Background Although major improvements in morbidity and mortality have occurred over the last half century, lupus remains a chronic disease with many unmet needs. Using an evidence based approach to identifying the efficacy of new therapeutic modalities, one must conduct randomised clinical trials with rigorous attention to design. Epidemiologic studies of SLE indicate clearly that there are both racial/ethnic and socioeconomic differences in pathophysiology, clinical outcome, and response to therapy. The target population for future trials must include significant representation from minority and disadvantaged patients. Brooklyn, with its rich diversity of racial/ethnic and socioeconomic communities, is an ideal environment for this goal. We therefore sought to assess the overall prevalence of SLE in Brooklyn, identifying the sociodemographic characteristics of its varied neighbourhoods and health care centres.
Materials and methods To estimate the overall prevalence of diagnosed SLE in Brooklyn, we used 2015 population statistics derived from Truven Health Analytics, Inc. Data is supplied for each zip code in Brooklyn, specified by race/ethnicity (White non-Hispanic, Black non-Hispanic, Asian non-Hispanic, Hispanic, and all others), gender, and age (0–14, 15–17, 5-year groups from age 18–64, and >65). Data for each zip code included household income and educational level. To calculate the expected number of SLE patients residing in each zip code, we extrapolated from recent age-standardised prevalence rates by race and gender from the CDC-sponsored Manhattan Lupus Surveillance Study (presented at American College of Rheumatology Annual Meeting, November 2015).
Results Based on 2015 population statistics, there are an estimated 1515 adult SLE patients residing in Brooklyn (Table 1). The Bedford-Stuvesant and Bushwick neighbourhoods have a heavy concentration of African Americans, with the West Indian community including individuals predominantly from Jamaica, Haiti, and Guyana located largely in Canarsie, Flatbush, and East Flatbush. Asian Americans, mostly Chinese, tend to settle in Southern Brooklyn, while immigrants from Arab countries are concentrated in BayRidge in southwest Brooklyn, and Eastern European and Soviet immigrants in the Coney Island, Brighton Beach, and Sheepshead Bay areas. There is a strong overlap between the predicted high neighbourhood prevalence of SLE and Brooklyn’s economically disadvantaged neighbourhoods.
Conclusions Identifying the Brooklyn neighbourhoods with a high prevalence of SLE patients of specific sociodemographic groups will allow us to plan culturally relevant educational programs to target their needs and encourage participation in research studies including randomised clinical trials.
Acknowledgements Carried out in collaboration with members of the Brooklyn Health Disparities Centre, SUNY Downstate Medical Centre and the Arthur Ashe Institute for Urban Health
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