There have been two other studies, one in Michigan (with 2,278 patients) and one in Georgia (with 267 patients), that examined racial divides among lupus sufferers. The researchers that focused on Medicaid users released another study in 2015, also using Medicaid data, that looked at lupus deaths across the U.S. In that one, they found that Native Americans on Medicaid were most at risk of death from complications of lupus, followed by Black and white populations; Hispanic and Asian patients were a bit less at risk. Yes, lupus kills.
The Georgia study found that young Black women are particularly at risk. "Black women had very high rates of lupus, with an incidence rate in Georgia nearly three times higher than that for white women, with significantly high rates in the 30-39 age group,” Dr. S. Sam Lim, who led the study, told the Lupus Foundation of America. So what's going on to cause the big racial differences?
In an editorial for Arthritis & Rheumatology, the editors of the journal point out that there's an interesting parallel study from Canadian researchers that might shed some light on how income levels and race intersect to influence outcomes in women with lupus. In that study, Asian people with lupus had fewer strokes and heart attacks than white people, and Native Canadians had more specific problems with strokes and blood disorders. The less access they had to healthcare due to cost, the worse the Canadian patients were. This suggests that the solution to the problem might be partially genetic and partially societal.
Poverty, which affects many Americans along racial lines, has a big impact on how severe lupus can get and how well it can be treated; it creates more stress, makes it more difficult to get medication or to take proper healthcare steps, and may mean people don't get proper care and so aren't diagnosed properly. (Diagnosis is a big problem with lupus because it often looks like other illnesses, and therefore can be misdiagnosed.) But the big, complex results these new studies have revealed indicate that there are a lot of things at play here. There's now some science to suggest that Black women in particular might have a genetic susceptibility to lupus, and the LUMINA (Lupus In Minorities) study performed on women across the U.S. from 1993 onwards has revealed that two particular genes seem to be associated with worse lupus illness in minority women. This is important because it might suggest genetic-based treatments in the future.
Overall, the picture of lupus in women of color is diverse and complicated, and a lot more research is needed to help us understand precisely what's going on, from discrimination and poverty to genetic susceptibility. If you do suspect that you might have lupus symptoms, see your GP immediately; early diagnosis is extremely important for treatment.