ArticleMultiple sclerosis and related disorders2022
The impact of socioeconomic status on subsequent neurological outcomes in multiple sclerosis.
Article in Multiple sclerosis and related disorders, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed.
- Psychiatric comorbidities cluster early after onset in MOGAD: a cross-sectional comparative study with MS and NMOSD.Journal of neurology, neurosurgery, and psychiatry · 2026Article
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- Sex and gender as contributors to brain pathophysiology, clinical course, and therapeutic response in multiple sclerosis.Frontiers in behavioral neuroscience · 2026Review
- The Interplay of Neighborhood Deprivation, Race, and Multiple Sclerosis.Ethnicity & disease · 2026Article
- Plasmaphosphorylated tau as biomarkers for multiple sclerosis diagnosis, subtyping, and prognosis.Brain communications · 2026Article
- Demographic, Clinical, and Molecular Determinants of Quality of Life and Oxidative Stress in Multiple Sclerosis: A Cross-Sectional Study from Sulaymaniyah, Iraq.Journal of molecular neuroscience : MN · 2025Article
- Detecting New Lesions Using a Large Language Model: Applications in Real-World Multiple Sclerosis Datasets.Annals of neurology · 2025Article
- Aging-dependent change in Th17 and cytokine response in multiple sclerosis.Journal of neuroinflammation · 2025Article
- Longitudinal Digital Phenotyping of Multiple Sclerosis Severity Using Passively Sensed Behaviors and Ecological Momentary Assessments: Real-World Evaluation.Journal of medical Internet research · 2025Article
- Impact of the COVID-19 Pandemic on the Personal Networks and Neurological Outcomes of People With Multiple Sclerosis: Cross-Sectional and Longitudinal Case-Control Study.JMIR public health and surveillance · 2024Article
- Premorbid Sociodemographic Status and Multiple Sclerosis Outcomes in a Universal Health Care Context.JAMA network open · 2023Observational
- Social determinants of health and disparate disability accumulation in a cohort of Black, Hispanic, and White patients with multiple sclerosis.Multiple sclerosis (Houndmills, Basingstoke, England) · 2023Article
- Association of neighborhood deprivation with white matter connectome abnormalities in temporal lobe epilepsy.Epilepsia · 2023Article
- Predicting Multiple Sclerosis Outcomes During the COVID-19 Stay-at-home Period: Observational Study Using Passively Sensed Behaviors and Digital Phenotyping.JMIR mental health · 2022Article
- Diversity, Equity, and Inclusion in the Multiple Sclerosis Community: A Call to Action.International journal of MS careArticle
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9 authors.
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Abstract
backgroundTo examine whether lower neighborhood-level and individual-level indicators of socioeconomic status (SES) are associated with subsequently worse neurological disability in people with MS (pwMS).
methodsIn a multi-center study using prospectively collected data from discovery cohorts (University of Pittsburgh, N=1316) and replication cohorts (Columbia University, N=488), we calculated a neighborhood SES indicator, area deprivation index (ADI), based on participants' residence at enrollment, and we derived an individual SES indicator based on participants' household income. Patient-reported neurological outcomes included the Multiple Sclerosis Rating Scale-Revised (MSRS-R), Patient-Determined Disease Steps (PDDS), and Patient-Reported Outcomes Measurement Information System (PROMIS) Physical Function scores from 2018 to 2020. We performed covariate-adjusted regression analyses in each cohort and then random-effects meta-analyses.
resultsHigher ADI (lower SES) in 2015 was associated with subsequently worse neurological outcomes during 2018-2020 (discovery: MSRS-R, β=0.62, 95%CI [0.36,0.89], p<0.001; PDDS, β=0.11, 95%CI [0.02,0.20], p=0.02 | replication: MSRS-R, β=0.46, 95%CI [0.21,0.72], p<0.001; PDDS, β=0.12, 95%CI [0.03,0.21], p=0.009, PROMIS, β=-0.60, 95%CI [-1.12,-0.08], p=0.025). Lower neighborhood percent with college education (MSRS-R, β=-7.31, 95%CI [-8.99,-5.64], p<0.001; PDDS, β=-1.62, 95%CI [-2.20,-1.05], p<0.001; PROMIS, β=9.31, 95%CI [5.73,12.89], p<0.001), neighborhood median household income (MSRS-R, β=-3.80e-05, 95%CI [-5.05e-05,-2.56e-05], p<0.001; PDDS, β=-8.58e-06, 95%CI [-1.28e-05,-4.32e-06], p<0.001; PROMIS, β=2.55e-05, 95%CI [5.96e-07,5.05e-05], p=0.045), and neighborhood median home value (MSRS-R, β=-6.50e-06, 95%CI [-8.16e-06,-4.84e-06], p<0.001; PDDS, β=-1.54e-06, 95%CI [-2.11e-06,-9.65e-07], p<0.001; PROMIS, β=4.98e-06, 95%CI [1.81e-06,8.14e-06], p=0.002) drove the association between higher ADI and subsequently worse neurological disability (in joint analyses). Neighborhood percent of population with Medicaid, but not private insurance, significantly mediated the observed covariate-adjusted associations. Higher individual-level household income bracket was associated with better neurological outcomes in joint analyses (MSRS-R: R=-0.39, p<0.001; PDDS: R=-0.35, p<0.001; PROMIS: R=0.37, p<0.001), independent of ADI.
conclusionsLower neighborhood SES is associated with subsequently worse neurological outcomes in pwMS. Future testing of targeted intervention through public policies that improve SES are warranted.
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