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Reframing health disparities in SLE: A critical reassessment of racial and ethnic differences in lupus disease outcomes
Örebro University, School of Medical Sciences. Örebro University Hospital. Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden; Department of Gastroenterology, Dermatology and Rheumatology, Karolinska University Hospital, Stockholm, Sweden; Department of Rheumatology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.ORCID iD: 0000-0002-4875-5395
Genomics of Autoimmune Rheumatic Disease Section, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA.
Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden; Department of Gastroenterology, Dermatology and Rheumatology, Karolinska University Hospital, Stockholm, Sweden.
Division of Rheumatology, Department of Medicine, Hospital for Special, Surgery, New York, NY, USA.
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2024 (English)In: Baillière's Best Practice & Research: Clinical Rheumatology, ISSN 1521-6942, E-ISSN 1532-1770, Vol. 37, no 4, article id 101894Article, review/survey (Refereed) Published
Abstract [en]

Health disparities in the prevalence and outcomes of systemic lupus erythematosus (SLE) are well documented across racial and ethnic groups. Similar to other chronic diseases, differences in disease severity among individuals with SLE are likely influenced by both genetic predisposition and multiple social determinants of health. However, research in SLE that jointly examines the genetic and environmental contributions to the disease course is limited, resulting in an incomplete understanding of the biologic and social mechanisms that underly health disparities. While research on health disparities can reveal inequalities and inform resource allocation to improve outcomes, research that relies on racial and ethnic categories to describe diverse groups of people can pose challenges. Additionally, results from research comparing outcomes across socially constructed groups without considering other contributing factors can be misleading. We herein comprehensively examine existing literature on health disparities in SLE, including both clinical studies that examine the relationship between self-reported race and ethnicity and disease outcomes and studies that explore the relationships between genomics and lupus outcomes. Having surveyed this body of research, we propose a framework for research examining health disparities in SLE, including ways to mitigate bias in future studies.

Place, publisher, year, edition, pages
Elsevier, 2024. Vol. 37, no 4, article id 101894
Keywords [en]
Ancestry, Disparities in health, Ethnicity, Race, Systemic lupus erythematosus
National Category
Clinical Medicine
Identifiers
URN: urn:nbn:se:oru:diva-110083DOI: 10.1016/j.berh.2023.101894ISI: 001339168700001PubMedID: 38057256Scopus ID: 2-s2.0-85179029254OAI: oai:DiVA.org:oru-110083DiVA, id: diva2:1817674
Funder
Swedish Rheumatism Association, R-969696Stiftelsen Konung Gustaf V:s 80-årsfond, FAI-2020-0741Swedish Society of Medicine, SLS-974449Nyckelfonden, OLL-974804Region Stockholm, FoUI-955483Karolinska InstituteNIH (National Institutes of Health), K24 AR074534; P30 AR070155
Note

Funding agencies:

The Swedish Rheumatism Association

King Gustaf V's 80-year Foundation

Swedish Society of Medicine

Nyckelfonden

Professor Nanna Svartz Foundation

Ulla and Roland Gustafsson Foundation

Region Stockholm

Karolinska Institutet

NIH/NIAMS

Available from: 2023-12-07 Created: 2023-12-07 Last updated: 2025-02-18Bibliographically approved

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Parodis, Ioannis

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