Results from this study highlighted greater disease damage as a principal factor in increased mortality rates among low-income patients with systemic lupus erythematosus.
“Preventing disease damage from worsening is not an easy task, made more so by the fact that the reasons the poor experience greater damage includes inadequate access to high quality care, but also extends to the stress associated with facing food, housing and medical insecurity and living in neighborhoods that are inherently stressful,” study co-author Edward Yelin, PhD, told Healio Rheumatology.
Yelin and colleagues performed their analysis using 807 patients with SLE identified from the University of California, San Francisco Lupus Outcomes Study in 2009. Investigators determined the impact of poverty on the risk of mortality and examined mortality with and without adjusting findings for demographics. They also determined the impact of other variables such as demographics; lupus status, including the extent of disease damage; overall health status; health behaviors and health care characteristics.
Results showed that by 2015, 71 patients had died. Of these, 57 patients were not poor and 14 patients were poor, as defined as having a household income of no more than 125% of the federal poverty level. Of the patients who died, poor patients lived 13.9 fewer years compared with patients who were not poor. Investigators noted poverty status in 2009 correlated with a greater chance of mortality after they adjusted findings for age. However, poverty was no longer correlated with a greater risk for mortality after investigators adjusted for the extent of disease damage and age.
“The results indicate that understanding why the poor experience higher levels of disease damage may reduce mortality among this group,” the researchers wrote. – by Monica Jaramillo
Disclosure: The study received grant support from the Robert Wood Johnson Investigator in Health Policy Awards (NIAMS P60 AR-053308, 2R01-AR-056476 and NIAMS K23 AR-060259).