The Rheumatologist
COVID-19 NewsACR Convergence
  • Connect with us:
  • Facebook
  • Twitter
  • LinkedIn
  • YouTube
  • Feed
  • Home
  • Conditions
    • Rheumatoid Arthritis
    • SLE (Lupus)
    • Crystal Arthritis
      • Gout Resource Center
    • Spondyloarthritis
    • Osteoarthritis
    • Soft Tissue Pain
    • Scleroderma
    • Vasculitis
    • Systemic Inflammatory Syndromes
    • Guidelines
  • Resource Centers
    • Axial Spondyloarthritis Resource Center
    • Gout Resource Center
    • Psoriatic Arthritis Resource Center
    • Rheumatoid Arthritis Resource Center
    • Systemic Lupus Erythematosus Resource Center
  • Drug Updates
    • Biologics & Biosimilars
    • DMARDs & Immunosuppressives
    • Topical Drugs
    • Analgesics
    • Safety
    • Pharma Co. News
  • Professional Topics
    • Ethics
    • Legal
    • Legislation & Advocacy
    • Career Development
      • Certification
      • Education & Training
    • Awards
    • Profiles
    • President’s Perspective
    • Rheuminations
    • Interprofessional Perspective
  • Practice Management
    • Billing/Coding
    • Quality Assurance/Improvement
    • Workforce
    • Facility
    • Patient Perspective
    • Electronic Health Records
    • Apps
    • Information Technology
    • From the College
    • Multimedia
      • Audio
      • Video
  • Resources
    • Issue Archives
    • ACR Convergence
      • Gout Resource Center
      • Axial Spondyloarthritis Resource Center
      • Psoriatic Arthritis
      • Abstracts
      • Meeting Reports
      • ACR Convergence Home
    • American College of Rheumatology
    • ACR ExamRheum
    • Research Reviews
    • ACR Journals
      • Arthritis & Rheumatology
      • Arthritis Care & Research
      • ACR Open Rheumatology
    • Rheumatology Image Library
    • Treatment Guidelines
    • Rheumatology Research Foundation
    • Events
  • About Us
    • Mission/Vision
    • Meet the Authors
    • Meet the Editors
    • Contribute to The Rheumatologist
    • Subscription
    • Contact
  • Advertise
  • Search
You are here: Home / Articles / A Window into Health Disparities

A Window into Health Disparities

October 7, 2011 • By Edward H. Yelin, PhD, MCP

  • Tweet
  • Email
Print-Friendly Version / Save PDF

What, aside from access to good healthcare, could account for the impact of race/ethnicity and low socioeconomic status on outcomes? Having more stressful living conditions and fewer resources to deal with the stress may play a role. Like many autoimmune conditions, stress may increase disease activity and prolong flares in SLE; one source of stress may be not having any employment or having only marginal and episodic work. Persons with lower levels of education may also have a more difficult time managing the disease through a combination of self-management and gaining access to patient groups and to more experienced healthcare providers.

You Might Also Like
  • Racial Disparities Result in Unprecedented Differences in Outcomes for SLE Patients
  • To Bridge Health Disparities, Diagnose Lupus Early & Improve Access
  • The Lupus Initiative Launches Cohorts & Partnerships to Reduce Health Disparities & Improve Outcomes
Explore This Issue
October 2011

One study points to a mechanism to explain how poverty affects outcomes. That study demonstrated separate effects of being in poverty oneself and of living in areas of concentrated poverty (typically ghettos) on a range of lupus measures, including activity, symptoms, functional status, and depression. The combined effect of being poor and living in an area of concentrated poverty profoundly increased depression rates among persons with SLE.1 This suggests a model of “stress overload” of having few personal resources in a situation with SLE that demands many, while also living in communities in which the ambient stress level is high and resources, including healthcare providers, few.

ad goes here:advert-1
ADVERTISEMENT
SCROLL TO CONTINUE

Recently, an article appeared describing the ideal features of healthcare for persons with conditions like SLE that are complex, chronic, and have diverse comorbidities. The authors state that in the current system, “Treatment burdens are often imposed on patients with little coordination between, or even within, clinics dealing with different conditions and little explicit recognition that treatment regimens are demanding in time and effort.”2 The effects are likely to be heightened for persons with limited capacity due to background and/or compromised cognitive function, especially with respect to coordination of care among providers. It is also clear that the transition from pediatric to adult care is often difficult both because young adults do not generally have to focus on organizing their own care and because many this age do not have access to health insurance.

The care for disadvantaged persons with SLE may be the best example of how healthcare often fails the vulnerable in society. There is much evidence that outcomes are better for hospitals, clinics, and individual physicians with more experience in caring for this condition, but for many reasons the disadvantaged may not have good access to these providers. The disadvantaged with SLE are also disproportionately covered by Medicaid, but many providers do not accept Medicaid patients, forcing such persons to travel long distances for care. Some studies indicate that where one lives affects the kinds and amounts of healthcare received for SLE; many if not most of the disadvantaged live in communities without experienced providers. Even among the privately insured, there may be access problems as certain kinds of managed care plans limit healthcare to small panels of providers without needed expertise in SLE care. Some providers may exacerbate the difficulties faced by persons with SLE trying to organize their care because of communication styles that do not take into account their literacy levels or their ability to comprehend information given impairment in cognitive function. Language differences between patients and physicians may exacerbate the communication issues.

ad goes here:advert-2
ADVERTISEMENT
SCROLL TO CONTINUE

Pages: 1 2 3 4 | Single Page

Filed Under: Conditions, SLE (Lupus) Tagged With: disparity, ethnicity, Lupus, patient care, race, SLEIssue: October 2011

You Might Also Like:
  • Racial Disparities Result in Unprecedented Differences in Outcomes for SLE Patients
  • To Bridge Health Disparities, Diagnose Lupus Early & Improve Access
  • The Lupus Initiative Launches Cohorts & Partnerships to Reduce Health Disparities & Improve Outcomes
  • Racial Disparities in Rheumatology: What Are We Doing About It?

Simple Tasks

Learn more about the ACR’s public awareness campaign and how you can get involved. Help increase visibility of rheumatic diseases and decrease the number of people left untreated.

Visit the Simple Tasks site »

Meeting Abstracts

Browse and search abstracts from the ACR Convergence and ACR/ARP Annual Meetings going back to 2012.

Visit the Abstracts site »

ACR Convergence

Don’t miss rheumatology’s premier scientific meeting for anyone involved in research or the delivery of rheumatologic care or services.

Visit the ACR Convergence site »

The Rheumatologist newsmagazine reports on issues and trends in the management and treatment of rheumatic diseases. The Rheumatologist reaches 11,500 rheumatologists, internists, orthopedic surgeons, nurse practitioners, physician assistants, nurses, and other healthcare professionals who practice, research, or teach in the field of rheumatology.

About Us / Contact Us / Advertise / Privacy Policy / Terms of Use / Cookie Preferences

  • Connect with us:
  • Facebook
  • Twitter
  • LinkedIn
  • YouTube
  • Feed

Copyright © 2006–2023 American College of Rheumatology. All rights reserved.

ISSN 1931-3268 (print)
ISSN 1931-3209 (online)