Health care expenditures in the US reached $1.877 trillion in 2004, or 15% of the country's gross domestic product. On a per-capita basis, the US spent $5,635 on health care in 2003, more than any other nation (1). Despite these figures, some groups in the population receive less health care and have worse health than others. Members of racial and ethnic minority groups are especially likely to be underserved (1). In addition, there are important differences in the use of health services on the basis of sex, social class, and geographic location (1). Disparities in arthritis care have also been documented (2). Among individuals with chronic joint symptoms, men, people with a high school education or less, those without health insurance, and Hispanics are all less likely to have seen a health care provider for the joint symptoms (2). Other types of disparities in the rheumatic diseases have also been noted. Some of these will be discussed below.
Part of this issue of Arthritis Care & Research is dedicated to health disparities in the rheumatic diseases. Eight articles submitted in response to a call for manuscripts are published in this issue. The articles cover various aspects of health disparities, ranging from disparities in disease onset and clinical expression to disparities in treatment. Before discussing these articles, it will help to review some important definitions.