Lupus & antiphospholipid syndrome
Associations between social determinants of health and long-term outcomes in systemic lupus erythematosus: a nationwide population-based cohort study in Sweden
Authors' conclusion
In this population-based SLE cohort, lower education, lower income, being divorced, widowed or single and reduced work ability were independently associated with increased risk of organ damage and mortality.
Study context
- Population
- Individuals aged 23–59 years with newly diagnosed systemic lupus erythematosus (SLE), Sweden, 2005–2021
- Participants
- 2,434 individuals
- Exposure
- Social determinants of health (SDH) at diagnosis and SLE outcomes
- Outcome
- Organ damage (Lupus Register-Based Organ Damage Index) and all-cause mortality
Methodological detailsCox proportional hazards models adjusted for age, sex and morbidity
- Cox proportional hazards models adjusted for age, sex and morbidity
Main finding
As reported in the abstract
Organ damage
Hazard ratio (95% CI)
Sick leave or disability
1.44(1.27–1.64)
Lower income
1.33(1.09–1.63)
Divorced or widowed
1.30(1.10–1.54)
- Developed organ damage during follow-up
- 1044 (42.4%)
Observational data: associations, not effects.
Further findings
All-cause mortality
| HR (95% CI) | ||
|---|---|---|
| Lower education level | 1.67 (1.05–2.66) | |
| 0.20.5125Hazard ratio (log scale) |
- All-cause mortality — Died during follow-up
- 140 (6%)
All-cause mortality
- Sick leave or disability, lower income, divorced or widowed also associated with mortality
- Immigration status and unemployment not associated with mortality
Sensitivity analysis: SDH measured 2 years prior to diagnosis
- Results similar
Original publication
Associations between social determinants of health and long-term outcomes in systemic lupus erythematosus: a nationwide population-based cohort study in Sweden. RMD Open. Published 6 January 2026. doi:10.
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