How Ethnicity Affects Osteoarthritis

Physical therapist working on a man's leg

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Depending on your ethnicity, you may be more likely to develop osteoarthritis, according to new study results. Risk factors for osteoarthritis are more common among certain ethnic groups.

Women's Health Initiative Sheds Light on Ethnicity

Older African-American, Native American (or American Indian), and non-white Hispanic women are more likely to develop osteoarthritis than white women, according to results from a group of postmenopausal women participating in a study, known as the Women's Health Initiative. Based on answers to a questionnaire, 44% of the women reported they had been diagnosed with osteoarthritis (referred to as self-reported osteoarthritis).

Two other risk factors for osteoarthritis, older age and higher body mass index (BMI), were strongly associated with self-reported osteoarthritis in the study.

The prevalence of obesity (defined as BMI greater than or equal to 30) and osteoarthritis was:

  • 57.9% for African-Americans
  • 51% for American Indians
  • 41.9% for Hispanic whites
  • 32.9% for non-Hispanic whites

Non-Hispanic white women who fit into the extremely obese category (BMI greater than or equal to 40) had 2.8 times greater risk of self-reported osteoarthritis. But even greater odds were found in extremely obese American Indians (4.22 times greater odds) and extremely obese African-American women (3.31) which shows there's a clear connection between BMI and ethnicity for the risk of developing osteoarthritis.

Even among younger women, those in their 50s, osteoarthritis prevalence varied with ethnicity:

  • 39.3% for Hispanic whites
  • 36.4% for American Indians
  • 33.8% for African-Americans
  • 25.8% for Asians
  • 22.6% for non-Hispanic whites

Other osteoarthritis risk factors, such as physical inactivity, showed a similar pattern of higher prevalence among ethnic groups. These data support the need to focus on maintaining a healthy weight and participate in regular physical activity.

Ethnicity Tied to Specific Types of Osteoarthritis

In the United States, the risk for different types of osteoarthritis has been found to differ among racial groups.

Knee osteoarthritis is more common and causes more pain and physical limitations for African-Americans than non-Hispanic whites; hand and hip osteoarthritis are less common among Chinese individuals than non-Hispanic whites. For women, knee osteoarthritis is more common in Chinese than non-Hispanic whites.

Genetic differences in joint structure may account for some differences found among ethnic groups.

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  1. Wright NC, Riggs GK, Lisse JR, Chen Z. Self-reported osteoarthritis, ethnicity, body mass index, and other associated risk factors in postmenopausal women-results from the Women's Health Initiative. J Am Geriatr Soc. 2008;56(9):1736-43. doi:10.1111/j.1532-5415.2008.01812.x

  2. Centers for Disease Control and Prevention. Defining adult overweight and obesity. Updated April 3, 2020.

  3. Allen KD. Racial and ethnic disparities in osteoarthritis phenotypesCurr Opin Rheumatol. 2010;22(5):528-532. doi:10.1097/BOR.0b013e32833b1b6f