| Summary: | 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.
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