The Intersections Between Community Disparities and Autoimmune Diseases

Written by Jocelyn Chamu, Edited by Rushlenne Pascual

Introduction 

In the US, the number of people who live with autoimmune diseases makes up 8% of the population, and as of 2024, 80% of patients diagnosed with autoimmune diseases are women.¹ Of the more than 80 autoimmune diseases known, a significant gap exists in research and treatment for patients. Addressing this can be challenging, given that funding toward autoimmune disease research is allocated to cancer, Alzheimer's, and other diseases. Although it is important to consider that funding for autoimmune research is lacking, underrepresented communities, such as racial and ethnic minorities, are excluded from clinical trials. 

Disparities in Autoimmune Diseases Research

Over the years, there has been a rise in autoimmune diseases in the US, in which the immune system attacks the body, causing a prognosis of chronic and painful symptoms.² Autoimmune diseases can be debilitating in patients’ everyday lives, and disproportionately affect women, low-income individuals, and communities with underserved populations. There has been an uphill battle for health care providers to diagnose autoimmune diseases. The timeline for diagnosis has been estimated to be over 4 years.³ For example, in the US, Congress passed the NIH Revitalization Act of 1993, which allowed for the inclusion of women and minorities in clinical research.⁴ With the act being passed in 1993, women have recently been medically represented, and people of color are being included in disease research. 

The inclusion of race and ethnicity in autoimmune disease research is relevant, as discovered in the disease, lupus, an autoimmune disease in which the patient's own immune system attacks its healthy tissues and organs. Lupus has been a statistically prevalent condition in women with high estrogen levels.¹ When it comes to the way in which autoimmune diseases affect populations differently, 9 out of 10 are women. In ethnic minority groups, African American and Asian women face a higher risk of developing lupus compared to their white counterparts.⁵

Clinical Trials in Autoimmune Diseases

 Clinical trials are an essential part of treatment development for diseases, as they are a critical step in protecting research subjects, consist of collecting data, and ensuring new treatments meet Federal and Drug Administration (FDA) regulations.⁶ In recent years, medical research and clinical trials have introduced questions and experimental designs that include patients from diverse intersectionalities, such as different age groups, ethnicities, races, genders, and socio-economic backgrounds. This represents a significant step forward from past research designs, which were based on rigid guidelines that often overlooked underrepresented communities. However, the lack of funding and underrepresentation in clinical trials has become exacerbated by federal cuts across the Department of Public Health, the National Cancer Institute, and the National Institutes of Health (NIH). Clinical trials and patient care, to name a few, have been at jeopardy as a result. In early June 2025, the new administration’s federal cuts of $3.8 billion were implemented at the National Institutes of Health (NIH), halting numerous disease research projects, resulting in job losses and the cancellation of research fellowships.⁷ 

Exploring Inclusivity in Autoimmune Diseases

With the funding of the NIH and Lupus Research Alliance, the efforts between public institutions, organizations, and federal funding go hand in hand for the progression of curing autoimmune diseases. Ongoing research in the field of autoimmune diseases continues. At UC Berkeley, Professor Gregory Barton has led research in autoimmune disease, Lupus, at the genetic level.⁸ Research conducted by private and public institutions for the future has been and continues to be essential for the personalized treatment of patients. Over the course of decades, men have been the focus of research subjects and the development of clinical trials, shaping present-day treatment. However, recent research has helped recognize that the inclusion of women and minorities is essential to provide an inclusive dataset and a wide scope understanding that will help solve for treatments in autoimmune diseases. As of December 2023, the NIH has planned for 2026-2030 to expedite and further fund Autoimmune Disease Research, which aims to include diverse populations.⁹ In this plan, the NIH has recognized the exclusion of women and minorities from past research and has made it clear that, in this proposed plan, research includes women, different ethnic and racial groups. Additionally, in-depth analysis of the environmental and socioeconomic backgrounds of patients with autoimmune diseases will be included. Therefore, the plans presented by the NIH would be a step forward for public health as a whole. 

The Future of Autoimmune Disease Research 

Future implications of budget cuts on patients with autoimmune diseases would lead to a decrease in health care access and treatment. Given the massive cut in federal funding across the US, this has brought uncertainty for current and future research in the development of treatments for autoimmune diseases. Efforts towards public partnership and outreach will be essential moving forward. Aside from providing patients with affordable healthcare and treatment costs, increasing public education about the challenges patients with autoimmune diseases face will be crucial for change. Increasing awareness of the rising rate of autoimmune diseases in the US could inform the general public about the foreseeable harm that underfunding of research on these diseases may pose to people in the US. The future of autoimmune disease research and funding ultimately depends on people's action to move legislation to fund the necessary tools to treat all diseases. Community support should involve community members advocating, voting, and supporting local and legislative proposals that would fund autoimmune disease research. 

Conclusion

The rise in high costs of living, cuts in health centers, and research will exponentially harm patients dependent on these resources at all levels. The urgency for the public to advocate for the inclusion of minorities and federal funding to address the detrimental effects that federal cuts bring to all with incurable, life-threatening, and debilitating diseases, as in this case, autoimmune diseases, is essential. There must also be an emphasis across all of the medical field to include diverse populations. For decades, many have been omitted or sidelined in medical research. The future of autoimmune disease research is dependent on the public outreach, the infrastructure of existing research, and the government's inclusion of all in autoimmune disease treatment.

References

1. Goulmamine S, Chew S, Aninye IO. Autoimmune health crisis: An inclusive approach to addressing disparities in women in the United States. Int J Environ Res Public Health. 2024;21(10):1339. doi:10.3390/ijerph21101339

2. Autoimmune diseases. Cleveland Clinic. September 6, 2023. Accessed November 13, 2025. https://my.clevelandclinic.org/health/diseases/21624-autoimmune-diseases

3. The economic effects of autoimmune disease research. Autoimmune Association. Accessed November 13, 2025. https://autoimmune.org/advocacy/economic-effects-of-autoimmune-disease-research/

4. Institute of Medicine (US) Committee on Ethical and Legal Issues Relating to the Inclusion of Women, Mastroianni AC, Faden R, Federman D. NIH Revitalization Act of 1993 Public Law 103-43. National Academies Press; 1994.

5. CDC. People with. Lupus. May 22, 2024. Accessed November 13, 2025. https://www.cdc.gov/lupus/data-research/index.html

6. Novitzke JM. The significance of clinical trials. J Vasc Interv Neurol. 2008;1(1):31.

7. Faiman B. The impact of federal funding cuts on research, practice, and patient care. J Adv Pract Oncol. 2025;16(4):124-125. doi:10.6004/jadpro.2025.16.4.1

8. Berkeley.edu. Accessed November 13, 2025. https://news.berkeley.edu/2024/05/23/tracking-down-the-genetic-causes-of-lupus-to-personalize-treatment/

9. Nih.gov. Accessed November 13, 2025. https://orwh.od.nih.gov/OADR-ORWH/Strategic-Planning-for-ADR.

In this article, the prevalence and outcomes of autoimmune disease differ between the sexes. The terms “women” and “females” are not interchangeable, as “sex” refers to a person’s biological attributes, such as chromosomes, hormones, and reproductive anatomy. In contrast, gender refers to a cultural and social construct of identity. In biomedical research, participants are categorized by their biological sex, and in this research article, “female” is used to describe biological or physiological factors related to autoimmune diseases. The term “women” refers to populations or social contexts in which gendered experiences impact health. The authors recognize the diversity of gender identity, encompassing transgender, nonbinary, and gender-expansive individuals who often encounter being overlooked due to their health experiences not aligning with conventional frameworks. The author aims to highlight the constraints of current research methodologies while respecting all gender identities. Future studies should be inclusive and acknowledge that sex and gender identity are relevant to health.

This post is not a substitute for professional advice. If you believe that you may be experiencing a medical emergency, please contact your primary care physician, or go to the nearest Emergency Room. Results from ongoing research are constantly evolving. This post contains information that was last updated in December 2025.