Objective: To determine the associations between place of residence and sex-specific prevalence rates of radiographic hip and knee osteoarthritis (OA).
Methods: We used data from the first National Health and Nutrition Examination Survey (NHANES I), 1971-1975, to calculate and compare sex-specific prevalence rates for radiographic hip and knee OA in urban and rural areas; standard metropolitan statistical areas (SMSAs) and non-SMSAs; other urban-rural subtypes that we defined; and major geographic regions of the United States. We used logistic regression to estimate crude and adjusted odds ratios for the associations between place of residence and radiographic hip and knee OA.
Results: We found no significant differences in the prevalence rates of hip or knee OA by place of residence for either men or women. After adjusting for age, race, and body mass index, we found a nonsignificant 40-50% increase in the odds of radiographic hip OA among men living in rural areas and non-SMSAs; no such increase was seen among women. No increased odds of knee OA were noted for subjects of either sex living in rural areas or non-SMSAs.
Conclusion: In the NHANES I population, rural and non-SMSAs residence may be modestly associated with radiographic hip OA for men. Place of residence does not appear to be associated with radiographic hip OA among women or with radiographic knee OA in either sex.