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Neuromyelitis optica spectrum disorder (NMOSD) disproportionately affects Black and Hispanic/Latino individuals. Black individuals face a higher risk of developing NMOSD and an increased associated mortality from NMOSD. Moreover, Black and Hispanic/Latino individuals face greater disease severity and faster disease progression than white individuals.

Researchers at the Keck School of Medicine at the University of Southern California conducted a narrative review to explore to what degree social determinants of health (SDOH) contribute to racial and ethnic disparities in NMOSD and other autoimmune disorders.

Key takeaways of the study, published in JAMA Neurology, include

  • Black and Hispanic/Latino individuals with multiple sclerosis (MS) and other autoimmune diseases experience poorer health outcomes due to SDOH.
  • Inequities patients face in accessing health care for autoimmune diseases can lead to delayed diagnosis and underuse of available services. For Blacks and Hispanics/Latinos with MS or other autoimmune diseases, access to neurological specialists is rare and diagnostic tools are limited.
  • Low income, low health literacy, and low education were associated with lower health services utilization among Black and Hispanic/Latino individuals. Unemployment was associated with poorer outcomes for Black patients.  
  • Negative perceptions of illness—a patient’s belief that they cannot improve their MS or another disorder—were also associated with autoimmune disorder disparities.
  • There is a lack of data about racial and ethnic disparities in NMOSD, MS, and other autoimmune diseases. In prior studies, only about 1% of the medical literature reflects minority patients. Literature related to SDOH among Asian Americans and autoimmune disorders was too limited to reference for this study [1].
  • The study authors call for the development of research frameworks to understand just how much SDOH impact autoimmune disorder diagnoses and treatment. Such research can support better development of multilevel interventions across the care spectrum [2].
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[1] Deutchman, J. (2021, October 4). Health disparities and inequities impact Black and Latino Americans with autoimmune diseases, says new USC study. Keck School of Medicine of USC. https://keck.usc.edu/health-disparities-and-inequities-impact-black-and-latino-americans-with-autoimmune-diseases-says-new-usc-study/


[2] Amezcua, L., Rivera, V. M., Vazquez, T. C., Baezconde-Garbanati, L., & Langer-Gould, A. (2021). Health disparities, inequities, and social determinants of health in multiple sclerosis and related disorders in the US. JAMA Neurology, 78(12), 1515. https://doi.org/10.1001/jamaneurol.2021.3416