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Podcast on Identifying and Understanding Barriers to Care in Underserved Populations With MS in the United States
Sandra Parawira1, Victoria Reese2
1Department of Neurology, University of Cincinnati, Waddell Center for Multiple Sclerosis, 3113 Bellevue Ave, Cincinnati, OH, 45219, USA. parawisa@ucmail.uc.edu.
Abstract:
Multiple sclerosis (MS) can affect people from all racial and ethnic backgrounds, but, historically, the incidence of MS in the United States was thought to be highest in White individuals. More recent data suggest that the incidence of MS in Black or African American individuals is comparable to that in White individuals. In Hispanic or Latino individuals, incidence of MS is lower, but age of onset may be earlier compared with White individuals. Additionally, there are important differences in MS disease severity, disease progression, and mortality in Black or African American and Hispanic or Latino populations. Compared with their White counterparts, individuals from these underrepresented groups are more likely to be affected by MS in specific areas of the nervous system, such as accelerated loss of retinal and brain tissue in Black or African American individuals and optic neuritis in Hispanic individuals. Additionally, Black or African American individuals with MS tend to have an aggressive disease course, earlier disability, and higher risk of requiring ambulatory assistance. Although these differences may be attributed to genetic factors, systemic racism and biases and barriers to accessing care may perpetuate health disparities. Moreover, non-White communities remain broadly underrepresented in clinical trials; however, it is vital that these populations are appropriately represented so that any potential differences in drug efficacy or safety implications are detected. Thus, it is important to increase awareness of MS in these populations. In this podcast, the authors discuss characteristics of MS in Black or African American and Hispanic or Latino populations, identify barriers to care, and propose solutions to improve access to MS care in these populations. MP4 (358385 KB).
Insights
Multiple sclerosis (MS) affects diverse populations differently. Black or African American and Hispanic or Latino individuals experience unique disease characteristics and face significant barriers to care, necessitating increased awareness and improved access.
Area of Science:
- Neurology
- Epidemiology
- Health Disparities
Background:
- Historically, multiple sclerosis (MS) incidence was considered highest in White populations in the U.S.
- Recent data indicate comparable MS incidence in Black or African American individuals versus White individuals.
- Hispanic or Latino individuals show lower MS incidence but potentially earlier age of onset.
Purpose of the Study:
- To discuss the characteristics of MS in Black or African American and Hispanic or Latino populations.
- To identify barriers to accessing care for these underrepresented groups.
- To propose solutions for improving MS care access and outcomes.
Main Methods:
- The study is based on a podcast discussion.
- Key discussion points include disease characteristics, barriers to care, and potential solutions.
- Data presented reflects current understanding of MS epidemiology and clinical presentation in diverse populations.
Main Results:
- Black or African American and Hispanic or Latino individuals exhibit distinct MS disease severity, progression, and mortality compared to White individuals.
- Specific neurological impacts include accelerated tissue loss in Black or African American individuals and optic neuritis in Hispanic individuals.
- These groups often face more aggressive disease courses, earlier disability, and greater need for assistance.
Conclusions:
- Genetic factors, systemic racism, and healthcare access barriers contribute to MS health disparities.
- Underrepresentation in clinical trials poses a risk for detecting population-specific drug efficacy and safety.
- Increasing awareness and addressing care barriers are crucial for improving MS outcomes in non-White communities.
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