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Updated: Jan 23, 2026
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Author Spotlight: Enhancing Rheumatoid Arthritis Research Through HR-pQCT Imaging Analysis
Published on: October 6, 2023
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Health Disparities Among Hispanics With Rheumatoid Arthritis: Delay in Presentation to Rheumatologists Contributes to
Mariam Riad1, Daniel P Dunham2, Jacquelin R Chua1
1From the Division of Rheumatology.
Summary
Hispanic patients with rheumatoid arthritis (RA) experienced significant delays in seeking rheumatology care, leading to higher disease severity at presentation. Early referral was linked to higher C-reactive protein levels.
Area of Science:
- Rheumatology
- Health Disparities
- Clinical Research
Background:
- Timely diagnosis and treatment of rheumatoid arthritis (RA) are crucial for managing disease activity and preventing joint damage.
- Ethnic and racial disparities in healthcare access and outcomes are well-documented across various medical conditions.
- Understanding delays in rheumatology referrals is essential for improving patient care and reducing disease burden.
Purpose of the Study:
- To evaluate referral and treatment delays by ethnicity/race in patients with rheumatoid arthritis (RA).
- To identify factors associated with delayed presentation to a rheumatology center.
- To assess disease severity at presentation across different ethnic/racial groups.
Main Methods:
- Retrospective review of medical records for 152 disease-modifying antirheumatic drug-naive RA patients (2011-2016).
- Analysis of time from symptom onset to first rheumatology visit and treatment initiation.
- Comparison of demographic data, referral sources, and baseline disease markers (RAPID3, ESR, CRP) across ethnic/racial groups.
- Logistic regression used to identify predictors of early referral.
Main Results:
- Median time to first rheumatology visit was significantly longer for Hispanic patients (22.7 months) compared to other groups (6-8 months).
- Hispanic patients had a higher rate of self-referral (40%).
- Black and Hispanic patients presented with higher disease severity, indicated by elevated RAPID3 scores and erythrocyte sedimentation rates.
- High C-reactive protein at baseline was associated with earlier referral.
Conclusions:
- Significant delays in initial presentation to a rheumatologist were observed, particularly impacting Hispanic patients.
- Delayed presentation is associated with increased disease severity at the time of diagnosis.
- Addressing ethnic/racial disparities in healthcare access is critical for timely RA management.
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