Racial, ethnic and social disparities may affect the risk of symptom flare-ups in people with generalized myasthenia gravis (gMG), according to a study recently published in Muscle & Nerve.
A review of nearly 11,000 U.S. health insurance claims showed that Black patients had a significantly higher risk of flare-ups than white individuals, even after taking income and health insurance coverage into consideration.
Hispanic patients’ risk was similar to that of white patients. Asian patients appeared to be at lower risk, but the number of Asian patients in the study was relatively low, and the team noted that further research is needed to confirm this result.
The authors explained that in addition to income and insurance considerations, differences in environmental exposure, health care access and other factors known as “social determinants of health” may impact the risk to specific racial and ethnic groups.
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The authors noted that Black patients in particular have a higher risk of flare-ups in part because referrals and access to specialist care can vary in this population.
“Primary care physicians are less likely to refer Black patients than white patients to a specialist and Black patients are around 30% less likely than white patients to see a neurologist,” the authors explained. “Among patients with neurologic conditions, Black individuals are more likely to be cared for in the emergency department, have more hospital stays, and have higher inpatient expenditures compared with their white counterparts.”
The team noted that future research should investigate interpersonal barriers to health care access and provision, in addition to social determinants of health mentioned, to gain more insight into the differences in gMG exacerbation risk in specific patient groups.
The authors also suggested that interventions aimed at reducing inequities in health care access and provision among high-risk groups should be a focus for both providers and caregiver organizations.
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