The role of social determinants of health on disease outcomes in axial spondyloarthritis: A narrative review

This review provides a narrative exploration of the literature on various social determinants of health that influence outcomes in axial Spondyloarthritis (axSpA). By using the PROGRESS-Plus framework (place of residence, race, occupation, gender/sex, religion, education, socioeconomic status, social capital, age), this review discusses how these factors have been studied and their impact on disease outcomes in axSpA. The findings suggest that various patient-level factors (e.g. female sex, blue-collar jobs, low educational level) and country-level factors (e.g. low-income countries) associate with worse health outcomes in axSpA. These insights highlight the importance of adopting a multifaceted and holistic approach, that also considers social determinants of health, when managing patients with axSpA. This work also identifies unmet needs in this area including the importance of thinking beyond just biological factors, when considering drivers of suboptimal outcomes in axSpA.