Dr. Mitzi Joi Williams Shares Why MS Is Diagnosed Late In Black Patients
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Black patients can be diagnosed with multiple sclerosis later for a variety of reasons. Again, sometimes those first symptoms may come on and go away and so you may not think anything of it. I’ve had many people that have come to see me and say, “Dr. Williams, when I had my last child, I had a little bit of numbness in my leg. I thought it wasn’t anything. It went away and I never went to the doctor.” And that may have been that first symptom of multiple sclerosis.
And if the next symptom doesn’t happen until five or six years later, that can delay diagnosis when we should have hopefully caught it as early as possible.
Another reason is that sometimes there’s bias within the medical system. So traditionally we did not think that African Americans got MS so when an African American would come to see the doctor and had those symptoms, MS may not have been on the top of their list.
Also, traditionally there have been issues with access to care, especially MRIs. Even when I first started training, which wasn’t that long ago, I remember it was very difficult to get an MRI on somebody as an outpatient, so if someone came to my clinic and their hand or arm was a little numb, it was very difficult to get an MRI for that. So we may have diagnosed it as something else and then later found out that it was multiple sclerosis, but now that we have more access, we’re able to diagnose people earlier.
So access to care is certainly an issue. Also bias within the system and then certainly ignoring symptoms or attributing them to something else is one reason that people may be diagnosed later.
Is MS More Aggressive In Black Patients?
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There is a body of research over the past 10 years that suggests that MS is more aggressive in African Americans. There are several studies that have looked at MRIs that show that African Americans tend to have more white spots on their MRIs in their brain. They also tend to have more involvement of the spinal cord. The spinal cord is an area that I call expensive real estate and essentially what that means is that there’s a lot of function packed into a very small area.
So if you have lesions in your brain, you can have several spots there and it really not affect your overall function, but a very small area affected in the spinal cord