The Impact of Ethnicity in Myasthenia Gravis

Health disparities are prevalent across all diseases. They encompass factors not just related to ethnicity. Health disparities are based on other factors such as sex, sexual orientation, immigration status, age, socioeconomic status, and religion.¹

For the purposes of this article, we will focus on ethnic disparities, particularly in the African American population, in people with myasthenia gravis (MG).

What are health disparities?

Health disparity, as defined by the National Institutes of Health, is "a significant disparity in the overall rate of disease incidence, prevalence, morbidity, or mortality in the specified population as compared with the general population."¹

These are a few examples of health disparities:²

• African Americans are less likely than white people to be referred for certain procedures, such as heart catheterization, a procedure which is used to diagnose and treat heart conditions.
• African Americans are more likely to die of heart causes than white people.
• African Americans are less likely to achieve health targets, such as their blood cholesterol targets, compared to white patients.
• African American women are less likely to survive ovarian and cervical cancer when compared to white women, despite having the same cancer stage at diagnosis.

Ethnicity implications in MG

One study discovered that not only is MG found in different rates across various ethnicities, but the severity and presentation of MG varies as well.³

For example:^3,4

• African American patients are more likely to have eye symptoms of MG, including eye paralysis and eyelid droopiness, which do not respond to treatment compared to white patients.
• For patients with ocular MG, non-Caucasians are more likely to be diagnosed at an earlier age, on average 17 years earlier than their Caucasian counterparts.
• African Americans had earlier onset MG which tends to be more severe than Caucasians.
• Anti-MuSK antibodies, a marker used to diagnose MG, varies across ethnic groups. African Americans are more likely to have a greater frequency of positivity than Caucasians.

Why is identifying ethnic differences important?

It is important to address the impact of ethnicity on health outcomes because it can help inform better means of diagnosis and approach to management. For example, we have studies showing that African Americans are less likely to have insurance coverage from their employer and are less likely to receive continuity of care.²

In addition, we know that minority ethnic groups are often underrepresented in genetic studies when pharmaceuticals are studied. This means that, particularly for some older drugs, the drug was mainly studied in white patients.⁵

Open the dialogue

Let’s open the dialogue of ethnicity’s impact on health. Reducing health care disparities requires a system reformation including addressing our implicit biases.

The key is to continue the conversation to raise awareness – we all deserve access to the same health outcomes.

Are you a minority living with MG? Did you find that being a minority has affected any aspect of your MG diagnosis or treatment? Share your experiences below!