Poverty, Neighborhoods, Persistent Stress, and Systemic Lupus Erythematosus Outcomes: A Qualitative Study of the Patients' Perspective

Arthritis Care & Research
Edward YelinJinoos Yazdany

Abstract

To obtain the perspective of individuals with systemic lupus erythematosus (SLE) regarding the role of poverty, neighborhood, and chronic stress in SLE outcomes. Through annual structured interviews as part of the Lupus Outcomes Study, 723 persons with SLE were followed from 2003 to 2015 in order to establish the effect of combinations of poverty, persistent poverty, residence in an area of concentrated poverty, access to health care, and chronic stress on accumulated damage. We obtained a sample of 28 of the 723 individuals on the basis of household income, geography, and outcomes in their last interview, and administered qualitative interviews to explore their perspectives on the impact of these factors on SLE outcomes. The interviews were recorded, transcribed, and analyzed using a grounded theory approach. Persons in poverty frequently reported that poverty necessitated a choice to deal with food, medical care, and housing insecurity on a daily basis and to relegate their management of SLE to occurrences of disease flares. They also reported that exposure to crime in their neighborhoods was a stressor that triggered worse disease activity. Affluent participants reported that neighborhood neither helped nor hindered dealing ...Continue Reading

References

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Feb 3, 2007·Arthritis and Rheumatism·Edward YelinPeter Panopalis
Aug 1, 2007·Arthritis and Rheumatism·Glinda S CooperMary Anne Dooley
May 15, 2008·Journal of Epidemiology and Community Health·M M GlymourL F Berkman
Oct 15, 2008·Lupus·Graciela S Alarcón
Apr 3, 2009·Current Opinion in Rheumatology·Kristina L Demas, Karen H Costenbader
May 18, 2011·Arthritis Care & Research·Jinoos YazdanyPatricia P Katz
Oct 21, 2011·The New England Journal of Medicine·Jens LudwigThomas W McDade
Sep 22, 2012·Science·Jens LudwigLisa Sanbonmatsu
Nov 3, 2012·Science·Anuj K ShahEldar Shafir
Nov 7, 2013·Administration and Policy in Mental Health·Lawrence A PalinkasKimberly Hoagwood
Jan 1, 2014·Arthritis Care & Research·Patricia KatzJinoos Yazdany
Dec 20, 2014·Health Services Research·Geraldine Foley, Virpi Timonen
Sep 28, 2016·Qualitative Health Research·Monique M HenninkVincent C Marconi

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