This revised grant is submitted in response to a request for proposals on clinical and epidemiologic research on minority populations of the U.S. and studies the effect of social, nutritional and environmental factors on disease activity among low-income American Blacks and Whites with Systemic Lupus Erythematosus (SLE). Nearly all studies examining the epidemiology of SLE have observed higher morbidity and mortality for black patients. Lower socioeconomic status is believed to explain this discrepancy, in part. Lower socioeconomic status is associated with factors such as diminished access to health care, inadequate knowledge of disease, less availability of social supports, etc. Many of these are amenable to public health and social policy strategies to improve health status in high-risk populations. A multicentered cross-sectional study is proposed. The study will confirm previous observations on the discrepant morbidity of black patients and identify potentially modifiable factors of public health importance which affect disease activity.
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