DIVERGENT RACIAL TRENDS IN MORTALITY FROM SYSTEMIC LUPUS-ERYTHEMATOSUS

Objective. To compare trends in mortality from systemic lupus erythema tosus (SLE) between black and white females in the United States. Meth ods. Analysis of nationwide cause of death data collected by the Natio nal Center for Health Statistics, 1968 to 1991. Results. During the la tter half of the 1968-91 period, trends in SLE mortality for black and white women under age 45 diverged and racial differences in total mor tality from SLE widened, Among white females, total SLE mortality has been stable since the late 1970s at a mean annual rate of 4.6 deaths p er million. This stability results from a balance between declining ri sk among whites under age 45 and increasing in those beyond 55. Among blacks, total mortality has risen more than 30% since the late 1970s t o a mean annual rate of 18.7 per million, This increase results from a combination of constant risk in black females under 45 and rising ris k in women over 55. Conclusion. Trends for whites are consistent with a shift in mortality from younger to older women. This shift can be ex plained by longer postdiagnosis survival resulting from improved clini cal management of SLE, The trends for blacks imply higher prevalence o f SLE among black females than previously recognized and/or the existe nce of some impediment to young black females sharing in the full bene fits of effective treatment.