Multiple Sclerosis among Caucasians, Particularly Those of Northern European Descent

Multiple Sclerosis has so far been found to be most prevalent among Caucasians, particularly those of Northern European ancestry. There are a number of studies showing that whites are most likely to get MS. Caucasians are twice as likely to suffer from MS as African-Americans. MS is also not commonly found in people of Asian, Indian, South American, and Native American descent, and particularly uncommon in people from the African sub-continent. There have also been studies that have found that there are certain ethnicities that seem to have a resistance to MS, these groups include American Inuit, the Lapps of Scandinavia, and the Maoris of New Zealand. In addition to MS being most common among Caucasians, it is also two to three times more likely to occur in white females. There are numerous studies that have been carried out to try and explain the epidemiology of multiple sclerosis. One thing the medical community has come to a consensus on is the geographical distribution of MS. It has been found that MS occurs mostly in regions away from the equator- the Northern United States, Canada, Northern Europe, Southern Australia, and New Zealand. (As shown in the map below)

 

There is some debate though, to what actually causes this distribution. Some believe it is climatic, others believe it is related to patterns of migration and ancestry, and still others believe it is related to socioeconomic issues that hinder awareness and diagnoses. The climatic factors are an example of medical ecology. One of these factors being studied is the relation of the amount of sun a person gets, and therefore their vitamin D levels, and the fact that the prevalence seems to occur in areas away from the equator. This is an intersection of health and environment, and one of the arguments backing this line of thought, is that African-Americans who live in these northern regions have a much higher rate of MS than Africans living on the sub-continent. The migration argument is an example of political ecology. Some researchers think that this distribution of MS backs the race or ethnicity theory because it follows the historical migration patterns of Northern Europeans- to North America, Australia, and New Zealand- in particular the patterns of the ancient Vikings and Scots. One backing of this theory is that Northern Ireland has a much higher prevalence of MS than the Irish Republic, and this area was historically, much more populated with those of Scottish descent. Lastly, is the social determinant of perhaps a lack of awareness about MS, this falls into cultural ecology. Some researchers believe this distribution of MS is an indicator of cultures that are not readily aware of MS and therefore lack the number of diagnoses found elsewhere, in more developed countries. I personally believe it is a combination of all these factors. There are probably ancestral components, as well as relationships between the patterns of migration found in the geographical areas with more prevalence. Also, there has been a lot of convincing research regarding the climatic and environmental effects on the onset and prevalence of MS, that I believe must be factored in, when discussing the patterns of multiple sclerosis.

 

Sources:

1-      Marrie, R. (2004). Environmental risk factors in multiple sclerosis aetiology. The Lancet Neurology, 3(12), 709-718. Retrieved from http://www.sciencedirect.com/science/article/pii/S1474442204009330

2-      The Multiple Sclerosis Trust. http://www.mstrust.org.uk/information/publications/msexplained/who_gets_ms.jsp (Photo)

3-      Compston, A. (2008). Multiple sclerosis. The Lancet, 372(9648), 1502-1517. Retrieved from http://www.sciencedirect.com/science/article/pii/S0140673608616207

4 thoughts on “Multiple Sclerosis among Caucasians, Particularly Those of Northern European Descent

  1. First off, I want to say how much I enjoyed your post. Until reading it I never realized that people of European descent had higher rates of Multiple Sclerosis. I does make sense though. You touched on a couple of the reasons in your post. First off, multiple sclerosis is normally diagnosed by a neurologist. My son has multiple sclerosis and when he was initially diagnosed it was done by a neurologist at the University of Michigan MOTT Children’s Hospital. Where are most of the world’s neurologists located? Most of them are located in industrialized nations therefore this may account for the disparity of multiple sclerosis in northern countries. Another factor would include infant mortality rates within a community. If it was not for western medicine my son would not have lived long enough to be diagnosed with multiple sclerosis. He is currently taking multiple medications to control seizures and has gastrostomy tube that leads into his stomach for feedings. He is unable to swallow food so if it was not for this technology he would have starved to death long ago. Another reason why northern countries may have higher levels of multiple sclerosis is the pollutants in our air, water, and homes. Industrialized nations have very unhealthy air and our homes are filled with plastics that emit toxic elements into the air we breathe. Although the water we drink in America is much safer than the water people drink in undeveloped countries, there are still chemicals added to the water that could affect the health of the people drinking it. In short, the people who live in industrialized countries are poisoned by industry and thus this may account for an increased level of multiple sclerosis.

    It has been said that people of African descent possess all genetic variation. Having this said, it makes no sense for a genetic or “racial” reason behind increased levels of multiple sclerosis amongst people of European decent. People from Africa hold the same genetic information. I think culture, industry, and modern western medicine holds the key behind the increased rate.

  2. I was surprised to find that multiple sclerosis is prevalent among Caucasians of Northern European descent because I did my health disparity on Cystic Fibrosis and I too found that the disease was found to be most common in Caucasians of the same descent. Something I didn’t consider in my reflection was the occurrence of the disease among Caucasians across the world. I like how you included the map that displays the cases of multiple sclerosis on different continents. I think the inclusion about social, political, and economic issues is also helpful in determining and evaluating why multiple sclerosis tends to be more common among whites. Racial categories can provide some insight as to whether or not certain races are more susceptible to disease, but only in the context of various factors including environmental, political, and cultural ecologies because there are no biologically discrete races. I think that because often times people of the same race will live in close proximity to one another and participate in the same social circles that diseases and illnesses often times will get passed on through that particular race and stay bounded as a healthy disparity to the race. It is also considerable that the same mutated genes keep getting passed within one race because of social behaviors and practices that are displayed by a race.

  3. I found your post quite interesting, and had no idea MS was more prevalent among (female) Caucasians. I found it particularly interesting because of it being a neuological condition, (having one myself, I wanted to research something similar but settled on another after not finding much other information – apparently i didn’t look hard enough, it looks as though there are others posted), which is something I would have thought was much more generalized throughout populations (the map was a nice touch), because of it being biological & based on ones genetics. I thought you did a great job with researching & explaining the disparities, what the reasons may be, and why. I agree with all of them. However, race is not biological but social, and therefore I believe there maybe needs to be some more information about this, & in terms of ‘racial disparity’. Everyone in the world is too genetically similar to have this be biological, or for a true racial disparity. Like I said the other supporting information is great (the social, political, etc.), its very thorough, and I really enjoyed it.

  4. Your evaluation of the relationship between geographic distribution of Multiple Sclerosis and prevalence within those of Northern European ancestry was intriguing. Other than providing ecological niches for pathogens and disease vectors harboring them, I had not considered climactic variables (in this case, sun exposure) as a risk factor for disease. However, this makes sense because environmental factors could precipitate MS expression, and also because since solar energy falls under the category of abiotic elements, which reciprocally influence organisms within a given environment. Also, I wonder if the genes for MS served any adaptive purpose for inhabitants distant from the equator, in accord with the theory of antagonistic pleiotropy discussed in McElroy. Furthermore, you mentioned the migration argument as an example of political ecology, but I think that it also intersects with the biological approach, as it is premised on a degree of genetic similarity between individuals in the groups classified as Vikings and Scots. Presumably, there was little genetic drift within these groups, such that alleles predisposing them to development of MS increased in frequency and were passed to subsequent generations. Moreover, the social determinant theory you mentioned is something I would not have considered. Perhaps there is less reporting of symptoms, recognition, or diagnosis of MS in other groups, according to differences in cultural perception or divergence in linguistic categories, consistent with the ethnomedical approach.

    I think racial categories are useful in clinical studies insofar as individuals that self-identify as belonging to a certain group may possess differential rates of disease compared to other groups. Despite the fact that racial categories are artificial, empirical investigations should be conducted to disentangle the reasons behind health disparities between groups because those who affiliate with different ethnic heritages often share other variables. In clinical trials, race should not be a proxy for genetic similarity or considered a discrete biological classification; instead, it should be used in concert with social, political, economic, cultural, and ecological determinants of disease to ascertain why some groups are more vulnerable to certain diseases.

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