Neighborhood Socioeconomic Status and Short-Term Functional Outcomes in Systemic Lupus Erythematosus

Area of Science:

• Rheumatology
• Public Health
• Health Disparities

Background:

• Systemic Lupus Erythematosus (SLE) can lead to functional status (FS) impairment.
• Neighborhood socioeconomic disadvantage is a potential contributor to health outcomes in SLE patients.

Purpose of the Study:

• To evaluate the association between neighborhood socioeconomic disadvantage, measured by the Area Deprivation Index (ADI), and functional status (FS) in a national SLE sample.
• To examine the relationship between ADI and both cross-sectional FS scores and longitudinal FS decline.

Main Methods:

• Utilized data from the RISE registry, a national electronic health record-based registry.
• Included adults (18+) with SLE and at least one functional status assessment measure (FSAM) between 2016-2022.
• Employed multi-level regression models to analyze the association between ADI quintiles and FS, as well as FS decline.

Main Results:

• Higher ADI (greater deprivation) was associated with worse adjusted mean FS scores.
• Individuals in the lowest SES quintile (highest ADI) had higher FS scores compared to those in the highest SES quintile (lowest ADI).
• A greater proportion of patients experienced functional decline in more deprived neighborhoods (quintile 5: 17.0% vs. quintile 1: 11.4%).

Conclusions:

• Greater neighborhood deprivation is significantly associated with worse physical function in adults with SLE.
• Higher socioeconomic disadvantage increases the likelihood of short-term functional decline in SLE patients.
• Clinical practice should incorporate routine functional assessments and patient-centered interventions addressing social and structural health barriers.