Gender and Ethnic Inequities in Gout Burden and Management.

Although effective and low-cost urate-lowering therapy has been available for decades, inequities in gout management exist. Despite high impact of disease, rates of urate-lowering therapy prescription are low in women, in African-Americans in the United States, in Māori (Indigenous New Zealanders), and in Pacific peoples living in Aotearoa/New Zealand. Social determinants of health, barriers to accessing the health care system, health literacy demands, stigmatization, and bias contribute to inequities in gout burden and management. Approaches that focus on building health literacy and delivering culturally safe care lead to improved outcomes in gout, and offer important solutions to achieve health equity.
Competing Interests: Disclosure A.G. Guillén and L. Te Karu have no disclosures. J.A. Singh has received consultant fees from Crealta/Horizon, MediSYS, Fidia, UBM LLC, Trio health, Medscape, WebMD, Clinical Care options, Clearview health care partners, Putnam associates, Focus forward, Navigant consulting, Spherix, Practice Point communications, the National Institutes of Health, and the American College of Rheumatology (ACR). J.A. Singh owns stock options in Amarin pharmaceuticals and Viking therapeutics. J.A. Singh is on the speaker’s bureau of Simply Speaking. J.A. Singh is a member of the executive of OMERACT, an organization that develops outcome measures in rheumatology and receives arms-length funding from 12 companies. J.A. Singh serves on the Food and Drug Administration Arthritis Advisory Committee. J.A. Singh is the chair of the Veterans Affairs Rheumatology Field Advisory Committee. J.A. Singh is the editor and the Director of the UAB Cochrane Musculoskeletal Group Satellite Center on Network Meta-analysis. J.A. Singh previously served as a member of the following committees: member, the ACR Annual Meeting Planning Committee and Quality of Care Committees; the Chair of the ACR Meet-the-Professor, Workshop, and Study Group Subcommittee; and the cochair of the ACR Criteria and Response Criteria subcommittee. N. Dalbeth has received fees from Janssen, AbbVie, CymaBay, AstraZeneca, Crealta, Takeda, Kowa, Horizon, Hengrui, Dyve Biosciences, Arthrosi, Selecta, bpac, the Health Research Council of New Zealand, UpToDate, Oxford University Press, the Pharmaceutical Society of New Zealand, the Spanish Society for Rheumatology, the Asia Pacific Gout Consortium, and the ACR. Her institution has received research grants from the Health Research Council of New Zealand, the Auckland Medical Research Foundation, PHARMAC, AstraZeneca, and Amgen.
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