Racial Disparities in the Modern Gout Epidemic

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Figure 1.
Multivariable hazard ratios for incident gout according to quintiles of the Dietary Approaches to Stop Hypertension (DASH) score in (A) the Nurses Health Study (NHS) cohort (predominantly White)^a; (B) Health Professionals Follow-Up Study (HPFS) cohort (predominantly White); and (C) the Multiethnic Cohort (MEC) overall^b and according to self-reported race/ethnicity: (D) White, (E) Black, (F) Native Hawaiian, (G) Japanese, and (H) Latino. ^a Adapted from Yokose et al¹⁹, JAMA Intern Med 2022 Jan 31 (Epub ahead of print). ^b Adapted from Rai et al, BMJ 2017;357:j1794 with permission from BMJ Publishing Group Ltd.

Table 1.

Studies reporting on racial disparities in gout burden and care in the US.

Racial Disparity	Comparison for Black vs White Race (95% CI)	Comments
Prevalence
Chen-Xu et al, 2019²	4.8% (3.8–6.0) vs 4.0% (3.1–5.3)	Nationally representative sample
Helget et al, 2021¹¹	7.0% (7.0–7.1) vs 6.0% (5.9–6.0)	> 99% male (VHA)
Incidence
Hochberg et al, 1995¹⁰	RR 1.69 (1.02–2.80)	All male physicians
Maynard et al, 2014⁹	Men: HR 1.92 (1.44–2.56); women: HR 1.69 (1.29–2.22)	ARIC study cohort, age 45–64 yrs at enrollment
Helget et al, 2021¹¹	IR 7.3 (7.1–7.5) vs 5.9 (5.8–6.0) per 1000 PY	> 99% male (VHA)
Ambulatory visits for gout
Castro et al, 2018⁵	OR 1.33 (1.03–1.72)	Nationally representative sample
ULT use
Krishnan et al, 2008²⁷	OR 0.18 (0.04–0.78)	Nationally representative sample
Chen-Xu et al, 2019²	OR 0.84 (0.53–1.34)	Nationally representative sample

ARIC: Atherosclerosis Risk in Communities; HR: hazard ratio; IR: incidence rate; OR: odds ratio; PY: person-years; RR: relative risk; ULT: urate-lowering therapy; VHA: Veterans Health Administration.