{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T15:01:09Z","timestamp":1789398069947,"version":"build-2803163510"},"reference-count":35,"publisher":"SAGE Publications","issue":"10","license":[{"start":{"date-parts":[[2023,7,12]],"date-time":"2023-07-12T00:00:00Z","timestamp":1689120000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["NS113757"],"award-info":[{"award-number":["NS113757"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Mult Scler"],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Black and Hispanic patients with multiple sclerosis (MS) have been shown to accumulate greater multiple sclerosis\u2013associated disability (MSAD) than White patients. Disparities in social determinants of health (SDOH) among these groups have also been reported.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To determine the extent to which associations of race and ethnicity with MSAD may be attributable to differences in SDOH.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Retrospective chart analysis of patients at an academic MS center grouped by self-identified Black ( n = 95), Hispanic ( n = 93), and White ( n = 98) race\/ethnicity. Individual patient addresses were geocoded and matched with neighborhood-level area deprivation index (ADI) and social vulnerability index (SVI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Average Expanded Disability Status Scale (EDSS) scores at last-recorded evaluations of White patients (1.7 \u00b1 2.0) were significantly lower than Black (2.8 \u00b1 2.4, p = 0.001) and Hispanic (2.6 \u00b1 2.6, p = 0.020) patients. Neither Black race nor Hispanic ethnicity was significantly associated with EDSS in multivariable linear regression models that included individual-level SDOH indicators and either ADI or SVI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Black race and Hispanic ethnicity are not significantly associated with EDSS in models that include individual and neighborhood-level SDOH indicators. Further research should elucidate mechanisms by which structural inequities affect MS disease course.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/13524585231185046","type":"journal-article","created":{"date-parts":[[2023,7,12]],"date-time":"2023-07-12T06:24:26Z","timestamp":1689143066000},"page":"1304-1315","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":23,"title":["Social determinants of health and disparate disability accumulation in a cohort of Black, Hispanic, and White patients with multiple sclerosis"],"prefix":"10.1177","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9357-7076","authenticated-orcid":false,"given":"Christopher M","family":"Orlando","sequence":"first","affiliation":[{"name":"Division of Multiple Sclerosis and Neuroimmunology, Department of Neurology, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos A","family":"P\u00e9rez","sequence":"additional","affiliation":[{"name":"Maxine Mesinger Multiple Sclerosis Comprehensive Care Center, Department of Neurology, Baylor College of Medicine, Houston, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paunel","family":"Agyei","sequence":"additional","affiliation":[{"name":"Division of Multiple Sclerosis and Neuroimmunology, Department of Neurology, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marwah","family":"Elsehety","sequence":"additional","affiliation":[{"name":"Inova, Fairfax, VA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonia Kaur","family":"Singh","sequence":"additional","affiliation":[{"name":"Division of Multiple Sclerosis and Neuroimmunology, Department of Neurology, McGovern Medical School, 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