Spotlight on Research for 2005

March 2005 (historical)

Lupus Deaths May Be Underestimated in Ethnic Minorities with Low Education Levels

Deaths caused by systemic lupus erythematosus (lupus) may be more prevalent among ethnic minorities with low levels of education than available data suggests, according to research conducted and funded by the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS).

In epidemiologic studies, higher socioeconomic status has been consistently coupled with lower overall mortality, and specifically with fewer deaths from cardiovascular and cerebrovascular diseases. In race-specific studies, similar associations have been found. But researchers have wondered whether the incidence of lupus-caused deaths follows the same pattern.

NIAMS’ Michael Ward, M.D., drawing on data from the National Center for Health Statistics, recently studied U.S. deaths in people with lupus between 1994 and 1997. He examined the association between education level and incidence of lupus in whites, African Americans, Native Americans and Asian/Pacific Islanders. He found that for whites of both genders, the incidence of lupus-caused deaths does decrease as socioeconomic status increases. But in three minority categories—African American men, African American women and Asian/Pacific Islander women—the risk of death from lupus was lower among those with lower education levels.

Dr. Ward also compared the education/mortality link in lupus to that of other causes of death, and found that people with lower educational levels were underrepresented among deaths from lupus for the three minority categories. The underrepresentation, he speculates, was likely due to underreporting and underdiagnosis.

Lupus is often called an antibody-mediated disease, which means it occurs when the body makes antibodies towards itself. It can affect many parts of the body, including the joints, skin, kidneys, heart, lungs, blood vessels and brain. Some of the most common lupus symptoms include extreme fatigue, painful or swollen joints (arthritis), unexplained fever, skin rashes and kidney problems. Many more women than men have lupus. It is three times more common in African American women than in Caucasian women, and it is also more common in women of Hispanic, Asian and Native American descent.

The mission of the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), a part of the Department of Health and Human Services’ National Institutes of Health, is to support research into the causes, treatment and prevention of arthritis and musculoskeletal and skin diseases; the training of basic and clinical scientists to carry out this research; and the dissemination of information on research progress in these diseases. For more information about NIAMS, call the information clearinghouse at (301) 495-4484 or (877) 22-NIAMS (free call) or visit the NIAMS Web site at http://www.niams.nih.gov/.

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Ward M. Education level and mortality in systemic lupus erythematosus (SLE): evidence of underascertainment of deaths due to SLE in ethinic minorities with low education levels. Arthritis & Rheumatism 2004;51:616-624.