Redlining, structural racism, and psoriatic arthritis outcomes: underrecognized limitations and clinical implications: comment on the article by Dowell et al...Dowell S, Banbury B, Jenkins C, et al. The influence of race, ethnicity, and historical redlining on psoriatic disease burden and clinical outcomes. Arthritis Rheumatol 2026;78(3):644–653.

The article critically examines a recent study linking historical redlining, assessed by Home Owners' Loan Corporation (HOLC) grades, with outcomes in psoriatic arthritis (PsA), highlighting limitations that affect its conclusions on structural racism's impact. Key concerns include underrepresentati...

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Publicado en:Arthritis & Rheumatology Vol. 78; no. 4; pp. 1008 - 1010
Autores principales: Chen, Shiuan‐Chih, Lee, Yuan‐Ti
Formato: commentary letter Journal Article
Publicado: Wiley-Blackwell Apr2026
Acceso en línea:Ver este registro en EBSCOhost
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      pub: Wiley-Blackwell
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        atl: Redlining, structural racism, and psoriatic arthritis outcomes: underrecognized limitations and clinical implications: comment on the article by Dowell et al...Dowell S, Banbury B, Jenkins C, et al. The influence of race, ethnicity, and historical redlining on psoriatic disease burden and clinical outcomes. Arthritis Rheumatol 2026;78(3):644–653.
      aug:
        au:
          Chen, Shiuan‐Chih
          Lee, Yuan‐Ti
        affil: Community Health Care Center and Department of Family and Community Medicine, Chung Shan Medical University Hospital and School of Medicine, College of Medicine, Chung Shan Medical University, Taichung, Taiwan
      sug:
        subj:
          Race Factors
          Ethnic Groups
          Arthritis, Psoriatic Economics
          Arthritis, Psoriatic Prognosis
          Systemic Racism
          Economic Aspects of Illness
          Arthritis, Psoriatic Ethnology
          Arthritis, Psoriatic Drug Therapy
      ab: The article critically examines a recent study linking historical redlining, assessed by Home Owners' Loan Corporation (HOLC) grades, with outcomes in psoriatic arthritis (PsA), highlighting limitations that affect its conclusions on structural racism's impact. Key concerns include underrepresentation of Black patients and those from redlined neighborhoods, reliance on overlapping socioeconomic measures that may confound redlining effects, and exclusive use of the Routine Assessment of Patient Index Data 3 (RAPID3), which omits important PsA-specific disease domains. Additionally, attrition and missing data disproportionately exclude vulnerable populations, potentially underestimating disparities, while the study’s focus on patient and neighborhood factors overlooks provider- and system-level contributors such as implicit bias and healthcare barriers. These limitations suggest the study may understate the full influence of structural racism and systemic factors on PsA outcomes and treatment equity.
      pubtype: Academic Journal
      doctype:
        commentary
        letter
        Journal Article
      ougenre: Article
    language: English
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