Investigating Multiple Sclerosis Racialized Disparities Using Intersectionality, The Life Course Perspective, and Critical Sociological Theories

Multiple sclerosis (MS) is a chronic, progressive immune disorder once thought only to affect White people. Over the last ten years a small body of studies reveal equal MS prevalence among Black and White Americans but worse MS outcomes for Black Americans across measures of physical and cognitive health. However, few studies assess possible social causes that may be driving MS racialized disparities. The overall objective of this dissertation is to understand MS racialized disparities through a sociological lens by reviewing the current archive on the topic and to offer an alternative approach that understands racism and social determinants of health as driving forces of racialized health disparities. In Chapter I “The MS Racialized Health Disparities Archive: The Reproduction of Bioracist Narratives in Published MS Studies,” I conduct a content analysis of existing MS racialized disparities studies to answer the question what epistemological frameworks are MS researchers using to design and implement racialized MS health disparities studies and interpret the findings? In Chapter II “Identifying Differences in Multiple Sclerosis Diagnosis Pathways Between Black and White Americans,” I use the life course perspective in conversation with critical sociological theories to identify differences in the diagnosis pathways between Black and White Americans that may result in diverging illness trajectories and subsequent health outcomes. Chapter II seeks to answer the question does the diagnosis pathway for Black Americans differ from that of White Americans, and how? In Chapter III “Conceptualizing and Measuring Racism as a Determinant of Multiple Sclerosis Racialized Disparities,” I draw on the work of race scholars and critical sociological theorists to assess if racism is associated with MS outcomes for Black Americans. In its totality, this body of work is a call to action for the MS field to abandon a bioracist framework and to work in collaboration with sociologists to design ethical and rigorous MS racialized disparities studies.