Gout is a painful, even debilitating, arthritic condition afflicting more than 9 million Americans.
Specifically, gout is a buildup of uric acid in the body, which can be caused by genetic and lifestyle factors, other risk factors such as chronic kidney disease, as well as by some medications. The disease cannot be cured, but effective uric acid reducing treatments are available to manage chronic gout and prevent painful flareups.
Yet although the disease’s causes and effective treatments are known, millions of gout patients suffer needlessly because of inequities in diagnosis, treatment and access to care.
Minorities, Southeast Most at Risk
Black Americans are two to three times more likely than White Americans to develop gout. Asian Americans, especially the Hmong community, Native Hawaiians and Pacific Islanders are also at heightened risk for gout and other arthritic conditions.
Southeastern states – notable for both their affinity for gout-inducing foods and lower investments in public health – are also beset with higher rates of gout diagnoses. Nor is it likely a coincidence that geographic gout prevalence maps closely coincide with local obesity rates.
Chronic disparities in gout treatment and outcomes led the National Minority Quality Forum to compile available data into a Gout Index. NMQF also partnered with the Alliance for Gout Awareness to impanel an advisory committee of patients and health care providers, to review the data and make recommendations.
Data Shows Costs of Inequality
One stark finding from the Index is that ethnic and regional care disparities contribute to higher costs, worse patient outcomes and unnecessarily diminished quality of life for patients and their families.
Black gout patients are less likely to access preventive treatments. This not only leads to worse pain and disease progression, but also increased likelihood of more expensive emergency room visits and hospitalization.
Often, patients are treated for severe symptoms in the emergency department setting because of inadequate preventive care. One study of Hawaii gout patients found ER visits were 3.4 times more expensive than outpatient visits to doctors’ offices. This makes addressing gout inequities and increasing preventive care critical not just for patient health, but for the health care system as well.
The most powerful weapon against gout is information. The disease has long been subjected to stigma, and its prevalence among underserved ethnic and geographic communities suggests misinformation and inaccessible care magnify the problem. Improving health literacy about gout with at-risk communities is key, especially among patients’ families, as is increasing access to preventive care, appropriate diagnosis and effective treatment.
Taken together, education, advocacy and increased access to care can help improve diagnosis and management of gout among communities of color.