ASSOCIATIONS BETWEEN SOCIAL DETERMINANTS OF HEALTH AND OUTCOMES AMONG PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS
Author(s)
Ami Vyas, MBA, MS, PhD1, Steven Cohen, DrPH, MPH2, Christine Eisenhower, PharmD, BCPS2;
1The University of Rhode Island, Associate Professor, Kingston, RI, USA, 2The University of Rhode Island, Kingston, RI, USA
1The University of Rhode Island, Associate Professor, Kingston, RI, USA, 2The University of Rhode Island, Kingston, RI, USA
OBJECTIVES: To examine the associations between social determinants of health (SDOH) and outcomes among patients with systemic lupus erythematosus (SLE).
METHODS: Using retrospective population-based study using 2017-2022 Medical Expenditure Panel Survey data, patients with SLE included who had both a self-reported SLE diagnosis and either SLE-related medication use and/or a visit to a rheumatologist. SDOH domains were economic stability (ES), education, healthcare access and quality (HAQ), social and community context (SCC), and neighborhood and built environment (NBE). Multivariable regression was conducted to examine the association between each SDOH and several clinical and psychosocial outcomes.
RESULTS: For the ES domain, patients with SLE with low/very low food security, used food stamps and were unemployed, had higher odds for fair/poor health status, cognitive limitations, and functional limitations (adjusted odds ratios [AOR] of 2.77 to 6.79), and lower mean physical component summary (PCS) and mental component summary (MCS) scores (p<0.05). For the SCC domain, patients with SLE of minor races/ethnicities and divorced/widowed had significantly higher odds of fair/poor health status, while those who lived in the Northeast or South had higher odds of psychological distress (AORs of 4.79 to 6.76). For the NBE domain, those with no physical activity had higher odds of fair/poor health status (AOR=8.00), cognitive limitations (AOR=4.11), and significantly lower mean PCS and MCS scores (p<0.05). For the HAQ domain, those with unmet medical or prescription needs had higher odds of fair/poor health status, major depressive symptoms, and lower mean PCS scores.
CONCLUSIONS: Our study finds significantly lower PCS and MCS scores, poor health status, and cognitive and functional limitations, for patients with SLE with factors of economic instability, of certain racial/ethnic identities, and of specific social/community status. Future studies should explore how to best assist patients with these specific SDOH.
METHODS: Using retrospective population-based study using 2017-2022 Medical Expenditure Panel Survey data, patients with SLE included who had both a self-reported SLE diagnosis and either SLE-related medication use and/or a visit to a rheumatologist. SDOH domains were economic stability (ES), education, healthcare access and quality (HAQ), social and community context (SCC), and neighborhood and built environment (NBE). Multivariable regression was conducted to examine the association between each SDOH and several clinical and psychosocial outcomes.
RESULTS: For the ES domain, patients with SLE with low/very low food security, used food stamps and were unemployed, had higher odds for fair/poor health status, cognitive limitations, and functional limitations (adjusted odds ratios [AOR] of 2.77 to 6.79), and lower mean physical component summary (PCS) and mental component summary (MCS) scores (p<0.05). For the SCC domain, patients with SLE of minor races/ethnicities and divorced/widowed had significantly higher odds of fair/poor health status, while those who lived in the Northeast or South had higher odds of psychological distress (AORs of 4.79 to 6.76). For the NBE domain, those with no physical activity had higher odds of fair/poor health status (AOR=8.00), cognitive limitations (AOR=4.11), and significantly lower mean PCS and MCS scores (p<0.05). For the HAQ domain, those with unmet medical or prescription needs had higher odds of fair/poor health status, major depressive symptoms, and lower mean PCS scores.
CONCLUSIONS: Our study finds significantly lower PCS and MCS scores, poor health status, and cognitive and functional limitations, for patients with SLE with factors of economic instability, of certain racial/ethnic identities, and of specific social/community status. Future studies should explore how to best assist patients with these specific SDOH.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
CO117
Topic
Clinical Outcomes
Topic Subcategory
Clinician Reported Outcomes
Disease
SDC: Rare & Orphan Diseases, SDC: Systemic Disorders/Conditions (Anesthesia, Auto-Immune Disorders (n.e.c.), Hematological Disorders (non-oncologic), Pain)