AAN 2026 | Social determinants of health influence outcomes in pediatric NMOSD

So my focus and my research is on social determinants of health. And so those are the conditions in which children are born, grow up, and ultimately work and hopefully thrive. And there’s a lot of literature in the adult MS population suggesting the impact of social determinants of health on outcomes. And so living in more disadvantaged neighborhoods, lower access to food, more vacant housing, lower socioeconomic status, all of these things, you know, in cumulation may contribute to kind of toxic stress that can actually impact the brain or impact outcomes. There’s also a huge relationship with access to care that can really preclude patients from getting access to timely and appropriate therapies. And so we did a multicenter study where we looked at 38 pediatric aquaporin-4 positive NMO patients and looked at a variety of factors, one of which was, does where you live impact how you do? And we did find that disability scores through something called the EDSS were significantly worse at two years from diagnosis and at most recent EDSS for children that lived in more disadvantaged neighborhoods. And so that’s kind of a preliminary study that we’ve done and we’re hoping to expand that work not just to look at where you live, but also individual factors. And so individually, insurance status, race and ethnicity, because of a lot of systemic racism and other factors can impact misdiagnoses and access to care as well. And so really kind of thinking about the global picture rather than just what is the medication we’re going to start for a patient.

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