Perceptions of Multiple Sclerosis in Hispanic Americans

Obiwuru, Ozioma; Joseph, Sarah; Liu, Lihua; Palomeque, Ana; Tarlow, L S; Langer‐Gould, Annette; Amezcua, Lilyana

doi:10.7224/1537-2073.2015-081

Cited by 16 publications

(11 citation statements)

References 32 publications

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“…We found 10 studies supporting that SDOH disproportionately impacts Black and Hispanic and Latinx patients in MS outcomes, health care utilization, health behaviors, and lived experience with MS (Table 2; Figure 1B). We found no studies specific to SDOH that pertained to social and community context.…”

Section: Methodsmentioning

confidence: 75%

Health Disparities, Inequities, and Social Determinants of Health in Multiple Sclerosis and Related Disorders in the US

et al. 2021

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he COVID-19 pandemic has exposed racial and ethnic health disparities, inequities, and systemic racism in neurology. 1 Health disparities are negative differences in health that are associated with social, economic, and environmental disadvantages. Inequities are differences in access to or availability of facilities and services that are considered modifiable and associated with social disadvantage. Social determinants of health (SDOH) are conditions in which people are born, grow, live, work, and age that adversely affect health (Figure 1). 2 In many cases, SDOH are unevenly distributed and are shaped by the distribution of power, money, and resources (Figure 2). 2-4 Recently, the negative health impact of systematic racism in the US 5 has come to the forefront.Central nervous system immune-mediated diseases like multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD) start in early adulthood, carry a high risk of disability, and disproportionately affect Black 6,7 and Hispanic and Latinx 7 individuals. Myelin oligodendrocyte glycoprotein antibody (MOG-Ab)associated disease is a rare central nervous system inflammatory dis-order accounting for up to 42% of patients with NMOSD. 8 These conditions are expected to increase in Black and Hispanic and Latinx individuals as the US population grows. It is thus crucial to consider the disadvantages these populations face in achieving health equity. This review provides a contemporary synthesis of evidence examining health disparities, inequities, and SDOH in US Black and Hispanic and Latinx patients with MS, NMOSD, and MOG-Ab disorders. MethodsWe searched PubMed, MEDLINE, and EMBASE with medical subject heading terms race OR ethnicity OR minorities OR African/ African American/Black OR Hispanic/Latin/Latin American/Latinx OR Asian AND disparities OR inequality OR inequity OR social determinants of health AND (1) multiple sclerosis OR (2) neuromyelitis optica spectrum disorder/neuromyelitis optica OR NMOSD/NMO (3) Myelin oligodendrocyte glycoprotein antibody OR MOG/ IMPORTANCE There is empirical evidence that social determinants of health (SDOH) impact health outcomes in Black and Hispanic and Latinx individuals in the US. Recently, SDOH have risen to the top as essential intervention targets that could help alleviate racial and ethnic disparities. Neuromyelitis optica spectrum disorder (NMOSD) disproportionately affects Black individuals, and multiple sclerosis (MS) has seen a recent shift in select racial groups. It is unclear to what degree SDOH have been investigated and contribute to racial and ethnic health disparities and inequities.OBSERVATIONS This narrative review provides a contemporary synthesis of SDOH associated with racial and ethnic health disparities and inequities in MS, NMOSD, and other autoimmune disorders, such as myelin oligodendrocyte glycoprotein antibody (MOG-Ab)-associated disease. These immune-mediated neurological diseases were chosen for their capacity to be a high burden to society and because of complementary SDOH-associa...

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Section: Methodsmentioning

confidence: 75%

Health Disparities, Inequities, and Social Determinants of Health in Multiple Sclerosis and Related Disorders in the US

et al. 2021

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“…There is evidence supporting health literacy problems when it comes to MS-related disease modifying treatments and their realistic expectations, 39 poor access to specialty care, and illness perceptions affecting self-care. 40,41 Analysis of individuals with MS using the Independence Care System, a Medicaid long-term managed care plan in New York, found several deficiencies in the care of low-income minorities with MS where 30% had never seen an MS specialist and another 30% were not taking disease modifying treatments due to poor compliance and understanding of the drug. 39 Similar access problems were recently reported using a nationally representative dataset from the 2006–2013 Medical Expenditure Panel Survey where both blacks and Hispanics with MS were less likely to see a neurologist compared to whites (30% and 40% less, respectively).…”

Section: Disparities In Health Outcomesmentioning

confidence: 99%

Race and ethnicity on MS presentation and disease course

Amezcua

McCauley

2020

Mult Scler

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Multiple sclerosis (MS) has a strong racial and ethnic component and disproportionately affects whites of European background. Recent incidence reports suggest an increasing rate of MS among African Americans compared with whites. Despite this recent increase in MS in African Americans, Hispanics and Asians are significantly less likely to develop MS than whites of European ancestry. MS-specific mortality trends demonstrate distinctive disparities by race/ethnicity and age, suggesting that there is an unequal burden of disease. Inequalities in health along with differences in clinical characteristics that may be genetic, environmental, and social in origin may be contributing to disease variability and be suggestive of endophenotypes. The overarching goal of this review was to summarize the current understanding on the variability of disease that we observe in selected racial and ethnic populations: Hispanics and African Americans. Future challenges will be to unravel the genetic, environmental, and social determinants of the observed racial/ethnic disparities.

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“…Hispanic culture is characterized by strong values attached to family and cultural health beliefs. 94 , 95 While limited, a qualitative study using focus group responses and direct inquiries ( n = 106) 96 participants reported MS to be caused by an environmental encounter such as stress (44%) with stress being significantly more common in individuals who were US born compared to immigrant Hispanics (81% vs. 60%, p = 0.01). Sociocultural factors identified included cultural idioms such as fright ( susto ), or sadness ( tristeza ), which significantly were more common in individuals who were immigrants compared to US born (30% vs 9%, p = 0.04).…”

Section: Potential Risk Factors In Hispanics With Msmentioning

confidence: 99%

MS in self-identified Hispanic/Latino individuals living in the US

Amezcua

Oksenberg

McCauley

2017

Multiple Sclerosis Journal - Experimental, Translational and Cl

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Self-identified Hispanic/Latino individuals living with multiple sclerosis (MS) in the continental United States (US) are a diverse group that represents different cultural and ancestral backgrounds. A marked variability in the way MS affects various subgroups of Hispanics in the US has been observed. We reviewed and synthesized available data about MS in Hispanics in the US. There are likely a host of multifactorial elements contributing to these observations that could be explained by genetic, environmental, and social underpinnings. Barriers to adequate MS care in Hispanics are likely to include delivery of culturally competent care and social and economic disadvantages. Considerable efforts, including the formation of a national consortium known as the Alliance for Research in Hispanic Multiple Sclerosis (ARHMS), are underway to help further explore these various factors.

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Perceptions of Multiple Sclerosis in Hispanic Americans

Cited by 16 publications

References 32 publications

Health Disparities, Inequities, and Social Determinants of Health in Multiple Sclerosis and Related Disorders in the US

Health Disparities, Inequities, and Social Determinants of Health in Multiple Sclerosis and Related Disorders in the US

Race and ethnicity on MS presentation and disease course

MS in self-identified Hispanic/Latino individuals living in the US

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