Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Effects of Poverty and Neighborhood Stress on SLE

Arthritis Care Res; ePub 2018 May 21; Yelin, et al

Mitigating poverty and reducing exposure to crime through moving to safer neighborhoods are factors identified by patients as potentially critical in outcomes for systemic lupus erythematosus (SLE), according to a recent study. 723 persons with SLE were followed from 2003‐2015 through annual structured interviews as part of the Lupus Outcomes Study to establish the effect of combinations of poverty, persistent poverty, living in an area of concentrated poverty, access to health care, and chronic stress on accumulated damage. Researchers sampled 28 from the 723 on the basis of household income, geography, and outcomes in their last interview, and administered qualitative interviews to explore their perspectives on these factors on outcomes. They found:

  • Persons in poverty frequently reported that poverty necessitated a choice to deal with food, medical care, and housing insecurity on a daily basis and to relegate dealing with SLE to a time of disease flares.
  • They also reported that exposure to crime in their neighborhoods was a stress that triggered worsened disease activity.


Yelin E, Trupin L, Bunde J, Yazdany J. Poverty, neighborhoods, persistent stress, and SLE outcomes: A qualitative study of the patients’ perspective. [Published online ahead of print May 21, 2018]. Arthritis Care Res. doi:10.1002/acr.23599.

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