Agencies   /   Department of Veterans Affairs (VA)

VA, Military Studies Suggest MS ‘Shifting’ to be More Likely in African-Americans

By US Medicine

By Sandra Basu

BALTIMORE — Why are incident rates for multiple sclerosis (MS) increasing in African-Americans compared with other racial backgrounds, and why is the disease, on average, more severe in that population?

Those are among the questions plaguing VA and military researchers as they try to respond to the trends and provide appropriate care to patients.

Christopher Bever, MD, who serves as director of VA’s MS Center of Excellence (MSCoE) East, told U.S. Medicine that MS in African-Americans has been “shifting” and it is an area of “active study” both by VA and by others.

“African-American patients oftentimes have more impairment and more disability, and so we are working in our programs to make sure we can deal with the more severe consequences of MS,” Bever noted. “Many of those problems turn out to be like the problems seen in the spinal injury population because MS does affect the spinal cord.”

A veteran with multiple sclerosis (MS) receives personalized exercise education and instruction through televideo

MS and Race

Two recently published studies on MS demographics in certain segments of the military population raise issues about race and disease incidence.

One of the studies, published in 2012 by VA researchers, examined Gulf War medical records and data from the DoD and VA for cases of MS in servicemembers who served in the Gulf War era between 1990 and 2007 and who were service-connected for the disorder by VA from 1990 on.

For the study, active duty population data were obtained for each year 1990-2000 and 2001-10 from the Defense Medical Epidemiological Database. In the study, a total of 2,691 patients were confirmed as having MS.

What the researchers called “novel,” was their findings that the black veterans had a higher incidence rate of MS (12.1 per 100,000 persons) than white veterans (9.3 per 100,000 persons).

“Potential explanations for the high multiple sclerosis incidence rates for blacks are important to explore,” the researchers wrote, noting that, historically, MS rates have been higher in whites. Based on their prior work with military cohorts, the researchers wrote that “these changes have manifested themselves fairly recently, over the past two to three generations.”

Environmental risk factors as well as genetic susceptibility were among the factors that the authors said should be explored to better understand their observations.

Another 2012 study, published in Military Medicine, examined estimated incidence of MS among military personnel from 2000 to 2009, also finding that black non-Hispanics had a higher incidence rate than white non-Hispanics, at 18.3 per 100,000 person-years vs. 12.5 per 100,000 person-years, respectively. That study also indicated that black females had higher rates than their white counterparts.

“[Incidence rates] of MS diagnoses among blacks, and specifically black females, were higher than their white counterparts. This relationship in an adult population has not been previously seen in literature and has only recently been described in children. The novelty of this finding is perplexing,” the study stated. “Do these results represent an unidentified risk factor in our population among black females, or are these results representative of actual risk not previously appreciated in the general U.S. population?”

Click table to expand in new tab

Related Articles

Shulkin Ousted, White House Physician Nominated for VA Secretary

WASHINGTON — After several weeks of speculation regarding his future in the Trump Administration, VA Secretary David Shulkin, MD’s tenure came to an abrupt end on March 28.

Congress Seeks More Oversight of VA EHR Program

WASHINGTON — Legislation under consideration by Congress would increase oversight of VA’s adoption and implementation of its forthcoming electronic health record (EHR) system. The VA announced last year that it would adopt the same Cerner... View Article


U.S. Medicine Recommends


More From department of defense dod

Department of Defense (DoD)

GAO: ‘Gaps’ in MHS Physician Specialties Could Affect Wartime Readiness

Vascular Events Lead to Stroke About a Fourth of the Time. INDIANAPOLIS — While many healthcare systems measure the quality of their stroke care, looking at performance early in the vascular disease process can help... View Article

Department of Veterans Affairs (VA)

VA Vows to Meet Deadline for Revamp of Veteran Claims Appeal Process

Vascular Events Lead to Stroke About a Fourth of the Time. INDIANAPOLIS — While many healthcare systems measure the quality of their stroke care, looking at performance early in the vascular disease process can help... View Article

Department of Defense (DoD)

DoD, VA Still Struggle with Diagnosing, Treating Mild Traumatic Brain Injuries

Diagnosing and treating mild traumatic brain injury continues to pose challenges for clinicians, TBI experts told lawmakers.

Department of Defense (DoD)

VA Promises to Resolve Late Payment Issues with Community Healthcare Providers

Vascular Events Lead to Stroke About a Fourth of the Time. INDIANAPOLIS — While many healthcare systems measure the quality of their stroke care, looking at performance early in the vascular disease process can help... View Article

Department of Defense (DoD)

Change in VA/DoD Guidelines for Low Back Pain Surprising Even for Authors

If VA clinicians are surprised by the significant changes in the updated recommendations recently issued by the VA and DoD for the diagnosis and management of low back pain, they are not alone. The evidence review even shocked many members of the work group that wrote the new clinical practice guidelines.

Facebook Comment

Subscribe to U.S. Medicine Print Magazine

U.S. Medicine is mailed free each month to physicians, pharmacists, nurse practitioners, physician assistants and administrators working for Veterans Affairs, Department of Defense and U.S. Public Health Service.

Subscribe Now

Receive Our Email Newsletter

Stay informed about federal medical news, clinical updates and reports on government topics for the federal healthcare professional.

Sign Up