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Work Disability in Rheumatoid Arthritis: Effects of Disease, Social, and Work Factors

EDWARD YELIN, Ph.D.; ROBERT MEENAN, M.D.; MICHAEL NEVITT, M.A., M.C.P.; and WALLACE EPSTEIN, M.D.
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Grant support: in part by the Robert Wood Johnson Foundation, Princeton, New Jersey; Multipurpose Arthritis Center Grant Numbers AM-20684 and AM-20613 from the National Institute of Arthritis, Metabolism, and Digestive Diseases; Dissertation Grant Number 90-A1200(01) from the Administration on Aging; and The American Rheumatism Association Medical Information System. The opinions, conclusions, and proposals in the text do not necessarily represent the views of the funding agencies.

▸Requests for reprints should be addressed to Edward Yelin, Ph.D.; University of California School of Medicine, 350 Parnassus Avenue, Suite 407; San Francisco, CA 94117.


San Francisco and Berkeley, California; Boston, Massachusetts


© 1980 American College of PhysiciansAmerican College of Physicians


Ann Intern Med. 1980;93(4):551-556. doi:10.7326/0003-4819-93-4-551
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We explore here the relative contribution of selected disease, social, and work-related factors to disability status in a population of persons with rheumatoid arthritis. Our study differs from previous studies in that it is limited to one diagnostic entity, yet at the same time evaluates a broad range of social and work-related factors in disability. One hundred-eighty persons with rheumatoid arthritis sampled from 19 socially diverse practice settings were given a structured survey about their medical and work histories and social backgrounds. We found significant effects of stage and duration of illness on continued employment but no positive effect of selected therapies. Social and work factors combined had a far larger effect on work disability than all disease factors. Among work factors, control over the pace and activities of work and self-employment status had the greatest effect on continued employment, suggesting that time control issues are crucial to the maintenance of one's job after onset of this illness.

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