Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2025 Jan 9:17:1-12.
doi: 10.2147/OARRR.S493457. eCollection 2025.

Health Disparities in Rheumatology in the United States

Grace C Wright  1 , Patrick M Zueger  2 , Catherine Copley-Merriman  3 , Shahnaz Khan  4 , Jessica Costello  5 , Alisha Krumbach  3 , Priya Reddy  1   6 , Oishi Tanjinatus  7 , Alvin F Wells  8
Affiliations
Review

Health Disparities in Rheumatology in the United States

Grace C Wright et al. Open Access Rheumatol. .

Abstract

Objective: Underserved populations are often at risk of experiencing systematic healthcare disparities. Existing disparities in care access, quality of care received, and treatment outcomes among patients with rheumatic disease are not well understood.

Methods: We conducted a targeted literature review to understand disparities in health outcomes, treatment patterns, and healthcare management faced by rheumatology patients in the United States, with a focus on rheumatoid arthritis (RA), psoriatic arthritis (PsA), and ankylosing spondylitis (AS).

Results: The findings of this review indicate that disparities in RA, PsA, and AS affect several historically underserved populations, including underrepresented racial and ethnic groups, persons with lower socioeconomic status (SES), persons experiencing homelessness, and patients with Medicare or Medicaid insurance types. The disparities experienced by these populations include greater disease activity and severity, decreased or delayed access to specialist care, decreased likelihood of receiving advanced therapeutics, and worse clinical outcomes.

Conclusion: To provide equitable healthcare for all patients with RA, PsA, and AS, multiple closely linked health disparities must be addressed. Possible solutions include partnerships between healthcare systems and community-based organizations, targeted outreach tailored to patients with low SES, interventions to improve patient adherence and knowledge, and interventions to improve access to care for rural-residing and unhoused patients. In all, the findings of this literature review underscore the need for mitigation of health disparities in rheumatology care and may serve as a foundation for developing strategies to reduce disparities.

Keywords: Healthcare disparities; United States; ankylosing spondylitis; health inequities; psoriatic arthritis; rheumatoid arthritis; social determinants of health.

PubMed Disclaimer

Conflict of interest statement

CCM, SK, JC, and AK are full-time employees of RTI Health Solutions. Their compensation is unconnected to the studies on which they work. PMZ and OT are employees of AbbVie and hold shares and/or stock options in the company. GCW has served as a consultant for AbbVie, Amgen, Bristol Myers Squibb, Janssen, Eli Lilly, Novartis, Pfizer, Sanofi, and UCB. PR has participated on advisory boards, received speaker fees and/or had research support from AbbVie, Horizon/Amgen, Bristol Myers Squibb, Janssen, Lilly, Novartis, Pfizer, Sanofi, and UCB. AFW has served as a consultant and had research support from AbbVie, Amgen, Bristol Myers Squibb, Janssen, Eli Lilly, Novartis, Pfizer, Sanofi, and UCB.

Figures

Figure 1
Figure 1
PRISMA Flowchart.
Figure 2
Figure 2
Summary of Findings.
See this image and copyright information in PMC

References

    1. McNulty M, Smith JD, Villamar J, et al. Implementation research methodologies for achieving scientific equity and health equity. Ethn Dis. 2019;29(Suppl 1):83–92. doi:10.18865/ed.29.S1.83 - DOI - PMC - PubMed
    1. Purnell TS, Calhoun EA, Golden SH, et al. Achieving health equity: closing the gaps in health care disparities, interventions, and research. Health Affairs. 2016;35(8):1410–1415. doi:10.1377/hlthaff.2016.0158 - DOI - PubMed
    1. Centers for Disease Control and Prevention. Adolescent and school health: health disparities. 2020. Available from: https://www.cdc.gov/healthyyouth/disparities/index.htm. Accessed April 24, 2023.
    1. National Academies of Sciences‚ Engineering‚ and Medicine, Health and Medicine Division. Board on Population Health and Public Health Practice, Committee on Community-Based Solutions to Promote Health Equity in the United States. In: NY B, Geller A, et al. editors. Communities in Action: Pathways to Health Equity. Washington (DC): National Academies Press (US); 2017. - PubMed
    1. US Department of Health and Human Services. Healthy People 2023. Available from: https://health.gov/healthypeople/objectives-and-data/social-determinants.... Accessed April 17, 2023.

LinkOut - more resources