Acknowledgments The authors would like to thank all those involved in the EpiFunD study for their role in collecting the data used in this study, particularly the principal investigators Gary Macfarlane (University of Aberdeen) and John McBeth (Keele University, and the University of Manchester) who allowed use of the EpiFunD dataset. The EpiFunD study was funded by Arthritis Research UK (formerly the Arthritis Research Campaign), Grant Number: 17552.Peer reviewedPostprin