Racial Discrimination, Disease Activity, and Organ Damage: The Black Women's Experiences Living with Lupus (BeWELL) Study

David H. Chae, Connor D. Martz, Thomas E. Fuller-Rowell, Erica C. Spears, Tianqi Tenchi Gao Smith, Evelyn A. Hunter, Cristina Drenkard, S. Sam Lim

Research output: Contribution to journalArticlepeer-review

30 Scopus citations


Black women are disproportionately affected by systemic lupus erythematosus (SLE), a chronic, potentially debilitating autoimmune disease, and they also experience more rapid progression and worse outcomes compared with other groups. We examined if racial discrimination is associated with disease outcomes among 427 black women with a validated diagnosis of SLE, who live in the Atlanta, Georgia, metropolitan area, and were recruited to the Black Women's Experiences Living with Lupus Study (2015-2017). Frequency of self-reported experiences of racial discrimination in domains such as employment, housing, and medical settings was assessed using the Experiences of Discrimination measure. SLE activity in the previous 3 months, including symptoms of fatigue, fever, skin rashes, and ulcers, was measured using the Systemic Lupus Activity Questionnaire; irreversible damage to an organ or system was measured using the Brief Index of Lupus Damage. Results of multivariable linear regression analyses examining the Systemic Lupus Activity Questionnaire and log-transformed Brief Index of Lupus Damage scores indicated that increasing frequency of racial discrimination was associated with greater SLE activity (b = 2.00, 95% confidence interval: 1.32, 2.68) and organ damage (b = 0.08, 95% confidence interval: 0.02, 0.13). Comprehensive efforts to address disparities in SLE severity should include policies that address issues of racial discrimination.

Original languageEnglish
Pages (from-to)1434-1443
Number of pages10
JournalAmerican Journal of Epidemiology
Issue number8
StatePublished - 1 Aug 2019


  • black women
  • racial discrimination
  • systemic lupus erythematosus


Dive into the research topics of 'Racial Discrimination, Disease Activity, and Organ Damage: The Black Women's Experiences Living with Lupus (BeWELL) Study'. Together they form a unique fingerprint.

Cite this