Lupus among African American women

The health disparity that I chose to examine was systemic lupus erythematosus (SLE) among African American women. SLE is an autoimmune disorder. The body produces antibodies – molecules that assist in immune responses – in order to fight off infection. Antibodies recognize antigens (pathogens), and induce a response to remove them from the body.  In the case of autoimmune diseases, the antibodies produced are auto-reactive, meaning that they mistakenly recognize “antigens” that in reality are healthy cells. This results in inflammation of the skin, joints, and the heart, along with many other organs. Inflammation of the kidney can lead to kidney failure, which can result in death.

The study that I looked at found that age, sex, and race-specific disparities exist in SLE death rates and that death rates had increased by approximately 70% during the study period among black women aged 45–64 years (1). This is shown in the table below, and demonstrates how great the disparity among African American women is.

One of the reasons that I chose to look at lupus is because it’s cause is unknown (along with other autoimmune diseases). As a result of this, it makes it that much harder to determine why such a disparity exists. Genetics are thought to play a role, and continued research investigates this topic. Lupus is also more prevalent among African American males (along with other minorities), which is another reason I was interested in choosing this disease.  I personally identify with the African American race, and my father was diagnosed with lupus a few years back, so I would like to know as much as I could! Based on what I learned from class lectures this week, I feel that race is a subjective topic (in talking about Bidil and “self identification”) and therefore cannot be the only way to look at a disease.  Despite this, I believe that disparities among races exist, as in the case of lupus. However, other factors must be taken into account as well.

Figure 1

1. CDC. “Trends in Deaths from Systemic Lupus Erythematosus — United States, 1979–1998.” Last modified May 2, 2002. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5117a3.htm#tab1.

This Post Has 3 Comments

  1. Karra Larkins says:

    It is very good to look into an illness that has an impact on family and learn as much as you can about it. I like your evaluation on how lupus affects different races and genders. It seems that between races it is most seen in African Americans. Within genders it is more prevalent in women than men. This information is supported by the graph that you displayed. It also shows that lupus is most commonly diagnosed in African Americans age between fifteen and forty four, but least common in Caucasians fifteen to forty four. This could lead to the deduction that race is a very big factor in developing lupus. I think that racial categories are not helpful in the use of clinical diagnosing of aliments. Some of the other things that are more important in determining illness are age, weigh and quite possible income. Income has a vast effect on the health of a person and determining their chance of recovery. In some cases like lupus race seems to play a big part but I think there is an underling reason that is overlooked because race is the usual reason for cases like this. On race determining illness, I think more research should be done to see it the victims has anything else in common.

  2. Rebecca Chockley says:

    There are so many factors that affect how healthy we are that it can be difficult to understand causality. Genetics has an undeniable role in determining what we are predisposed to and how we respond physically to illness or damage to our bodies. There are many clear cut cases of genetic predisposition like Sickle Cell or Tay Sachs, but there are so many more that we don’t know about because our understanding of the disease mechanism itself is so limited. In the case of Lupus that you brought up, part of the disparity that your father may face is the lack of funding for research for a disease that affects African Americans more than Caucasians. This is a form of economic discrimination that is quite common in the medical field. My experience has been with the lack of research into Migraines because they affect more women than men and it was written off as a side effect of the “emotional nature of women”. This type of marginalization can be a result of institutional racism or sexism. Having a more diverse medical field will eventually help to eliminate this bias, but it will take time. Race might better be seen as an indicator of the types and levels of risk that a person is exposed to rather than just a way of eluding to their set of genes. It may be useful in a clinical setting, but more on the research side that is considering large numbers of people and thus the “average experience”. In a diagnostic setting it seems like race is less useful as a tool because you then only have a sample set of one, the person that is being treated.

  3. phill612 says:

    Hi Joseph,
    I think your topic is very interesting. I have not encountered many articles or other forms of media that discuss lupus. I agree with you that race is an important factor in medicine but should not be the only factor in studying diseases. It is true that some groups are increasingly susceptible to a particular disease but the underlying reasons should be investigated and not explained by race itself. I think that racial categories help to classify these factors in relation to other groups. This way studies like the one you described can be easily explained and the parameters are easy to follow should someone else want to recreate it. I also think that socioeconomic status of each racial group would be another factor that would help explain the increase in death toll by seventy percent. If those individuals affected the most by this disease could not be diagnosed at an early stage or afford medication that would help better understand the external factors and place more than race as a risk factor. I believe that these external factors help to individualize medicine and eliminate the racial category.

    However, I do have a few questions about your topic. I am curious to know if you came across any current theories that the genetics of lupus has amongst African Americans or any other racial group. Also was African American males the most prevalent comparative to other racial groups collectively or was this statistic categorized by gender?

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