ECTRIMS 2025 | Addressing structural determinants of health in MS: improving patient care and outcomes
Mitzi Joi Williams, MD, Joi Life Wellness Group, Smyrna, GA, discusses social determinants of health, specifically structural determinants of health, for patients with multiple sclerosis (MS) and other demyelinating disorders. Dr Williams highlights the challenges of addressing these structural determinants, but also notes the potential for clinicians and patients to work together to improve care plans and outcomes. This interview took place at the 41st Congress of the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) in Barcelona, Spain.
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Transcript
So I was very excited during the 2025 ECTRIMS meeting to give a talk focused on social determinants of health and specifically focused on structural determinants of health. This was a first-time course that I did with Dr Ruth Dobson, as well as Dr Wallace Brownlee. And my part of the course focused on what we call structural determinants, which are kind of the overarching things such as economic systems, as well as structural discrimination, digital divide, et cetera, those things that can actually impact healthcare much more than the medicines that we give...
So I was very excited during the 2025 ECTRIMS meeting to give a talk focused on social determinants of health and specifically focused on structural determinants of health. This was a first-time course that I did with Dr Ruth Dobson, as well as Dr Wallace Brownlee. And my part of the course focused on what we call structural determinants, which are kind of the overarching things such as economic systems, as well as structural discrimination, digital divide, et cetera, those things that can actually impact healthcare much more than the medicines that we give. And so this was a really interesting talk and also a bit of a challenge. So I talk a lot about social determinants of health, but usually we focus more on things like gender, we may focus on sexual orientation, or we may focus on socioeconomic status, which are things that sometimes people can’t, obviously people can’t change. But when we talk about the structural determinants, such as the economic systems, which may give advantage to some people more so than others, or if we talk about discrimination in a broad system-based way, those things can be a little bit more difficult to kind of wrap your arms around, wrap your hands around, so to speak. But I think that it was really helpful because when we talk about these structural determinants, we talk about ways that each person in different countries can look at the different policies in their area, also look at their individual clinics and look at ways to possibly impact these structural determinants to improve outcomes and to improve the care that people receive who are living with MS and other demyelinating disorders. So I thought that even though we did focus a bit on some of the problems and some of the issues, we did also focus on the research, which is advancing. We are looking at this now in multiple sclerosis. We are looking at ways that we as clinicians or those in the clinic can address these issues with our patients as well as how patients and people living with MS can bring up these issues to help improve their care plans as well as improve their outcomes.
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