A comprehensive review of health disparities in rheumatology reveals persistent inequalities affecting underserved populations in the United States. The study, published in Open Access Rheumatology: Research and Reviews, highlights significant disparities in disease activity, access to care, and treatment outcomes for patients with rheumatoid arthritis (RA), psoriatic arthritis (PsA), and ankylosing spondylitis (AS).
Researchers found that patients from underrepresented racial and ethnic groups, those with lower socioeconomic status, and individuals with Medicare or Medicaid insurance face greater challenges in managing their rheumatic conditions. Black and Hispanic patients with RA reported higher disease activity and worse functional outcomes compared to their White counterparts. Similarly, Black patients with AS experienced more severe disease in terms of activity, functional impairment, and radiographic progression.
Access to care remains a critical issue, with Hispanic patients facing longer delays in receiving specialist care. The study revealed that the median time from symptom onset to first rheumatologist visit was 22.7 months for Hispanic patients, compared to 6.0-8.0 months for other racial or ethnic groups.
Treatment disparities were also evident, with Black patients less likely to receive biologic disease-modifying antirheumatic drugs (bDMARDs) in some studies. However, results were inconsistent across different insurance types and conditions.
The authors emphasize the need for targeted interventions to address these disparities, including partnerships between healthcare systems and community organizations, improved patient education, and efforts to enhance access to care for rural and unhoused patients.
As rheumatology care continues to advance, ensuring equitable access and outcomes for all patients remains a critical challenge for the healthcare system.
See: “Health Disparities in Rheumatology in the United States” (January 9, 2025)
