Dr. Shivani Garg, a researcher dedicated to social determinants of health, discusses the profound impact these factors have on patients with Lupus Nephritis. She reveals how adverse social conditions can significantly worsen health outcomes, creating a multiplicative effect on patient experiences. The conversation highlights challenges faced by young lupus patients, especially among Latinx women, and emphasizes the need for holistic approaches in healthcare. Dr. Garg also shares her journey into rheumatology and the importance of mentorship in medicine.
Understanding the multiplicative impact of adverse social determinants is crucial for improving health outcomes in lupus nephritis patients.
Social factors, such as race and socioeconomic status, significantly influence the severity of lupus-related health outcomes, often more than genetic determinants.
Deep dives
Understanding Multipliers in Health Outcomes
Multipliers are key factors in health outcomes, representing individuals or events that integrate and enhance overall results. The discussion highlights that while luck can explain positive outcomes, a network of seemingly unrelated events often plays a significant role. Conversely, minor issues can cascade negatively, leading to deteriorating situations, which is particularly noticeable in healthcare contexts. This principle applies to lupus nephritis, where understanding the multiplicative effects of adverse social determinants is crucial for improving patient outcomes.
The Role of Social Determinants in Lupus Nephritis
Lupus nephritis significantly affects a high percentage of lupus patients, particularly young women from specific social backgrounds. Studies reveal that factors such as race and socioeconomic status influence the incidence and severity of lupus-related health outcomes. Notably, only a small fraction of poor outcomes is attributed to genetic factors, suggesting that social determinants play a larger role. This insight compels researchers to explore how factors like access to healthcare and community resources affect patient health and mortality.
Methodology of the Systematic Review
The systematic review included comprehensive literature screening and defined specific social determinants impacting lupus nephritis outcomes. Researchers set rigorous inclusion criteria focused on severe outcomes such as end-stage kidney disease and cardiovascular events, while employing robust quality assessment tools. A total of 31 high-quality studies were included after careful curation from a larger pool of over 500 initial manuscripts. This methodology allowed for a rigorous analysis of how different social determinants correlate with adverse health outcomes in lupus nephritis.
The Multiplicative Effect of Adverse Factors
Research findings indicate that patients facing multiple adverse social determinants exhibit significantly worse outcomes compared to those with fewer or no such factors. The analysis showed that individuals with several barriers, like lacking access to healthcare and experiencing systemic racism, had 12 times higher odds of poor health outcomes. This highlights the complex interplay of social determinants, as they do not act in isolation but rather amplify each other's negative effects. Recognizing these compounded effects presents opportunities for targeted interventions to improve health equity in lupus patients.
Genetic conditions, inherited personality traits, brain chemistry...these are but a few of the well-known biological determinants of health and are but a small sample of factors that can determine how severe disease may affect a patient. But what role can social factors play in determining a patient’s health? What of the ‘Social Determinants of Health (SDoH)’? Dr. Shivani Garg set out to identify these factors and understand how they play a role in determining the severity of symptoms in those with Lupus Nephritis (LN). What she discovered was that not only do these factors play a significant role, but each one added has a multiplicative effect on the patient’s reported outcome! Dr. Garg is our guest today and her study, published in Arthritis Care & Rheumatology titled: Multiplicative Impact of Adverse Social Determinants of Health on Outcomes in Lupus Nephritis: A Meta-analysis and Systematic Review, will be the focus of our discussion.
Get the Snipd podcast app
Unlock the knowledge in podcasts with the podcast player of the future.
AI-powered podcast player
Listen to all your favourite podcasts with AI-powered features
Discover highlights
Listen to the best highlights from the podcasts you love and dive into the full episode
Save any moment
Hear something you like? Tap your headphones to save it with AI-generated key takeaways
Share & Export
Send highlights to Twitter, WhatsApp or export them to Notion, Readwise & more
AI-powered podcast player
Listen to all your favourite podcasts with AI-powered features
Discover highlights
Listen to the best highlights from the podcasts you love and dive into the full episode