A new study suggests that neighborhood poverty, rather than race alone, may be a key factor in the severity of skin damage from lupus.
Researchers at the University of Pennsylvania found that people with discoid lupus erythematosus (DLE) living in disadvantaged areas were about four times more likely to have moderate to severe skin damage compared to those in less deprived neighborhoods.
While Black patients showed higher rates of severe disease (87%) versus white patients (52%), the racial disparity largely disappeared after accounting for neighborhood factors.
“These results may prompt a reevaluation of the role of race in DLE disease severity,” said lead author Dr. Katharina S. Shaw. “This emphasizes the importance of adopting a more nuanced, root-causal perspective that considers the socioeconomic context within which racial disparities are observed.”
The study examined 154 DLE patients in Philadelphia, using an “area deprivation index” to measure neighborhood disadvantage. Black patients were far more likely to live in deprived areas, with an average score of 6.8 compared to 2.7 for white patients.
Smoking and having systemic lupus were also linked to worse symptoms.
The researchers suggest targeting interventions to disadvantaged areas, including improving transportation, healthcare access, patient education, and medication affordability.
“Smoking cessation programs should be made accessible to all patients with DLE, with a particular emphasis placed on more disadvantaged areas,” Shaw said.
The findings highlight how poverty can exacerbate chronic health conditions, potentially worsening outcomes for vulnerable populations.
See “Poor Neighborhood, More Than Race, Predicts Greater Lupus Skin Severity” (July 25, 2024)
