Deadly Vasculitides and Reversed Racial/Ethnic Disparity?
Authors: John R. Stone
Journal: Annals of Internal Medicine (2019)

Editorials21 January 2020Deadly Vasculitides and Reversed Racial/Ethnic Disparity?John R. Stone, MD, PhDJohn R. Stone, MD, PhDCreighton University, Omaha, Nebraska (J.R.S.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M19-2755 Annals Author Insight Video - John R. Stone, MD, PhD SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Steinberg and colleagues report high but slowly declining mortality trends of antineutrophil cytoplasmic autoantibody–associated vasculitides (AAV) in the United States (1). Death certificate data for 1999 to 2017 were from the multiple-cause-of-death records from the Centers for Disease Control and Prevention's Wide-ranging Online Data for Epidemiologic Research Database. Of 11 316 AAV-associated deaths, the mortality rate was 1.86 per 1 000 000 persons, with an average annual decline of 1.6%. Vasculitis was the underlying cause of death in 64% of persons. Granulomatosis with polyangiitis accounted for 85% of overall deaths, perhaps meaning 85% of the 64%.Despite immunosuppressive therapy that has been used ...References1. Steinberg AW, Wechsler ME, FernándezPérez ER. Trends in antineutrophil cytoplasmic autoantibody-associated vasculitis-related mortality in the United States, 1999 to 2017. Ann Intern Med. 2020;172:160-3. doi:10.7326/M19-1564 LinkGoogle Scholar2. Tan JA, Dehghan N, Chen W, et al. Mortality in ANCA-associated vasculitis: a meta-analysis of observational studies. Ann Rheum Dis. 2017;76:1566-74. [PMID: 28468793] doi:10.1136/annrheumdis-2016-210942 CrossrefMedlineGoogle Scholar3. Arias E, Schauman WS, Eschbach K, et al. The validity of race and Hispanic origin reporting on death certificates in the United States. Vital Health Stat 2. 2008:1-23. [PMID: 19024798] MedlineGoogle Scholar4. Hunt LM, Megyesi MS. The ambiguous meanings of the racial/ethnic categories routinely used in human genetics research. Soc Sci Med. 2008;66:349-61. [PMID: 17959289] CrossrefMedlineGoogle Scholar5. Stonington SD, Holmes SM, Hansen H, et al. Case studies in social medicine—attending to structural forces in clinical practice. N Engl J Med. 2018;379:1958-61. [PMID: 30428284] doi:10.1056/NEJMms1814262 CrossrefMedlineGoogle Scholar6. Stone JR. Saving and ignoring lives: physicians' obligations to address root social influences on health—moral justifications and educational implications. Camb Q Healthc Ethics. 2010;19:497-509. [PMID: 20719028] doi:10.1017/S0963180110000393 CrossrefMedlineGoogle Scholar7. Krieger N. Stormy weather: race, gene expression, and the science of health disparities. Am J Public Health. 2005;95:2155-60. [PMID: 16257941] CrossrefMedlineGoogle Scholar8. Bonham VL, Green ED, Pérez-Stable EJ. Examining how race, ethnicity, and ancestry data are used in biomedical research. JAMA. 2018;320:1533-4. [PMID: 30264136] doi:10.1001/jama.2018.13609 CrossrefMedlineGoogle Scholar9. Duster T. A post-genomic surprise: the molecular reinscription of race in science, law and medicine. Br J Sociol. 2015;66:1-27. [PMID: 25789799] doi:10.1111/1468-4446.12118 CrossrefMedlineGoogle Scholar10. Winker MA. Race and ethnicity in medical research: requirements meet reality. J Law Med Ethics. 2006;34:520-5. [PMID: 17144175] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Creighton University, Omaha, Nebraska (J.R.S.)Disclosures: The author has disclosed no conflicts of interest. The form can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M19-2755.Corresponding Author: John R. Stone, MD, PhD, Creighton University, 2500 California Plaza, Omaha, NE 68178; e-mail, [email protected]edu.This article was published at Annals.org on 8 October 2019. PreviousarticleNextarticle Advertisement Annals Author Insight Video - John R. Stone, MD, PhD FiguresReferencesRelatedDetailsSee AlsoTrends in Antineutrophil Cytoplasmic Autoantibody–Associated Vasculitis-Related Mortality in the United States, 1999 to 2017 Alexander W. Steinberg , Michael E. Wechsler , and Evans R. Fernández Pérez Metrics 21 January 2020Volume 172, Issue 2Page: 153-154KeywordsDeath ratesHealth careHealth care qualityHealth disparitiesHispanic peopleMortalityNative American peopleObservational studiesRacial and ethnic issuesVasculitis ePublished: 8 October 2019 Issue Published: 21 January 2020 Copyright & PermissionsCopyright © 2019 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...