Dr. Luis Manrique-Trujillo On Barriers And Disparities Latinx MS Patients Face - Exclusive

"Feeling like your brain is on fire." That's one of the possible symptoms Multiple Sclerosis (MS) patients can face, according to Dr. Luis Manrique-Trujillo, a neurologist with Georgetown Medstar Hospital. Coupled with other possible symptoms (numbness, dizziness, and vision problems), MS can be a debilitating disease.

For patients of color living with MS, the barriers preventing them from getting access to care for the chronic condition can cause neurological health disparities. According to a 2017 report by the American Academy of Neurology (AAN) Diversity Leadership Group, data shows people from racial/ethnic minority groups as "frequently having lower rates of evaluation, diagnosis, and intervention," which leads to "worse neurologic outcomes" than white patients.

A report published by the Journal of the American Medical Association (JAMA) Neurology states that social determinants of health (SDOH) are a factor that should be investigated further and could be contributing to health disparities seen among MS patients. The researchers also recommend developing research frameworks that will study these SDOH and help provide system-based solutions that can address those gaps. 

Dr. Manrique-Trujillo is currently researching the causes behind disparities Hispanic/Latinx MS patients are facing in Washington D.C. through the "I'M IN" EMD Soreno Neurodisparity Fellowship Initiative. He spoke exclusively to Health Digest on the barriers and disparities that Hispanic/Latinx MS patients face.

Dr. Luis Manrique-Trujillo reports that there are only 2.9 incidents of MS per 100,000 Hispanic individuals each year, compared to roughly 10 incidents per 100,000 Black individuals. "While this could mean Hispanic populations are three times less likely to develop MS, we believe this number is so low because Hispanic individuals are actually less likely to seek out a diagnosis," Dr. Manrique-Trujillo told us. 

With the U.S. Census data reporting that 11.5% of the D.C. population consists of people who identify as Hispanic/Latinx, he believes there could be several undiagnosed Hispanic/Latinx individuals living with MS in the D.C. area. According to Dr. Manrique-Trujillo, only 2.5% of MS patients who go to the Georgetown MS and Neuroimmunology Center identify as Hispanic/Latinx.

While the number of Hispanic/Latinx individuals diagnosed with MS is low, they often face worse health outcomes. Research conducted at the University of Miami found that Hispanic/Latinx MS patients (mainly of Caribbean descent) tended to be "younger at the time of diagnosis and had more mobility impairment than non-Hispanic white people with MS." Based on studies conducted in Mexico, the journal Practical Neurology cites that certain alleles responsible for MS can present a risk factor among people that have both indigenous and Spanish ancestry.

Dr. Manrique-Trujillo believes there may be several barriers preventing Washington D.C.-area Hispanic/Latinx individuals from getting access to care including difficulty in accessing transportation, being unable to take time off from work, and lack of affordable health insurance. According to a 2018 report by the Urban Institute, "17% of Latino immigrants” don't have health insurance in D.C., over three times higher than the total percentage of uninsured.

For Hispanic/Latinx immigrants, Dr. Manrique Trujillo notes that language barriers and immigration status can also present challenges. Some of his goals through the fellowship include encouraging D.C.-area Hispanic/Latinx individuals with MS to choose Georgetown Medstar MS Center for Treatment, establishing a MS clinic for Hispanic/Latinx patients, and starting a teleneurology program.

By doing so, he believes he can help increase the number of Hispanic/Latinx patients that are getting neurological care, and he hopes fewer Hispanic/Latinx MS patients will go undiagnosed. For the neurologist and Latinx immigrant, studying these disparities is personal: "My Hispanic patients come to me because I look and sound like them, which helps them feel a greater level of comfort during care."

Learn more about EMD Serono and the "I'M IN" Neurodisparity Fellowship Initiative on the EMD Serono website.