Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Pediatric Rheumatology
Published in: Pediatric Rheumatology 1/2017

Open Access 01-12-2017 | Research article

Education and employment in patients with juvenile idiopathic arthritis – a standardized comparison to the German general population

Authors: Jenny Schlichtiger, Johannes-Peter Haas, Swaantje Barth, Betty Bisdorff, Lisa Hager, Hartmut Michels, Boris Hügle, Katja Radon

Published in: Pediatric Rheumatology | Issue 1/2017

Login to get access

Abstract

Background

Although several studies show that JIA-patients have significantly lower employment rates than the general population, the research on educational and occupational attainments in patients with juvenile idiopathic arthritis (JIA) remain conflicting most likely due to small sample sizes. Therefore, aim of this study is to compare the educational achievements and employment status of 3698 JIA-patients with the German general population (GGP).

Methods

“SEPIA” was a large cross-sectional study on the current status of a historic cohort of JIA-patients treated in a single center between 1952 and 2010. For the analyses of education and employment a sub-cohort was extracted, including only adult cases with a confirmed diagnosis of JIA (N = 2696). Participants were asked to fill out a standardized written questionnaire on education and employment. Outcome measures (education/unemployment) were directly standardized to the GGP using data obtained from the National Educational Panel Study 2013 (N = 11,728) and the German Unemployment Statistics 2012 of the Federal Statistical Office (N = 42,791,000).

Results

After age- and sex-standardization, 3% (95% Confidence Interval 1.9 to 4.1%) more of the JIA-patients (26%) than of the GGP (23%) had only reached primary education. In contrast, parents of JIA-patients had similar levels of education as parents in the GGP. With a standardized difference of 0.2% (95% CI: 0.16 to 0.19%), the unemployment rate in JIA-patients was slightly, but not significantly higher than in the GGP. Stratifying for disease duration and the current treatment status, differences were confirmed for persons diagnosed before 2001, whilst for patients diagnosed after 2000, differences were found only in JIA-patients with ongoing disease. Medium and high educational achievements did not differ statistically significant between JIA patients and the GPP.

Conclusion

Educational achievements in German JIA-patients are significantly lower than in the GGP. Furthermore we were able to identify a slightly higher level of unemployment, especially in those with still under treatment and longer disease duration. Better treatment options as well as further development of social support programs might help to overcome this lifelong secondary effect of JIA.
Appendix
Available only for authorised users
Literature
1.
Malviya A, Rushton SP, Foster HE, Ferris CM, Hanson H, Muthumayandi K, et al. The relationships between adult juvenile idiopathic Arthritis and employment. Arthritis Rheum. 2012;64(9):3016–24.CrossRefPubMed
2.
3.
4.
Foster HE, Marshall N, Myers A, Dunkley P, Griffiths ID. Outcome in adults with juvenile idiopathic arthritis: a quality of life study. Arthritis Rheum. 2003;48(3):767–75.CrossRefPubMed
5.
Eisenstein EM, Berkun Y. Diagnosis and classification of juvenile idiopathic arthritis. J Autoimmun. 2014;(48-49):31–3.
6.
Minden K, Niewerth M, Listing J, Mobius D, Thon A, Ganser G, et al. The economic burden of juvenile idiopathic arthritis-results from the German paediatric rheumatologic database. Clin Exp Rheumatol. 2009;27(5):863–9.PubMed
7.
Gerhardt CA, McGoron KD, Vannatta K, McNamara KA, Taylor J, Passo M, et al. Educational and occupational outcomes among young adults with juvenile idiopathic Arthritis. Arthritis Rheumatism Arthritis Care Res. 2008;59(10):1385–91.CrossRef
8.
Packham JC, Hall MA. Long-term follow-up of 246 adults with juvenile idiopathic arthritis: social function, relationships and sexual activity. Rheumatology. 2002;41(12):1440–3.CrossRefPubMed
9.
Minden K, Niewerth M, Listing J, Biedermann T, Bollow M, Schontube M, et al. Long-term outcome in patients with juvenile idiopathic arthritis. Arthritis Rheum. 2002;46(9):2392–401.CrossRefPubMed
10.
Miller JJ 3rd. Psychosocial factors related to rheumatic diseases in childhood. J Rheumatol Suppl. 1993;38:1–11.PubMed
11.
White PH, Shear ES. Transition/job readiness for adolescents with juvenile arthritis and other chronic illness. J Rheumatol Suppl. 1992;33:23–7.PubMed
12.
Archenholtz B, Nordborg E, Bremell T. Lower level of education in young adults with arthritis starting in the early adulthood. Scand J Rheumatol. 2001;30(6):353–5.CrossRefPubMed
13.
Peterson LS, Mason T, Nelson AM, O'Fallon WM, Gabriel SE. Psychosocial outcomes and health status of adults who have had juvenile rheumatoid arthritis - a controlled, population-based study. Arthritis Rheum. 1997;40(12):2235–40.CrossRefPubMed
14.
Flato B, Lien GH, Smerdel A, Vinje O, Dale K, Johnston V, et al. Prognostic factors in juvenile rheumatoid arthritis: a case-control study revealing early predictors and outcome after 14.9 years. J Rheumatol. 2003;30(2):386–93.PubMed
15.
Diaz-Mendoza AC, Modesto Caballero C, Navarro-Cendejas J. Analysis of employment rate and social status in young adults with childhood-onset rheumatic disease in Catalonia. Pediatr Rheumatol Online J. 2015;13:29.CrossRefPubMedPubMedCentral
16.
Jetha A. The impact of arthritis on the early employment experiences of young adults: a literature review. Disabil Health J. 2015;8(3):317–24.CrossRefPubMed
17.
Gerhardt CA, McGoron KD, Vannatta K, McNamara KA, Taylor J, Passo M, et al. Educational and occupational outcomes among young adults with juvenile idiopathic arthritis. Arthritis Rheum. 2008;59(10):1385–91.CrossRefPubMed
18.
Jetha A, Badley E, Beaton D, Fortin PR, Shiff NJ, Gignac MA. Unpacking early work experiences of young adults with rheumatic disease: an examination of absenteeism, job disruptions, and productivity loss. Arthritis Care Res (Hoboken). 2015;67(9):1246–54.CrossRef
19.
Fischer M, Geis W. Bestimmungsgrößen der Bildungsmobilität in Deutschland. IW-Trends : Vierteljahresschrift zur empirischen Wirtschaftsforschung aus dem Institut der Deutschen Wirtschaft Köln. 2013;40(1):3–17.
20.
Duffy CM, Colbert RA, Laxer RM, Schanberg LE, Bowyer SL. Nomenclature and classification in chronic childhood arthritis - time for a change? Arthritis Rheum. 2005;52(2):382–5.CrossRefPubMed
21.
Petty RE, Southwood TR, Manners P, Baum J, Glass DN, Goldenberg J, et al. International league of associations for rheumatology classification of juvenile idiopathic arthritis: second revision, Edmonton, 2001. J Rheumatol. 2004;31(2):390–2.PubMed
22.
Krumrey-Langkammerer M, Hafner R. Evaluation of the ILAR criteria for juvenile idiopathic arthritis. J Rheumatol. 2001;28(11):2544–7.PubMed
23.
Brewer EJ Jr, Bass J, Baum J, Cassidy JT, Fink C, Jacobs J, et al. Current proposed revision of JRA criteria. JRA criteria Subcommittee of the Diagnostic and Therapeutic Criteria Committee of the American rheumatism section of the Arthritis Foundation. Arthritis Rheum. 1977;20(2 Suppl):195–9.PubMed
24.
Wood P. Special meeting on nomenclature and classification of arthritis in children. In: The care of rheumatic children [internet]. Basel: EULAR Publisher; 1978. p. 47–50.
25.
Petty RE. Classification of childhood arthritis: a work in progress. Bailliere Clin Rheum. 1998;12(2):181–90.CrossRef
26.
Weiland SK, Bjorksten B, Brunekreef B, Cookson WO, von Mutius E, Strachan DP. Phase II of the international study of asthma and allergies in childhood (ISAAC II): rationale and methods. Eur Respir J. 2004;24(3):406–12.CrossRefPubMed
27.
28.
Verbraucherschutz BfJu. Verordnung zur Durchführung des § 1 Abs. 1 und 3, des § 30 Abs. 1 und des § 35 Abs. 1 des Bundesversorgungsgesetzes (Versorgungsmedizin-Verordnung - VersMedV) Anlage zu § 2 der Versorgungsmedizin-Verordnung vom 10. Dezember 2008 2008. Available from: http://​www.​gesetze-im-internet.​de/​versmedv/​anlage.​html. Accessed 15 May 2017.
29.
30.
Bildung und Kultur. Allgemeinbildende Schulen. Schuljahr 2014/2015. 2015.
31.
Jöckel K-H, Babitsch B, Bellach B-M, Bloomfield K, Hoffmeyer-Zlotnik J, Winkler J, et al. Messung und Quantifizierung soziodemographischer Merkmale in epidemiologischen Studien. Messung Soziodemographischer Merkmale Epidemiologie RKI-Schriften. 1998;1(1998):7–38.
32.
Blossfeld H-P, von Maurice J. Education as a lifelong process. Z Erziehungswiss. 2011;14(2):19–34.CrossRef
33.
34.
Minden K, Niewerth M, Zink A, Seipelt E, Foeldvari I, Girschick H, et al. Long-term outcome of patients with JIA treated with etanercept, results of the biologic register JuMBO. Rheumatology. 2012;51(8):1407–15.CrossRefPubMed
35.
Horneff G, Forster J, Seyberth HW, Michels H, Arbeitgemeinschaft Kinder- und J. Recommendations by the pediatric and adolescent rheumatology study committee on therapy with Etanercept (p75 TNF-alpha receptor immunoglobulin fusion protein. Pharmacotherapy committee Z Rheumatol 2000;59(6):365-9.
36.
Hashkes PJ, Uziel Y, Laxer RM. The safety profile of biologic therapies for juvenile idiopathic arthritis. Nat Rev Rheumatol. 2010;6(10):561–71.CrossRefPubMed
37.
Klein A, Horneff G. Treatment strategies for juvenile idiopathic arthritis. Expert Opin Pharmacother. 2009;10(18):3049–60.CrossRefPubMed
38.
Curtin LR, Klein RJ, Statistics NCfH. Direct standardization (age-adjusted death rates). Hyattsville: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Center for Health Statistics; 1995.
39.
40.
41.
42.
Sturge C, Garralda M, Boissin M, Dore C, Woo P. School attendance and juvenile chronic arthritis. Br J Rheumatol. 1997;36(11):1218–23.CrossRefPubMed
43.
44.
Moonie S, Sterling D, Figgs L, Castro M. The relationship between school absence, academic performance, and asthma status. J Sch Health. 2008;78(3):140–8.CrossRefPubMed
45.
Hugle B, Haas JP, Benseler SM. Treatment preferences in juvenile idiopathic arthritis - a comparative analysis in two health care systems. Pediatr Rheumatol Online J. 2013;11(1):3.CrossRefPubMedPubMedCentral
46.
47.
48.
49.
50.
51.
Davies R, Gaynor D, Hyrich KL, Pain CE. Efficacy of biologic therapy across individual juvenile idiopathic arthritis subtypes: a systematic review. Semin Arthritis Rheum. 2016;
52.
53.
Sonne-Holm S, Sorensen TI, Jensen G, Schnohr P. Influence of fatness, intelligence, education and sociodemographic factors on response rate in a health survey. J Epidemiol Community Health. 1989;43(4):369–74.CrossRefPubMedPubMedCentral
54.
Korkeila K, Suominen S, Ahvenainen J, Ojanlatva A, Rautava P, Helenius H, et al. Non-response and related factors in a nation-wide health survey. Eur J Epidemiol. 2001;17(11):991–9.CrossRefPubMed
55.
Langhammer A, Krokstad S, Romundstad P, Heggland J, Holmen J. The HUNT study: participation is associated with survival and depends on socioeconomic status, diseases and symptoms. BMC Med Res Methodol. 2012;12:143.CrossRefPubMedPubMedCentral
Metadata
Title
Education and employment in patients with juvenile idiopathic arthritis – a standardized comparison to the German general population
Authors
Jenny Schlichtiger
Johannes-Peter Haas
Swaantje Barth
Betty Bisdorff
Lisa Hager
Hartmut Michels
Boris Hügle
Katja Radon
Publication date
01-12-2017
Publisher
BioMed Central
Published in
Pediatric Rheumatology / Issue 1/2017
Electronic ISSN: 1546-0096
DOI
https://doi.org/10.1186/s12969-017-0172-2

Other articles of this Issue 1/2017

Pediatric Rheumatology 1/2017 Go to the issue

Research article

Patients with juvenile idiopathic arthritis in clinical remission with positive power Doppler signal in joint ultrasonography have an increased rate of clinical flare: a prospective study

Research article

ASAS definition for sacroiliitis on MRI in SpA: applicable to children?

Research article

Cross sectional, qualitative thematic analysis of patient perspectives of disease impact in juvenile idiopathic arthritis-associated uveitis

Research article

A systematic review of psychosocial therapies for children with rheumatic diseases

Research article

Clinical study of children with Takayasu arteritis: a retrospective study from a single center in China

Case report

Munchausen by proxy syndrome mimicking systemic autoinflammatory disease: case report and review of the literature