August 18, 2025
2 min read
Key takeaways:
- Education and screening for social determinants of health can reduce disparities in care.
- Housing and food insecurity can impact rheumatic disease outcomes.
Disseminating information through community leaders and screening patients for social determinants of health can improve outcomes among underserved populations, according to a presenter at the 2025 AWIR annual conference.
“The goal of my talk is to describe drivers of differences in access to high quality care among individuals with rheumatic diseases and to present several interventions that aim to address these drivers,” Candace H. Feldman, MD, ScD, of Brigham and Women’s Hospital and Harvard Medical School, told Healio. “I will specifically highlight modifiable factors related to social determinants of health that have been shown to directly affect an individual’s ability to access sustained, high-quality care for their rheumatic conditions.”
According to Feldman, there are sociodemographic disparities across rheumatic conditions regarding access to providers, treatment, disease and medication monitoring, and prevention that result in uneven outcomes.
Housing insecurity, food insecurity and the inability to access health care or medications can impact rheumatic disease outcomes, she added.
“These directly impact your ability to get referred to a rheumatologist,” Feldman said.
Part of the solution may lie in addressing the ongoing workforce shortage in rheumatology. To that end, Feldman described the AWARD program — a collaboration between the American College of Rheumatology, AWIR and several colleges and universities — which aims to improve workforce issues particularly among underserved populations.
“What we are focused on is embracing differences,” she said. “We aim to increase engagement of individuals with disabilities, those who identify as first-generation low-income medical students, students who self-identify as being from under-resourced communities and individuals across geographic areas.”
On the patient side, Feldman counseled that education does not necessarily have to involve a classroom. She described a program that involved teaching “trusted leaders” in underserved communities — including individuals at a popular barber shop or a church group — about a disease like lupus.
“You train these individuals about the highest quality of care and teach them to disseminate this information throughout their communities,” she said. “Then it snowballs.”
Such programs have been used in Boston and Chicago to positive effect, according to Feldman.
In addition, screening protocols do not necessarily have to involve testing for a disease or condition, Feldman said. She described a screening program for social determinants of health used at multiple sites affiliated with Brigham and Women’s Hospital in Boston.
“Patients with systemic rheumatic conditions or inflammatory arthritis would receive a screening questionnaire that asked about factors ranging from unemployment to difficulty paying for utilities, housing needs and transportation needs,” she said.
This information can then be used to assist patients with their particular needs and navigate their care more effectively.
“My hope is to raise awareness of modifiable barriers to care and provide the rheumatology community with tangible ways we can advocate for all of our patients,” Feldman said.
For more information:
Healio Rheumatology can be reached at rheumatology@healio.com.
Sources/Disclosures
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Feldman C. Keynote Session: Improving Care and Outcomes Among Individuals with Rheumatic Conditions. Presented at: Association of Women in Rheumatology annual conference; July 24-26, 2025; Orlando, Florida (hybrid meeting).
Disclosures:
Feldman reports receiving research support to her institution from the NIH, the Arthritis Foundation, BMS Foundation, BWH.
