New study suggests Black and South Asian people with MS in the UK don’t have a higher risk of severe MS

MS doesn’t discriminate. It affects people from all ethnic backgrounds. Previous studies from the United States have suggested that people with MS from Black or Hispanic backgrounds may tend to have more disabling MS. This could be to do with the MS itself, or to do with disparities in access to healthcare. 

We wanted to find out whether people from Black or South Asian backgrounds living in the UK are at risk of having more severe MS. 

Using the UK MS Register to answer our question

To answer this question, we looked at data from the UK MS Register, a large study which includes over 20,000 people with MS in the UK. Participants in the UK MS Register are asked to complete an online survey every six months which includes various ‘scores’ for assessing disability in MS. 

In total we looked at information from:

• 147 people from South Asian ethnic backgrounds
• 115 people from Black backgrounds, and 
• 12,690 people from White ethnic backgrounds. 

No differences in disability between ethnic groups

We found that people from South Asian or Black backgrounds were diagnosed on average three to four years earlier than White participants, but reassuringly we found no differences in MS disability between ethnic groups. 

As no one MS disability ‘score’ captures all aspects of MS, we looked at five different scores which assess different ways that MS might affect someone, including walking, physical disability, quality of life, and fatigue. We found that Black and South Asian people with MS had very similar disability levels to White participants in all of these areas. 

To be sure of our findings, we then focused on the 8,000 people with MS who had multiple scores over a 5-year period – that is, those people that had answered questionnaires on more than one occasion over a number of years. Using this longer-term information, we found that Black and South Asian people with MS had the same risk of disability progressing over time as White participants. 

UK may differ from the USA 

Our findings suggest that Black and South Asian people with MS in the UK do not have a higher risk of severe MS than anyone else. 

These results are reassuring. However, they do contradict some results from the United States. We suspect this may be to do with differences in healthcare access, which may affect people from different ethnicities differently between the USA and the UK.

Some limitations of the study

An important caveat to our study is that people who have chosen to take part in the UK MS Register may not be wholly representative of everyone with MS in the UK. As the study relies on people registering and then logging in to complete online surveys, we may be missing information from people with more severe or advanced MS who find it difficult to take part online. 

Other aspects that could have affected our results include:

• the relatively short period of time we could look at (5 years)
• the relatively small number of people from diverse ethnic backgrounds in the study
• the lack of detailed treatment information available, and 
• the way that we had to group people into categories used in the UK Census, which don’t fully capture the wide range of ethnicities that we know there are. 

Healthcare inequality is a very real problem in the UK

Our study shows that people with MS from Black and South Asian backgrounds living in the UK do not seem to be at higher risk of more severe MS. To be certain of our results we need to see whether other researchers find the same answer in other studies, both in the UK and in other healthcare systems outside the US.

Although our study is reassuring, we know that healthcare inequality is a very real problem in the UK. Addressing this issue is essential to avoid perpetuating ethnic disparities in overall health and wellbeing, both in MS and beyond. 

Where can I find out more? 

We're helping to fund the ADAMS study, which Ben is co-leading. You can read more about the study on our website.  

And you can read the full paper in the Multiple Sclerosis Journal.