Racial discrimination and disease damage among African American women with systemic lupus erythematosus
© Chae et al.; licensee BioMed Central Ltd. 2014
Published: 18 September 2014
African American women with SLE experience faster progression and worse consequences of disease compared with their White counterparts. This study sought to examine whether self-reported routine experiences of discrimination, as a source of psychosocial stress, is associated with disease damage among African American women with SLE.
Participants were 578 African American women in the Georgians Organized Against Lupus study, a population-based cohort of SLE patients in Atlanta, GA, USA. Disease damage was assessed using the Self-Administered Brief Index of Lupus Damage (SA-BILD), a validated, patient-reported measure of organ damage since the onset of SLE. Discrimination was assessed using the Everyday Discrimination Scale, a widely used measure of routine experiences of unfair treatment. Ordinary least-squares regression analyses were used to examine the outcome of SA-BILD score by the primary predictors: unfair treatment, racial discrimination attribution, and their interaction, controlling for age and years since SLE diagnosis.
This study highlights the role that social stressors have in contributing to the progression of SLE and is the first to examine whether unfair treatment and racial discrimination are associated with disease damage among African American women with SLE. Consistent with findings from studies on discrimination and other health outcomes, these results suggest more complex, interactive rather than direct associations with SLE damage, with differential relationships being found between those who attributed unfair treatment primarily to racial discrimination versus those who did not.
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