Disparities in rheumatoid arthritis outcomes for North American Indigenous populations
ABSTRACTAdvances in rheumatoid arthritis (RA) management have significantly improved clinical outcomes of this disease; however, some Indigenous North Americans (INA) with RA have not achieved the high rates of treatment success observed in other populations. We review factors contributing to poor l...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Taylor & Francis Group
2023-12-01
|
| Series: | International Journal of Circumpolar Health |
| Subjects: | |
| Online Access: | https://www.tandfonline.com/doi/10.1080/22423982.2023.2166447 |
| _version_ | 1797385584925212672 |
|---|---|
| author | Carol A Hitchon Liam ONeil Christine A Peschken David B Robinson Amanda Fowler-Woods Hani S El-Gabalawy |
| author_facet | Carol A Hitchon Liam ONeil Christine A Peschken David B Robinson Amanda Fowler-Woods Hani S El-Gabalawy |
| author_sort | Carol A Hitchon |
| collection | DOAJ |
| description | ABSTRACTAdvances in rheumatoid arthritis (RA) management have significantly improved clinical outcomes of this disease; however, some Indigenous North Americans (INA) with RA have not achieved the high rates of treatment success observed in other populations. We review factors contributing to poor long-term outcomes for INA with RA. We conducted a narrative review of studies evaluating RA in INA supplemented with regional administrative health and clinical cohort data on clinical outcomes and health care utilisation. We discuss factors related to conducting research in INA populations including studies of RA prevention. NA with RA have a high burden of genetic and environmental predisposing risk factors that may impact disease phenotype, delayed or limited access to rheumatology care and advanced therapy. These factors may contribute to the observed increased rates of persistent synovitis, premature end-stage joint damage and mortality. Novel models of care delivery that are culturally sensitive and address challenges associated with providing speciality care to patients residing in remote communities with limited accessibility are needed. Progress in establishing respectful research partnerships with INA communities has created a foundation for ongoing initiatives to address care gaps including those aimed at RA prevention. This review highlights some of the challenges of diagnosing, treating, and ultimately perhaps preventing, RA in INA populations. |
| first_indexed | 2024-03-08T21:56:17Z |
| format | Article |
| id | doaj.art-b4783f78412d4960a2264381165e660d |
| institution | Directory Open Access Journal |
| issn | 2242-3982 |
| language | English |
| last_indexed | 2024-03-08T21:56:17Z |
| publishDate | 2023-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | International Journal of Circumpolar Health |
| spelling | doaj.art-b4783f78412d4960a2264381165e660d2023-12-19T21:44:11ZengTaylor & Francis GroupInternational Journal of Circumpolar Health2242-39822023-12-0182110.1080/22423982.2023.2166447Disparities in rheumatoid arthritis outcomes for North American Indigenous populationsCarol A Hitchon0Liam ONeil1Christine A Peschken2David B Robinson3Amanda Fowler-Woods4Hani S El-Gabalawy5Department of Internal Medicine, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, CanadaDepartment of Internal Medicine, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, CanadaDepartment of Internal Medicine, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, CanadaDepartment of Internal Medicine, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, CanadaDepartment of Community Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, CanadaDepartment of Internal Medicine, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, CanadaABSTRACTAdvances in rheumatoid arthritis (RA) management have significantly improved clinical outcomes of this disease; however, some Indigenous North Americans (INA) with RA have not achieved the high rates of treatment success observed in other populations. We review factors contributing to poor long-term outcomes for INA with RA. We conducted a narrative review of studies evaluating RA in INA supplemented with regional administrative health and clinical cohort data on clinical outcomes and health care utilisation. We discuss factors related to conducting research in INA populations including studies of RA prevention. NA with RA have a high burden of genetic and environmental predisposing risk factors that may impact disease phenotype, delayed or limited access to rheumatology care and advanced therapy. These factors may contribute to the observed increased rates of persistent synovitis, premature end-stage joint damage and mortality. Novel models of care delivery that are culturally sensitive and address challenges associated with providing speciality care to patients residing in remote communities with limited accessibility are needed. Progress in establishing respectful research partnerships with INA communities has created a foundation for ongoing initiatives to address care gaps including those aimed at RA prevention. This review highlights some of the challenges of diagnosing, treating, and ultimately perhaps preventing, RA in INA populations.https://www.tandfonline.com/doi/10.1080/22423982.2023.2166447Rheumatoid arthritisindigenousdisparitiesphenotypeoutcomesprevention |
| spellingShingle | Carol A Hitchon Liam ONeil Christine A Peschken David B Robinson Amanda Fowler-Woods Hani S El-Gabalawy Disparities in rheumatoid arthritis outcomes for North American Indigenous populations International Journal of Circumpolar Health Rheumatoid arthritis indigenous disparities phenotype outcomes prevention |
| title | Disparities in rheumatoid arthritis outcomes for North American Indigenous populations |
| title_full | Disparities in rheumatoid arthritis outcomes for North American Indigenous populations |
| title_fullStr | Disparities in rheumatoid arthritis outcomes for North American Indigenous populations |
| title_full_unstemmed | Disparities in rheumatoid arthritis outcomes for North American Indigenous populations |
| title_short | Disparities in rheumatoid arthritis outcomes for North American Indigenous populations |
| title_sort | disparities in rheumatoid arthritis outcomes for north american indigenous populations |
| topic | Rheumatoid arthritis indigenous disparities phenotype outcomes prevention |
| url | https://www.tandfonline.com/doi/10.1080/22423982.2023.2166447 |
| work_keys_str_mv | AT carolahitchon disparitiesinrheumatoidarthritisoutcomesfornorthamericanindigenouspopulations AT liamoneil disparitiesinrheumatoidarthritisoutcomesfornorthamericanindigenouspopulations AT christineapeschken disparitiesinrheumatoidarthritisoutcomesfornorthamericanindigenouspopulations AT davidbrobinson disparitiesinrheumatoidarthritisoutcomesfornorthamericanindigenouspopulations AT amandafowlerwoods disparitiesinrheumatoidarthritisoutcomesfornorthamericanindigenouspopulations AT haniselgabalawy disparitiesinrheumatoidarthritisoutcomesfornorthamericanindigenouspopulations |