Table 1.

Social determinants of health (SDH) factors that have been associated with adverse SLE outcomes

Adverse SLE outcome	SDH factor [References]
Increased SLE activity	Lower income level [27, 31]
	Lower educational attainment [34, 35]
	Neighbourhood crime [33]
	Rural residence [44, 45]
	Racial discrimination [59–62]
	Lower social support [46]
Increased SLE damage	Lower income level [21, 22, 25–28]
	Racial discrimination [59]
	Lower social support [63]
Mortality	Lower income level [21, 24, 26, 30]
	US Medicaid or Medicare insurance [53]
End-stage kidney disease	US Medicaid or Medicare insurance [53]
Lack of referral for kidney transplant	US Medicaid insurance or no insurance [54]
Failure to receive initial peritoneal dialysis	US Medicaid insurance or no insurance [55]
Decreased physical functioning	Lower income level [23, 27]
	Lower educational attainment [27]
Decreased quality of life	Lower income level [21]
Decreased health-related quality of life	Lower educational attainment [40]
	Lower social support [65, 66]
Depression	Lower income level [27]
	Higher financial strain [32]
	Lower educational attainment [38, 39]
	Racial segregation [42]
	Disadvantaged neighbourhood [27]
	Rural residence [46]
	Travel burden to receive SLE care [56–58]
	Lower social support [63, 64]
Anxiety	Lower educational attainment [38]
	Travel burden to receive SLE care [56–58]
	Lower social support [63]
Increased work disability or loss	Lower income level [29]
	Lower educational attainment [34]
Medication nonadherence	Lower educational attainment [36]
	Racial segregation [43]
	Disadvantaged neighbourhood [43]
	Travel burden to receive SLE care [56–58]
Missed appointments/poor retention in SLE care	Lower educational attainment [37]
	Disadvantaged neighbourhood [41]
	Travel burden to receive SLE care [56–58]
30-day hospital readmissions	US Medicaid or Medicare insurance [48, 51]
Preventable lupus hospitalizations	US Medicaid or Medicare insurance [49, 50]
Healthcare fragmentation	US Medicaid or Medicare insurance [52]