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Disparities in Rheumatoid Arthritis Care and Health Service Solutions to Equity

Author

Rheum Dis Clin North Am. 2020 Nov;46(4):685-692. doi: 10.1016/j.rdc.2020.07.005.Epub 2020 Sep 9.

Cheryl Barnabe 1

Author Information

1 Department of Medicine, Cumming School of Medicine, University of Calgary, 3330 Hospital Drive Northwest, Calgary, AB T2N 4N1, Canada; Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3330 Hospital Drive Northwest, Calgary, AB T2N 4N1, Canada. Electronic address: ccbarnab@ucalgary.ca.

Abstract

Proximal, intermediate, and distal social determinants of health inform the health of populations. Differences in rheumatoid arthritis outcomes between populations reflect inequities in these determinants. However, health service access, medication availability, and high-quality care interactions can be ensured through health system restructuring and innovations in individual-level care provision. This article summarizes disparities in rheumatoid arthritis care that have been recognized and described in the United States and Canada and proposes models of care and treatment approaches that can support better outcomes for population groups at risk for outcome inequities.