A data driven approach to understand the impact of the social determinants of health in pemphigus

Summary: Abstract Body: Social determinants of health (SDoH) are the macro-level conditions that shape health outcomes, such as economic policies, systemic racism, urban design, and education systems. Health-related social needs (HRSNs) are the individual-level, actionable expressions of these systemic factors. Together, these non-medical factors are known to account for up to 50% of all health outcomes. Addressing the burden of unmet HRSNs in a given population first requires a comprehensive characterization of those particular needs. While significant efforts towards this end have been undertaken in the context of other autoimmune diseases such as systemic lupus erythematosus (SLE), no such information is available regarding pemphigus patients. To address this gap, we developed a purpose-fit questionnaire integrating multiple, previously validated instruments to capture a cross-sectional snapshot of the burden of HRSNs in this population. Surveys were distributed in collaboration with the International Pemphigus and Pemphigoid Foundation, with n=165 respondents completing the survey. 97% had ≥1 HRSN, far exceeding reported values among various publicly insured populations (55-57%) and in line with similar estimates among SLE patients (94%). Furthermore, 65% of respondents were found to have a “high” HRSN burden (≥3 needs). The most common HRSNs were those related to mental health (80.8%), physical inactivity (71.9%), and health confidence (36.5%). Our findings reveal a high prevalence of unmet HRSNs among pemphigus patients, mirroring patterns observed in other autoimmune diseases. Associations between unmet HRSNs, poorer self-reported health status, and higher ED dependence, point to critical gaps in care. Integration of HRSN screening and intervention into routine pemphigus care therefore represent a crucial opportunity to improve outcomes in this high-need population. Justin Baroukhian¹, Rosy Zel¹, Kristina Seiffert-Sinha¹, Animesh A. Sinha¹ 1. Dermatology, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY, United States. Minoritized Populations and Health Disparities Research