Race, ethnicity, and multiple sclerosis in the U.S.

Multiple sclerosis (MS) is an autoimmune disease that damages the central nervous system, the part of the nervous system that includes the brain and spinal cord.

An autoimmune disease is a disorder where the body’s immune system attacks healthy cells. With MS, the immune system attacks a type of tissue called myelin, which forms a protective layer that covers nerves (called the myelin sheath).

This autoimmune attack causes damage to the myelin sheath and the nerves inside the myelin sheath. This damage disrupts the signals that travel along nerves. This can cause a wide range of symptoms.

Symptoms of MS can include vision problems, fatigue, difficulty walking, muscle weakness, muscle stiffness, pain, numbness, dizziness, problems with bowel and bladder control, and sexual dysfunction. MS can also contribute to emotional changes, changes in thinking and behavior, and depression.

MS, race, and ethnicity

Sometimes health conditions affect people of different races and ethnicities in different ways. Research suggests that there are differences in the severity, progression, and prevalence of MS among people of different races and ethnicities.

Prevalence

In the past, MS was believed to mostly affect white people and was considered uncommon in Black people. More recently, research has found that MS is more prevalent among Black people than previously believed.

MS is less common among Latin American people, Asian people, and Indigenous people—however, the prevalence of MS may be underestimated in these populations.

The reasons for these differences are not fully understood. Differences are believed to be a combination of factors, including genetics and the environmental factors a person is exposed to, but the research supporting these reasons is limited. More research is needed, and more diversity in MS research is an essential part of that research.

Progression and severity

MS is a progressive disease. This means MS changes over time, causing more severe symptoms as it causes more damage to the brain and spinal cord. Research has found that MS tends to progress differently among people from different races and ethnicities:

• MS may progress more aggressively and cause greater disability in Black people. This means that Black people may have more severe symptoms, shorter periods of recovery between relapses, and have greater difficulty with things like walking, balance, and vision.
• Research has found that Latin American people are diagnosed with MS at younger ages and experience more severe symptoms sooner, such as problems with mobility and problems with vision.

Treatment

There is no cure for MS, but there are treatments that can help slow the progression of the disease. These are referred to as “disease-modifying therapies” or DMTs. Research has found that people of different races and ethnicities may respond differently to different DMTs, though the reasons for this are not well understood.

Socioeconomic factors

Socioeconomic factors—like access to healthcare and health insurance—also influence disease progression and treatment. Black and Latin American people in the U.S. are more likely to be uninsured and less likely to have access to specialized healthcare, including appointments with a neurologist and disease-modifying therapies.

If you or a loved one is living with MS

MS requires ongoing treatment. If you or a loved one is living with MS, the most important thing you can do is work with healthcare providers who have experience treating the condition. Ideally, treatment will include a care team made up of different specialists, including a neurologist.

If you are a non-white person who is living with MS (or another health condition), consider participating in research about the condition. Non-white people make up a small percentage of study participants. Research does not always mean clinical trials for new medications. Providing information about your experiences to researchers studying MS can help improve knowledge about the condition and how it affects people of different races and ethnicities.

If this is something you would consider, talk about it with your healthcare provider. Organizations like the National MS Society may also be able to provide information about participating in research.