Social determinants of health and disparate disability accumulation in a cohort of Black, Hispanic, and White patients with multiple sclerosis.
Social determinants of health and disparate disability accumulation in a cohort of Black, Hispanic, and White patients with multiple sclerosis.
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DOI：
10.1177/13524585231185046
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发表时间：
2023-09
影响因子：
5.8
通讯作者：
Lincoln, John A.
中科院分区：
文献类型：
--
作者：
Orlando, Christopher M.;Perez, Carlos A.;Agyei, Paunel;Elsehety, Marwah;Singh, Sonia Kaur;Thomas, Joseph;Alaina, Omar;Lincoln, John A.
关键词：
黑人和西班牙裔多发性硬化症（MS）患者的多发性硬化相关残疾（MSAD）比白色患者更严重。据报告，这些群体之间在健康的社会决定因素方面存在差异。确定种族和民族与MSAD的关联在多大程度上可归因于SDOH的差异。一家学术性MS中心的患者回顾性图表分析，按照自认为的黑人（n = 95）、西班牙裔（n = 93）和白色（n = 98）人种/种族分组。个别病人的地址进行了地理编码，并与邻里水平的面积剥夺指数（ADI）和社会脆弱性指数（SVI）相匹配。白色患者末次记录评估时的平均扩展残疾状态量表（EDSS）评分（1.7 ± 2.0）显著低于黑人（2.8 ± 2.4，p = 0.001）和西班牙裔（2.6 ± 2.6，p = 0.020）患者。在多变量线性回归模型中，无论是黑人还是西班牙裔，都与EDSS显著相关，该模型包括个体水平的SDOH指标和ADI或SVI。在包括个人和社区水平SDOH指标的模型中，黑人种族和西班牙裔种族与EDSS没有显着相关性。进一步的研究应该阐明结构不平等影响MS病程的机制。
Black and Hispanic patients with multiple sclerosis (MS) have been shown to accumulate greater multiple sclerosis–associated disability (MSAD) than White patients. Disparities in social determinants of health (SDOH) among these groups have also been reported. To determine the extent to which associations of race and ethnicity with MSAD may be attributable to differences in SDOH. Retrospective chart analysis of patients at an academic MS center grouped by self-identified Black (n = 95), Hispanic (n = 93), and White (n = 98) race/ethnicity. Individual patient addresses were geocoded and matched with neighborhood-level area deprivation index (ADI) and social vulnerability index (SVI). Average Expanded Disability Status Scale (EDSS) scores at last-recorded evaluations of White patients (1.7 ± 2.0) were significantly lower than Black (2.8 ± 2.4, p = 0.001) and Hispanic (2.6 ± 2.6, p = 0.020) patients. Neither Black race nor Hispanic ethnicity was significantly associated with EDSS in multivariable linear regression models that included individual-level SDOH indicators and either ADI or SVI. Black race and Hispanic ethnicity are not significantly associated with EDSS in models that include individual and neighborhood-level SDOH indicators. Further research should elucidate mechanisms by which structural inequities affect MS disease course.
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影响因子：
39.2
作者：
Kind AJ;Jencks S;Brock J;Yu M;Bartels C;Ehlenbach W;Greenberg C;Smith M
通讯作者：
Smith M
影响因子：
9.9
作者：
Langer-Gould, Annette;Brara, Sonu M.;Zhang, Jian L.
通讯作者：
Zhang, Jian L.
DOI：
10.1186/1479-5868-4-49
发表时间：
2007-10-08
影响因子：
8.7
作者：
Doerksen, Shawna E.;Motl, Robert W.;McAuley, Edward
通讯作者：
McAuley, Edward
影响因子：
4
作者：
Boorgu, Devi Sai Sri Kavya;Venkatesh, Shruthi;Lakhani, Chirag M.;Walker, Elizabeth;Aguerre, Ines M.;Riley, Claire;Patel, Chirag J.;De Jager, Philip L.;Xia, Zongqi
通讯作者：
Xia, Zongqi
影响因子：
9.9
作者：
Harding, Katharine E.;Wardle, Mark;Tremlett, Helen
通讯作者：
Tremlett, Helen