Discrimination and Cumulative Disease Damage Among African American Women With Systemic Lupus Erythematosus.
OBJECTIVE
We examined associations between unfair treatment, attributions of unfair treatment to racial discrimination, and cumulative disease damage among African American women with systemic lupus erythematosus (SLE).


METHODS
We used multivariable regression models to examine SLE damage among 578 African American women in metropolitan Atlanta, Georgia, recruited to the Georgians Organized Against Lupus cohort.


RESULTS
When we controlled for demographic, socioeconomic, and health-related covariates, reporting any unfair treatment was associated with greater SLE damage compared with reporting no unfair treatment (b = 0.55; 95% confidence interval = 0.14, 0.97). In general, unfair treatment attributed to nonracial factors was more strongly associated with SLE damage than was unfair treatment attributed to racial discrimination, although the difference was not statistically significant.


CONCLUSIONS
Unfair treatment may contribute to worse disease outcomes among African American women with SLE. Unfair treatment attributed to nonracial causes may have a more pronounced negative effect on SLE damage. Future research may further examine possible differences in the effect of unfair treatment by attribution.
David H. Chae is with the Department of Epidemiology and Biostatistics, School of Public Health, University of Maryland, College Park. Cristina M. Drenkard and S. Sam Lim are with the Division of Rheumatology, School of Medicine, and Tené T. Lewis is with the Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA.
David H
DH
Chae
David H. Chae is with the Department of Epidemiology and Biostatistics, School of Public Health, University of Maryland, College Park. Cristina M. Drenkard and S. Sam Lim are with the Division of Rheumatology, School of Medicine, and Tené T. Lewis is with the Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA.
Cristina M
CM
Drenkard
David H. Chae is with the Department of Epidemiology and Biostatistics, School of Public Health, University of Maryland, College Park. Cristina M. Drenkard and S. Sam Lim are with the Division of Rheumatology, School of Medicine, and Tené T. Lewis is with the Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA.
Tené T
TT
Lewis
David H. Chae is with the Department of Epidemiology and Biostatistics, School of Public Health, University of Maryland, College Park. Cristina M. Drenkard and S. Sam Lim are with the Division of Rheumatology, School of Medicine, and Tené T. Lewis is with the Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA.
S Sam
SS
Lim
D000328:Adult; D001741:Black or African American / Q000523:psychology*; D000368:Aged; D005260:Female; D005845:Georgia; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000208:ethnology* / Q000523:psychology*; D008875:Middle Aged; D011287:Prejudice; D012042:Registries; D012307:Risk Factors; D011795:Surveys and Questionnaires