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Abstract：
Introduction This study aims to identify the influence of social determinants of health (SDoH) on patients with systemic lupus erythematosus (SLE), emphasizing racial and ethnic disparities in healthcare. Methods A cross-sectional study used the National Institute of Health\'s (NIH) All of Us Research Program (AoU). From 727,000 patients, SLE patients were categorized by race, ethnicity, and responses to the Social Determinants of Health survey from May 2018 until March 2023. Survey questions addressed transportation access, neighborhood safety, provider biases, and food insecurity. JMP Pro 16.0 and R 4.2.2 were used for statistical analysis. Results Significant racial disparities were evident amongst SLE patients for transportation access, neighborhood safety, food security, and respect from healthcare providers (p-value < 0.001). African Americans, Asians, and White participants showed different perceptions regarding neighborhood crime, healthcare provider courtesy, and feeling unheard by providers, with respective p-values of 0.001, 0.010, and 0.023. Hispanic participants perceived higher neighborhood crime rates, felt unsafe during nighttime walks, felt unheard by healthcare providers, and reported worrying about food security compared to non-Hispanic participants, with respective p-values of 0.003, 0.003, 0.009, and <0.001. Discussion SLE is affected by access to care, treatments, stress, and lifestyle habits. Therefore, identifying SDoH for SLE patients is critical as it impacts disease progression, leading to delays in diagnosis, improper management, and worsening morbidity. Conclusion Targeted social and community-based interventions may improve access to care, identify implicit biases among providers, and alleviate food insecurity.
摘要：
简介本研究旨在确定健康的社会决定因素（SDoH）对系统性红斑狼疮（SLE）患者的影响，强调医疗保健中的种族和族裔差异。方法采用美国国立卫生研究院（NIH）美国研究项目（AoU）的横断面研究。来自727,000名患者，SLE患者按种族分类，种族,以及2018年5月至2023年3月对健康的社会决定因素调查的回应。调查问题涉及交通通道，邻里安全,提供者偏见，和粮食不安全。采用JMPPro16.0和R4.2.2进行统计分析。结果SLE患者在交通方面存在明显的种族差异，邻里安全,粮食安全,以及医疗保健提供者的尊重(p值<0.001)。非洲裔美国人,亚洲人,白人参与者对邻里犯罪表现出不同的看法，医疗保健提供者的礼貌，感觉从未被提供者听到，各自的p值为0.001、0.010和0.023。西班牙裔参与者认为邻里犯罪率更高，在夜间散步时感到不安全，感觉没有被医疗保健提供者听到，与非西班牙裔参与者相比，他们担心食品安全，各自的p值为0.003、0.003、0.009和<0.001。讨论SLE受到获得护理的影响，治疗,压力，和生活习惯。因此,确定SLE患者的SDoH至关重要，因为它影响疾病进展，导致诊断延误，管理不当,发病率恶化。结论有针对性的社会和社区干预措施可以改善获得护理的机会，识别提供者之间的隐含偏见，缓解粮食不安全。
