Division of Rheumatology and Clinical Immunology, University of Pittsburgh, 3500 Terrace St., S720A BST, Pittsburgh, PA 15261, USA.
Curr Rheumatol Rep. 2012 Oct;14(5):463-71. doi: 10.1007/s11926-012-0276-0.
Racial and ethnic health disparities are a national health issue. They are well described in other chronic diseases, but in rheumatoid arthritis (RA), research into their causes, outcomes, and elimination is in its early stages. Health disparities occur in a complex milieu, with system-level, provider-level, and individual-level factors playing roles. Dissecting the overlapping aspects of race/ethnicity, socioeconomic variables, and how their individual components combine to explain the magnitude of disparities in RA can be challenging. Recent research has focused on the extent to which treatment preferences, adherence, trust in physicians, patient-physician communication, health literacy, and depression have contributed to observed disparities in RA. Practicing evidence-based medicine, improving patient-physician communication skills, reducing language and literacy barriers, improving adherence to therapies, raising awareness of racial/ethnic disparities, and recognizing comorbidities such as depression are steps clinicians may take to help eliminate racial/ethnic disparities in RA.
种族和民族健康差异是一个全国性的健康问题。在其他慢性疾病中，这些差异有详细的描述，但在类风湿关节炎 (RA) 中，对其病因、结果和消除的研究还处于早期阶段。健康差异存在于复杂的环境中，系统层面、提供者层面和个体层面的因素都发挥着作用。剖析种族/民族、社会经济变量及其各个组成部分如何结合起来解释 RA 差异的程度具有一定挑战性。最近的研究集中在治疗偏好、依从性、对医生的信任、医患沟通、健康素养和抑郁程度在多大程度上导致了 RA 中观察到的差异。临床医生可以采取一些措施来帮助消除 RA 中的种族/民族差异，如践行循证医学、提高医患沟通技巧、减少语言和文化障碍、提高治疗依从性、提高对种族/民族差异的认识以及认识到抑郁等共病。
