Understanding Social Drivers of Health Among US Adults with Psoriasis from Different Races and Ethnicities

Psoriasis, a chronic immune-mediated inflammatory skin condition with systemic implications and substantial psychosocial burden, affects individuals across races and ethnicities. This study explored social drivers of health (SDOH), disease burden, and the impact of psoriasis across races and ethnicities.

An online, cross-sectional survey was conducted among adult US patients with psoriasis (September-December 2023). Participants were recruited through the National Psoriasis Foundation and AmeriSpeak, a national sample panel. Descriptive data were collected using patient-reported outcome measures and questions on disease knowledge, healthcare access and utilization, quality of life (QoL), and social impact. Analyses were stratified by races and ethnicities.

Among 285 participants (mean age 46.7 years; 50.9% male), 68.1% identified as white, 19.3% as Black/African American (BAA), and 20.4% as Hispanic/Latino (H/L). Overall, psoriasis severity was reported as moderate by 36.8% (white: 37.6%, BAA: 25.5%, Asian: 50.0%, and H/L: 27.6%) and severe by 10.2% (white: 8.2%, BAA: 10.9%, Asian: 20.0%, and H/L: 6.9%) of patients. Participants reported moderate QoL impact (Dermatology Life Quality Index [DLQI] mean 10.3), with high burden among H/L (16.6) and BAA (15.1) groups. During flares, 58.6% used prescription medications, with similar rates across races and ethnicities. Transportation barriers were reported by 21.4% overall, more commonly reported by H/L (44.8%) and BAA (34.5%) participants. Difficulty accessing medicine/healthcare was reported by 26.3% overall, particularly white (29.4%) participants. Overall, 29.1% delayed care owing to cultural/linguistic differences, most commonly by BAA and H/L groups. Of the healthcare services requiring partial out-of-pocket payment for treatment of psoriasis, medications were reported as the highest burden by an overall 47.0% of patients (H/L: ~55%, white and BAA ~45%). Overall, only 29.5% received financial assistance.

In this descriptive survey, patients perceived psoriasis as a considerable burden across races and ethnicities. Understanding diversities in patient-reported SDOH and healthcare access issues through culturally competent integrated care may potentially optimize psoriasis outcomes.