The Impact Socioeconomic Status Has for Lupus Patients
The survival of patients with lupus has steadily improved from the estimated 5 to 10 year survival rate after the initial diagnosis. Now, there is nearly 90% of patients in over the last five years. However, serious complications of lupus are more often reported among minorities and low-income groups in contrast to those who have a higher income.
It is estimated that 1.5 Americans and at least 5 million people across the world suffer from some from of lupus with more than 90% of the cases involving women. It is also more common in Africans-Americans, Hispanics, and Asian Americans and mostly diagnosed between the ages of 15 – 44.
Although race is an important factor in the prognosis and development of lupus, it is difficult to separate the effects of race from socioeconomic status. Research studies suggest that poor lupus patients accumulate more damage, raising their risk of mortality.
Lupus is a chronic, autoimmune, and inflammatory disease in which the body's immune system becomes hyperactive and attacks its own healthy tissues. This can lead to inflammation, swelling, and damage to body organs such as the heart, the lungs, kidney, blood, skin, and joints.
Normally, the immune system makes antibodies fight and protect the body against antigens such as virus and bacteria. However, when affected by lupus, the immune system is unable to differentiate the healthy tissues from the antigens. This results in the immune system directing antibodies against the healthy tissue.
There is no cure for lupus, but its symptoms can be controlled with medication, and if there are any complications, it would at times lead to a kidney transplant in order for some symptoms to ease.
Lupus Disease and Socioeconomic Background
The relationship between lupus outcomes and socioeconomic status is a subject of investigation. Several studies suggest that poverty increases the extent of disease damage resulting in high mortality rates. Poor lupus patients accumulate more damage as compared to those who have a little more money, raising the risk of death significantly. This can be explained by several factors like:
A study by DL Kamen suggests that where an individual lives has a significant effect on their health-related behavior, disease control, and outcomes. Environmental factors such as exposure to air pollution, hazardous waste, high rates of smoking, and ultraviolet rays can trigger the onset of lupus in a genetically susceptible individual. An individual living in an area of concentrated poverty has an increased chance of living in a harsh environment, increasing the probability of lupus. Most people who have a lower income are obviously likely to live under such harsh environments due to the lack of alternatives.
Psychosocial stress has been implicated in the development of this autoimmune disease as pressure of ongoing problems due to poverty leads to more stressful responses. These factors can be due to a lack of clothes, food, and healthcare.
Stress may be fixed temporarily, but if not properly handled it can be devastating in the long run as it results in the suppression of the immune system, as well as autoimmunity. Recent reviews discuss the possible role of stress and major stress-related hormones in the pathogenesis of lupus.