Systemic lupus erythematosus in three ethnic groups. XIV. Poverty, wealth, and their influence on disease activity
Article first published online: 5 FEB 2004
Copyright © 2004 by the American College of Rheumatology
Arthritis Care & Research
Volume 51, Issue 1, pages 73–77, 15 February 2004
How to Cite
Alarcón, G. S., McGwin, G., Sanchez, M. L., Bastian, H. M., Fessler, B. J., Friedman, A. W., Baethge, B. A., Roseman, J., Reveille, J. D. and The Lumina Study Group (2004), Systemic lupus erythematosus in three ethnic groups. XIV. Poverty, wealth, and their influence on disease activity. Arthritis & Rheumatism, 51: 73–77. doi: 10.1002/art.20085
- Issue published online: 5 FEB 2004
- Article first published online: 5 FEB 2004
- Manuscript Accepted: 21 OCT 2002
- Manuscript Received: 17 MAR 2002
- National Institute of Arthritis and Musculoskeletal and Skin Disorders. Grant Number: R01-AR-42503
- General Clinical Center Research Grants. Grant Numbers: M01-RR02558 (UTH-HSC), M01-RR00073 (UTMB), M01-RR00032 (UAB)
- Socioeconomic status;
- Minority populations;
To determine the impact of wealth on disease activity in the multiethnic (Hispanic, African American, and Caucasian) LUMINA (Lupus in Minorities, Nature versus nurture) cohort of patients with systemic lupus erythematosus (SLE) and disease duration ≤5 years at enrollment.
Variables (socioeconomic, demographic, clinical, immunologic, immunogenetic, behavioral, and psychological) were measured at enrollment and annually thereafter. Four questions from the Women's Health Initiative study were used to measure wealth. Disease activity was measured with the Systemic Lupus Activity Measure (SLAM). The relationship between the different variables and wealth was then examined. Next, the impact of wealth on disease activity was examined in regression models where the dependent variables were the SLAM score and SLAM global (physician). Variables previously found to impact disease activity plus the wealth questions were included in the models.
Questions on income, assets, and debt were found to distinguish patients into groups, wealthier and less wealthy. Less wealthy patients tended to be younger, women, noncaucasian, less educated, unmarried, less likely to have health insurance, and more likely to live below the poverty line. They also tended to have more active disease, more abnormal illness-related behaviors, less social support, and lower levels of self reported mental functioning. None of the wealth questions was retained in the regression models, although other socioeconomic features (such as African American ethnicity, poverty, and younger age) did.
Wealth, per se, does not appear to have an additional predictive value, over and above traditional measures of socioeconomic status, in SLE disease activity.