Hospital for Special Surgery, Division of Rheumatology.
Weill Cornell Medicine, Division of General Internal Medicine, New York, New York, USA.
Curr Opin Rheumatol. 2021 Mar 1;33(2):117-121. doi: 10.1097/BOR.0000000000000782.
This review highlights the available data describing racial and ethnic health disparities among patients with rheumatoid arthritis in the United States from an epidemiological, disease activity, and wider socioeconomic standpoint.
Despite centralized government initiatives to include more underrepresentative minority populations into research, many of the studies that examined rheumatoid arthritis still fail to include sizeable cohorts of races or ethnic groups other than whites. Evidence is slowly mounting that individual, provider, and system-level barriers exist and contribute to unequal care that leads to poorer outcomes amongst patients with rheumatoid arthritis. As rheumatoid arthritis is a progressive disease, early treatment is crucial to delay functional decline - a narrow window for many minority patients who are disproportionality affected by disability.
To combat the inequality that exists amongst rheumatoid arthritis patients we must focus on why discrepancies exist on every level, system, physician, patient, and illness. Further research is needed to tease the complex interplay between race, social economic status, medical access, and outcomes to explain the disparities found in rheumatoid arthritis.
目的：本文综述了从流行病学、疾病活动和更广泛的社会经济角度描述美国类风湿关节炎患者种族和民族健康差异的现有数据。
发现：尽管政府采取了集中的措施来将代表性不足的少数族裔纳入研究，但许多研究类风湿关节炎的研究仍然未能纳入大量除白种人以外的其他种族或族裔群体。有证据表明，个体、医疗服务提供者和系统层面的障碍确实存在，导致对类风湿关节炎患者的护理不平等，从而导致他们的预后较差。由于类风湿关节炎是一种进行性疾病，早期治疗对于延缓功能下降至关重要——对于许多受残疾影响不成比例的少数族裔患者来说，这是一个很窄的窗口。
总结：为了解决类风湿关节炎患者中存在的不平等问题，我们必须关注为什么在各个层面，包括系统、医生、患者和疾病上都存在差异。需要进一步的研究来梳理种族、社会经济地位、医疗可及性和结果之间的复杂相互作用，以解释在类风湿关节炎中发现的差异。
