Systemic lupus erythematosus (SLE) is three times more common and its manifestations are more severe in African American women compared to women of other races. It is not clear whether this is due to genetic differences or factors related to the physical or social environments, differences in health care, or a combination of these factors. Health disparities in patients with SLE between African American patients and persons of other races have been reported since the 1960s and are correlated with measures of lower socioeconomic status. Risk factors for these disparities have been demonstrated, but whether their mitigation improves outcomes for African American patients has not been tested except in self-efficacy. In 2002, the first true US population–based study of patients with SLE with death certificate records was conducted, which demonstrated a wide disparity between the number of African American women and White women dying from SLE. Five years ago, another study showed that SLE mortality rates in the United States had improved but that the African American patient mortality disparity persisted. Between 2014 and 2021, one study demonstrated racism's deleterious effects in patients with SLE. Racism may have been the unmeasured confounder, the proverbial “elephant in the room”—unnamed and unstudied. The etymology of “risk factor” has evolved from environmental risk factors to social determinants to now include structural injustice/structural racism. Racism in the United States has a centuries-long existence and is deeply ingrained in US society, making its detection and resolution difficult. However, racism being man made means Man can choose to change the it. Health disparities in patients with SLE should be addressed by viewing health care as a basic human right. We offer a conceptual framework and goals for both individual and national actions.

中文翻译：

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选择结束非裔美国人系统性红斑狼疮患者的健康差异


与其他种族的女性相比，非裔美国女性患系统性红斑狼疮 (SLE) 的几率是其他女性的三倍，且其症状更为严重。目前尚不清楚这是否是由于遗传差异或与物理或社会环境相关的因素、医疗保健的差异或这些因素的组合所致。自 20 世纪 60 年代以来，就有报道称非裔美国患者与其他种族的 SLE 患者之间存在健康差异，并且与较低的社会经济地位相关。这些差异的危险因素已经得到证实，但除了自我效能之外，这些差异的缓解是否会改善非裔美国患者的预后尚未得到测试。 2002年，美国首次对有死亡证明记录的系统性红斑狼疮患者进行了真正的基于人群的研究，结果表明，死于系统性红斑狼疮的非裔美国女性和白人女性的人数存在巨大差异。五年前，另一项研究表明，美国的系统性红斑狼疮死亡率有所改善，但非洲裔美国患者的死亡率差异仍然存在。 2014 年至 2021 年间，一项研究证明了种族主义对系统性红斑狼疮患者的有害影响。种族主义可能是无法估量的混杂因素，是众所周知的“房间里的大象”——没有被提及，也没有被研究。 “风险因素”的词源已从环境风险因素演变为社会决定因素，现在包括结构性不公正/结构性种族主义。美国的种族主义已经存在了几个世纪，并且在美国社会根深蒂固，使其难以被发现和解决。然而，种族主义是人为的，意味着人类可以选择改变它。系统性红斑狼疮患者的健康差异应通过将医疗保健视为一项基本人权来解决。 我们为个人和国家行动提供概念框架和目标。