Neighborhood Disadvantage Associated with Lower Testing and Physician Access in Young People with Systemic Lupus Erythematosus Despite Insurance Coverage

In systemic lupus erythematosus (SLE), poor disease outcomes often occur in minoritized populations such as Black/African American or Hispanic/Latino populations, and socioeconomically disadvantaged populations. In a new study examining people with systemic lupus erythematosus (SLE) ages 18-35, researchers discovered an association between neighborhood disadvantage and access to rheumatology care, including lupus specific serology (or diagnostic) testing. The higher the neighborhood disadvantage level, the less likely people were to see a rheumatologist and undergo testing. 

The race, ethnicity, and neighborhood disadvantage of a group of 1,036 young adults with lupus and with Medicare as their primary insurance were studied. Only 39% of the group saw a rheumatologist at least once every 6 months and 28% had a serology test within the last year. People living in the most disadvantaged areas were nearly half as likely (48%) to experience lower serology testing and visit-based retention (those visited at home by providers) was 26% lower. White people living in disadvantaged areas had higher visit-based retention (64%), while Black/African American people had nearly half the visit-based retention of White people (30%) in the least disadvantaged areas. They also discovered that people living in the Midwest were less likely (50%) to receive serology testing than those living in the South. 

This study underscores significant disparities in lupus care based on neighborhood disadvantage despite insurance coverage. Regularly seeing a doctor and receiving testing and other care is critical to improving outcomes. More research is needed to understand how care differences impact lupus outcome disparities. Learn more about health disparities in lupus.

Read the study