Social determinants of health are the conditions in which people are born, grow, live, work and age. These circumstances are the nonmedical factors that influence health outcomes. Evidence indicates that health behaviours, comorbidities and disease-modifying therapies all contribute to multiple sclerosis (MS) outcomes; however, our knowledge of the effects of social determinants -that is, the 'risks of risks' -on health has not yet changed our approach to MS. Assessing and addressing social determinants of health could fundamentally improve health and health care in MS; this approach has already been successful in improving outcomes in other chronic diseases. In this narrative Review, we identify and discuss the body of evidence supporting an effect of many social determinants of health, including racial background, employment and social support, on MS outcomes. It must be noted that many of the published studies were subject to bias, and screening tools and/or practical interventions that address these social determinants are, for the most part, lacking. The existing work does not fully explore the potential bidirectional and complex relationships between social determinants of health and MS, and the interpretation of findings is complicated by the interactions and intersections among many of the identified determinants. On the basis of the reviewed literature, we consider that, if effective interventions targeting social determinants of health were available, they could have substantial effects on MS outcomes. Therefore, funding for and focused design of studies to evaluate and address social determinants of health are urgently needed. Sections Key points• Addressing an individual's social determinants of health -that is, the conditions under which they are born, grow, live, work and age -could provide opportunities to reduce the burden of living with multiple sclerosis (MS).• Individual factors that may influence MS-related outcomes include sex, gender and sexuality, race and ethnicity, education and employment, socioeconomic status, and domestic abuse.• Societal infrastructures, including access to food, health care and social support, can also affect MS-related outcomes.• Awareness of the specific circumstances of a patient with MS might help neurologists deliver better care.• Social determinants of health are not static and can change according to wider sociopolitical contexts, as highlighted by the COVID-19 pandemic.• Rigorous studies of interventions to ameliorate the effects of poor social determinants on people with MS are urgently needed.Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author selfarchiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. Review criteriaTo ensure an inclusive overview, we searched PubMed, Scopus, CINAHL through EBSCOhost, MEDLINE through OVID, all other Web of ...
ObjectiveTo establish the gender distribution of multiple sclerosis (MS) researchers across high-impact neurologic publications, MS-specific journals, and the European Committee for Treatment and Research in MS (ECTRIMS).MethodsJournal editorial boards and contents were retrieved online to assess first-named and senior authors. Published tables of contents for each journal from 2017 were reviewed. Congrex, the ECTRIMS organizers, were contacted and speaker names were obtained from online abstracts to assess visible opinion leaders.ResultsA total of 2,080 articles were analyzed across 4 general neurology journals, and 452 across 2 MS journals. Overall, 36% of general neurology articles had a female first name author and 25% had a female senior author. In MS-specific journals, 44% of first authors and 35% of senior authors were female, with similar proportions of unique authors. There is limited female representation on the ECTRIMS executive board, but reasonable balance on Council. Almost 50% of attendees in 2017 were female, but only 35% of invited speakers.ConclusionsThere is substantial female drop-off between junior and senior research level across multiple areas. Strategies to support gender balance are urgently required, including developing mentorship schemes, ensuring gender balance in conferences, and thorough examination of the barriers facing female academics with direct challenges to address unconscious bias.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.