For many years, people of European ancestry were believed to develop multiple sclerosis (MS) more often than people of other races and ethnicities. However, studies of California populations in 2013 and 2020 both found the highest rates of MS among Black women.

More research is needed to fully understand the possible connections, but race and ethnicity seem to influence many aspects of MS. These can include delays in diagnosis, which symptoms develop (and how severe they are), and longevity.

Who Is Most Likely To Be Diagnosed?

For now, studies appear to show that Black people have the highest risk of developing MS. White people appear to have the next highest risk. People with Hispanic ancestry appear at lower risk than white people, and they tend to be diagnosed at a younger age. People of Asian descent appear to have the lowest risk for developing MS. This is consistent with low numbers of MS being reported in Asian countries.

Why some racial and ethnic groups experience MS at higher rates is not yet known. More research is needed to understand the environmental and genetic factors that may contribute to MS risk. For example, higher levels of vitamin D appear to correlate with less MS risk among white people, but vitamin D levels in Hispanic and Black people do not appear to affect risk. There are similar inconsistencies with what we know about genes that appear to contribute to risk for MS in some racial groups, but not others.

Variety of Symptoms

Different racial and ethnic groups seem to experience different initial MS symptoms, which may make it harder for doctors to spot the condition.

In the early stages of MS, Black and Hispanic people are more likely to have symptoms involving damage to the optic nerve and spinal cord, such as:

• Vision problems
• Eye pain
• Pain radiating through the body

White people are more likely to have sensory problems such as tingling and numbness in the legs or arms.

These differences may lead to delayed diagnosis and treatment for some.

Severity of Symptoms

Research has shown that Black people with MS are at risk for more severe MS than other demographic groups. Black people experience faster disease progression and more atrophy in the brain, spinal cord, and optic nerves. This can lead to faster symptom onset and more pronounced motor, cognitive, and visual difficulties.

One recent study revealed that Hispanic Americans with MS also experience similar outcomes, as well as higher frequencies of pain, anxiety, and depression than African Americans with MS. According to current studies, white people appear to have the most favorable outcomes when compared to other groups.

This may be due to social determinants of health, such as:

• Socioeconomic status
• Access to neurology specialists
• Mental health support

Access to Treatment

Some studies have found disparities in the care that Black and Hispanic people with MS experience. One study found that Black and Hispanic people were less likely than white people to have ever seen a neurologist for any condition, including MS. A study of participants in one New York health care plan found that low-income minorities were also less likely to see an MS specialist or receive a disease-modifying treatment for MS. Health inequities like these may contribute to data that shows minority populations experiencing more severe disease.

Longevity and Mortality

Currently, studies on MS and mortality by race and ethnic group are limited. From these limited studies, it appears that white people are the most at risk for shortened life spans due to MS. However, one study found that Black men under age 55 had the greatest risk for mortality related to MS.

More studies are needed before conclusions can be drawn about mortality and survival rates of different ethnic and racial groups experiencing MS.

Diversity in Research

One 2015 study found that studies focused on MS in Black and Hispanic populations make up less than 1 percent of all MS research. Researchers are looking for ways to improve diversity in study populations. More outreach and better relationship-building between the scientific community and communities of color could help address this issue.

Talk With Others Who Understand

MyMSTeam is the social network for people with MS and their loved ones. On MyMSTeam, more than 182,000 members come together to ask questions, give advice, and share their stories with others who understand life with MS.

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