The impact of socioeconomic disparity in autoimmune diseases

Abstract Background Autoimmune diseases such as multiple sclerosis (MS) and rheumatoid arthritis (RA) pose an economic burden not only on patients and healthcare systems, but also on society as a whole, due to the high prevalence of functional disabilities and work limitations. Thus, we aimed to identify the underlying biopsychosocial factors influenced by reduced socioeconomic status in MS and RA patients. Methods We included 166 MS and 157 RA patients (75.3%/ 84.7% female; mean age 41±11.3/ 56.4±13.9 years; mean disease duration 11.6±7.1/ 19.5±9.5 years). All participants completed the Brief Illness Perception Questionnaire, General Health Questionnaire, 36-item Short Form Health Survey, Rosenberg Self-Esteem Scale, and Morisky Medication Adherence Scale. Correlations and t-tests were used to analyse the data. Results Income levels did not significantly differ between diseases. Bivariate analyses in MS and RA showed significant correlations between lower income and higher pain (r=.18; p ≤ 0.05/ r=.24; p ≤ 0.01), severe depression (r=-.31; p ≤ 0.001/ r=-.21; p ≤ 0.05), lower self-esteem (r=.24; p ≤ 0.01/ r=.31; p ≤ 0.001), worsened physical (r=.21; p ≤ 0.05/ r=.25; p ≤ 0.01) and mental health (r=.18; p ≤ 0.05/ r=.25; p ≤ 0.01). In RA, additional associations were found between lower income and worsened functional status (r=-.25; p ≤ 0.01), more threatening illness perception (r=-.24; p ≤ 0.01), and fatigue (r=.22; p ≤ 0.01). No associations of sex, age, marital status, disease duration, treatment adherence with income were found. Conclusions Our study highlights the significant impact of limited financial resources on MS and RA patients, underscoring the need for actions to address socioeconomic inequalities. Initiatives should focus on improving mental health support, ensuring equitable access to healthcare, revising policies to strengthen multidisciplinary care, and monitoring socioeconomic impacts on disease management. (Grants: VEGA:1/0608/23; APVV-22-0587) Key messages • Financial constraints in MS and RA have an huge impact on patients’ health, emphasizing the importance of initiatives to reduce socioeconomic inequality and support populations at risk. • Addressing financial strain in MS and RA is essential to reduce long-term public health costs.