Spondyloarthritis & psoriatic arthritis
The Influence of Race, Ethnicity and Historical Redlining on Psoriatic Disease Burden and Clinical Outcomes
Authors' conclusion
In the United States, Black patients with PsA have prevalent HDA and high social deprivation. Additionally, the enduring effects of structural racism appear to negatively influence PsA disease characteristics of patients living in historically redlined areas.
Study context
- Population
- Patients with PsA in the RISE registry of the ACR with reported race, region and ≥3 years of follow-up57.7% female
- Participants
- 21,429 patients
- Exposure
- Racial and ethnic subsets; Home Owners' Loan Corporation (HOLC) 4 vs HOLC 1 areas
- Outcome
- Disease burden (social deprivation by area deprivation index; disease activity) by race and ethnicity
Methodological detailsregistry-based (RISE registry of the ACR), stratified by race, subgroup analyses by HOLC grade
- Registry-based (RISE registry of the ACR)
- Stratified by race
- Subgroup analyses by HOLC grade
Further findings
High social deprivation, by race
High disease activity (HDA), by race
- HOLC 4 vs HOLC 1 areas (subgroup): HOLC 4 median 105.0 (IQR 0–690) person-days of high disease activity (HDA)
- HOLC 4 vs HOLC 1 areas (subgroup): HOLC 4 median 1.0 (IQR 0–5,457) person-days in remission
Patients living in HOLC-graded districts (subgroup)
- ≈7% of patients with PsA lived in HOLC-graded districts
HOLC 4 vs HOLC 1 areas (subgroup)
- Smoking, obesity, high social deprivation, federal insurance and HDA more prevalent in HOLC 4 vs HOLC 1 areas
- HOLC 4 had longer periods of HDA and fewer days in remission
Original publication
The Influence of Race, Ethnicity and Historical Redlining on Psoriatic Disease Burden and Clinical Outcomes. Arthritis Rheumatol. Published 19 December 2025. doi:10.
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