{"doi":"10.1002/acr.25359","title":"Multiplicative Impact of Adverse Social Determinants of Health on Outcomes in Lupus Nephritis: A Meta‐analysis and Systematic Review","abstract":"OBJECTIVE: Social determinants of health (SDoH) likely contribute to outcome disparities in lupus nephritis (LN). Understanding the overall burden and contribution of each domain could guide future health equity-focused interventions to improve outcomes and reduce disparities in LN. Objectives of this meta-analysis were to 1) determine the association of overall SDoH and specific SDoH domains on LN outcomes and 2) develop a framework for the multidimensional impact of SDoH on LN outcomes. METHODS: We performed a comprehensive search of studies measuring associations between SDoH and LN outcomes. We examined pooled odds of poor LN outcomes including death, end-stage kidney disease, or cardiovascular disease in patients with and without adverse SDoH. Additionally, we calculated the pooled odds ratios of outcomes by four SDoH domains: individual (eg, insurance), health care (eg, fragmented care), community (eg, neighborhood socioeconomic status), and health behaviors (eg, smoking). RESULTS: Among 531 screened studies, 31 meeting inclusion criteria and 13 with raw data were included in meta-analysis. Pooled odds of poor outcomes were 1.47-fold higher in patients with any adverse SDoH. Patients with adverse SDoH in individual and health care domains had 1.64-fold and 1.77-fold higher odds of poor outcomes. We found a multiplicative impact of having two or more adverse SDoH on LN outcomes. Black patients with public insurance and fragmented care had 12-fold higher odds of poor LN outcomes. CONCLUSION: Adverse SDoH is associated with poor LN outcomes. Having two or more adverse SDoH, specifically in different SDoH domains, had a multiplicative impact leading to worse LN outcomes, widening disparities.","journal":"Arthritis Care & Research","year":2024,"id":425496,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":19,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9617,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2024-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1146286,"name":"Nadia Sweet","orcid":null,"position":1,"is_corresponding":false},{"id":1224270,"name":"Brianna Boderman","orcid":null,"position":2,"is_corresponding":false},{"id":1149172,"name":"Daniel Montes","orcid":"0000-0002-2503-7737","position":3,"is_corresponding":false},{"id":343982,"name":"Theresa L. Walunas","orcid":"0000-0002-7653-3650","position":4,"is_corresponding":false},{"id":298585,"name":"Rosalind Ramsey‐Goldman","orcid":"0000-0001-8712-787X","position":5,"is_corresponding":false},{"id":561541,"name":"Arezou Khosroshahi","orcid":"0000-0001-8365-8497","position":6,"is_corresponding":false},{"id":407697,"name":"Brad C. Astor","orcid":"0000-0002-0876-0069","position":7,"is_corresponding":false},{"id":340315,"name":"S. Sam Lim","orcid":"0000-0003-2361-0787","position":8,"is_corresponding":false},{"id":395149,"name":"Christie M. Bartels","orcid":"0000-0001-6523-0374","position":9,"is_corresponding":false},{"id":395152,"name":"Shivani Garg","orcid":"0000-0001-7272-2692","position":0,"is_corresponding":true}],"reference_count":69,"raw_metadata":null,"created_at":"2026-07-19T01:58:32.160975Z","pmid":"38693617","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}