Social Determinants of Health in Multiple Sclerosis in Jackson, Mississippi: Focus Groups

Background: Mississippi is one of the poorest states in the United States, with multiple lagging health indicators. Multiple sclerosis (MS) outcomes can be impacted by social determinants of health (SDOH). Research in locations with high gradients in the SDOH is especially important. Methods: In 2023, 2 focus groups of adults living with MS in the Jackson, Mississippi, metro area were conducted online, hosted by the University of Mississippi Medical Center. Participants completed a survey about the US government's Healthy People 2030 SDOH list prior to the groups. The focus groups' transcripts were analyzed using a thematic inductive approach. Results: The 11 participants reported a median of 6 SDOH per person. Participants were mostly female (91%), Black (64%), older (average age 57 years). Most had relapsing MS (82%) with an average disease duration of 17 years. All were educated (100% with a bachelor's degree or above). Participants scored high (> 50% respondents were affirmative) on a history of incarceration (personal or family member), perceived treatment with "less respect in a medical setting," and access to MS medications without prohibitive cost. There was job loss (36%) and housing insecurity (36%). Eight SDOH were identified as salient: education; work and occupation; neighborhood and environment; transportation and disability services; water and food; crime, violence, and public safety; social isolation and integration; and race. The time of MS diagnosis was considered the most important period related to SDOH. Additional concerns included access to MS research. Conclusions: The lived experiences of people with MS in Jackson, Mississippi, are reported as foundational work to disaggregate and redress the many SDOH that were considered relevant by people living with MS.