Health Disparities in Multiple Sclerosis among Hispanic and Black Populations in the United States

Abstract

Multiple sclerosis (MS) is an acquired demyelinating disease of the central nervous system (CNS). Historically, research on MS has focused on White persons with MS. This preponderance of representation has important possible implications for minority populations with MS, from developing effective therapeutic agents to understanding the role of unique constellations of social determinants of health. A growing body of literature involving persons of historically underrepresented races and ethnicities in the field of multiple sclerosis is assembling. Our purpose in this narrative review is to highlight two populations in the United States: Black and Hispanic persons with multiple sclerosis. We will review the current understanding about the patterns of disease presentation, genetic considerations, response to treatment, roles of social determinants of health, and healthcare utilization. In addition, we explore future directions of inquiry as well as practical methods of meeting these challenges.

Keywords: DMT—disease modifying therapies; EDSS—Expanded Disability Severity Scale; MS—multiple sclerosis; SDOH—social determinants of health; SES—socioeconomic status; nSES—neighborhood socioeconomic status; pwMS—persons with multiple sclerosis.

Figure 1

Areas of emphasis in care of minority populations with multiple sclerosis and future directions. The diagram illustrates points of emphasis emerging from a review of literature on multiple sclerosis (MS) in minority populations, specifically Hispanic and Black persons with multiple sclerosis (pwMS). Items beyond the dashed line indicate areas of future research and practice strategy changes.