OBJECTIVES: Systemic Lupus Erythematosus (SLE) is a multifactorial chronic autoimmune disease with several clinical manifestations. Limited recent data is available on prevalence of SLE in the US, and especially by patient’s social determinants of health (SDOH). Using the most recent data, we estimated the prevalence of SLE overall and by patient’s SDOH.

METHODS: A retrospective population-based study using Medical Expenditure Panel Survey data for 2017-2021 was conducted. Patients with SLE were those with both self-reported SLE diagnosis and either who reported SLE-related medication use and/or visit to a rheumatologist in the survey year. SDOH domains included economic stability, education, healthcare access and quality, social and community context, and neighborhood and built environment. Average annual prevalence of SLE and that within each SDOH domain were examined.

RESULTS: During 2017-2021, the pooled weighted average annual prevalence of SLE was 199 per 100,000 US non-institutionalized adults (95% confidence intervals: 170, 224), and was 13 times higher in women versus men (359 vs. 28 per 100,000 adults; p<0.0001). For the economic stability SDOH domain, SLE prevalence was twice as high among those who used food stamps (355 vs. 182 per 100,000; p=0.0037) and were unemployed and more than three times in those with very low food security (667 vs. 180 per 100,000; p=0.0002), compared to their respective counterparts. Within the neighborhood and built environment SDOH domain, patients with serious psychological distress had four times the SLE prevalence than those without psychological distress (376 vs. 94 per 100,000; p<0.0001). Within healthcare access and quality SDOH domain, patients with Medicaid insurance had a higher prevalence of SLE than those with private insurance (380 vs. 161 per 100,000; p<0.0001).

CONCLUSIONS: Our study provided the most recent nationally representative estimates of prevalence of SLE in the US, and found that prevalence of SLE was substantially higher in populations with higher social disadvantage.