not Caucasian. They had higher levels of disease activity, needed more treatment and had higher depression scores.

“It’s not just that socioeconomic status and disability leads to depression. It’s the combination of the two,” Dr. Margaretten says.

Researchers can’t say why for sure, but they suspect it’s because those with lower socioeconomic status don’t have the same kinds of support or access to care as those with higher socioeconomic status.