Update on lupus epidemiology: advancing health disparities research through the study of minority populations

Abstract

Purpose of reviewThe current review focuses on recent population-based studies that have examined the burden of lupus, disease outcomes, and gaps in quality of care, with an emphasis in research addressing health disparities.Recent findingsThe Centers for Disease Control and Prevention National Lupus Registries underscored higher susceptibility of both systemic lupus erythematosus (SLE) and primary cutaneous lupus among people of color, compared with whites. Not only does SLE disproportionately strike people from racial and ethnic minorities, those individuals are also at increased risk of developing severe manifestations following SLE diagnosis. Mortality is higher and death occurs at a younger age among blacks, compared with whites. Furthermore, ongoing Centers for Disease Control and Prevention-supported population-based lupus cohorts, along with research by other groups, have provided new insight into the role of social determinants on outcomes and opportunities to improve care in diverse lupus populations.SummaryWhile descriptive epidemiological efforts have been critical to providing more accurate estimates of the burden and mortality of lupus across diverse demographic groups, emerging research suggests a significant influence of psychosocial and healthcare system factors on disease outcomes. These current efforts represent important steps toward the development of clinical and public health interventions aimed at eliminating health disparities in lupus populations.

Principles of pediatric lupus nephritis in a prospective contemporary multi-center cohort

“…In the United States, studies have shown that Black patients with SLE, regardless of age at diagnosis, more frequently have kidney involvement, higher disease activity, and higher risk for progression to ESKD. [30][31][32][33][34] Research is still ongoing to determine whether outcome disparities are due to more aggressive disease, genetic disposition, socio-economic causes, systemic racism and unequal access to health care, or a combination of these factors. 30 In this study, kidney function from baseline to the latest follow-up and achievement of remission were assessed as short-term outcomes.…”

Prevalence of Systemic Lupus Erythematosus in the United States: Estimates From a Meta‐Analysis of the Centers for Disease Control and Prevention National Lupus Registries

“…Previous estimates of the rates of SLE in the US have been predominantly derived from tertiary care settings and relatively small, homogeneous patient populations, for which limited data are available on key demographic groups in the US (1). Other explanations for the varied estimates, which range from 19 to 241 per 100,000, include racial/ethnic disparities in SLE susceptibility and mortality, differing case definitions, heterogeneous sources for case ascertainment, small populations, possible inaccuracy of self‐report, unreliability in coding in health system databases, and variable access to health care for high‐risk populations (2,3).…”

Systemic Lupus Erythematosus Presenting as Pulmonary Embolism After Liposuction: A Clinical Conundrum

“…Patients with SLE have a 2.2 to 3.3 times higher relative risk of death than the general population [ 5 ]. The pathogenesis of the disease is still under investigation but revolves around abnormalities in innate and acquired immunity [ 6 ].…”