Socioeconomic status and disability progression in multiple sclerosis: A multinational study

Area of Science:

• Neurology
• Public Health
• Epidemiology

Background:

• Socioeconomic status (SES) is increasingly recognized as a factor influencing health outcomes.
• Multiple sclerosis (MS) is a chronic neurological disease with variable disability progression.
• The relationship between SES and MS disability progression requires further investigation.

Purpose of the Study:

• To investigate the association between socioeconomic status (SES) and disability outcomes in multiple sclerosis (MS).
• To determine if SES at the onset of MS predicts disability progression.
• To inform the development of equitable MS care services.

Main Methods:

• Linked health administrative and clinical data from two MS cohorts in Canada and the UK.
• Socioeconomic status (SES) assessed by neighborhood-level income at MS symptom onset.
• Cox proportional hazards models and generalized estimating equations (GEE) used to analyze disability outcomes (EDSS scores, secondary progressive MS).

Main Results:

• A total of 3,113 patients with MS were analyzed.
• Higher SES was significantly associated with a lower hazard of reaching Expanded Disability Status Scale (EDSS) 6.0 and 4.0.
• Higher SES also correlated with a reduced risk of secondary progressive MS (SPMS) onset.

Conclusions:

• Lower neighborhood-level socioeconomic status (SES) is linked to increased risk of disability progression in multiple sclerosis (MS).
• Potential contributing factors may include lifestyle and comorbidities, suggesting areas for intervention.
• Findings highlight the need to consider SES in the planning and delivery of MS services.