Background/Purpose: Populations experiencing rheumatic diseases are often at higher risk of increased levels of stress. This may result in disease complications and can potentially lead to escalation and development of new diseases as well. Because of the heterogeneity of many rheumatic diseases, it is difficult to understand which forms of stress could exacerbate one’s condition. What is known however, is that stress intensifies mental health issues.The COVID-19 global pandemic and the national protest movement sparked by the latest round of police violence, both predominantly affect Black people. The events have caused immense stress on people with rheumatic conditions, a large percentage of which are Black, with 6.1 million Black people diagnosed with Rheumatoid Arthritis, and as many as 1 in 250 Black women diagnosed with and being treated for Lupus, according to the latest statistics for the United States.

Intervention:

Because of the added danger, patients are often advised to avoid stress and/or reduce any stressful activities in their lives. We are reminded very often of the necessity of living a stress-free life as part of our care regimen for our rheumatic diseases. As is well known, mental health directly affects physical health. Added stress in patients’ lives leads to increased consultations with rheumatologists and other specialists, because of the increased physical symptoms caused by stress. Additionally, psychological consults and support groups are recommended for mental and emotional support. Formal and informal support group settings are very beneficial to patients as a space to unpack their feelings and emotions.

Maintenance:

The goal is to decrease stress, as stress negatively impacts patient health. To that effect, issues of health disparities as well as extrajudicial violence must be addressed. To protect the overall health of the patient, racism and gender discrimination must be highlighted and eradicated. Women, specifically Black cis women like ourselves and espcially Black women of trans experience, are dying at a disproportionate rate due to societal violence and negligence within the healthcare system. We must remember that when we protect the most vulnerable and marginalized among us, we ensure protections and a better quality of life for all. 

Quality of Life:

International Rheumatology organizations (and the medical community at large) should be invested in dismantling these inhumane systems that overwhelmingly affect the physical and mental health of their patients. Stress is defined as physiological disturbance or damage caused to an organism by adverse circumstances. Patients deserve a life free of such a burden as we work together with our care teams to manage our rheumatic diseases.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/covid-19-racism-and-gender-discrimination-the-function-of-stress-in-widening-the-gap-in-health-disparities/