Multiple sclerosis (MS) susceptibility and prognosis vary by race and ethnicity in the USA. MS incidence is highest in Black individuals and, among individuals under the age of 35, so is the prevalence. Although MS incidence and prevalence is lower among Hispanic and particularly Asian/Pacific Islands compared to White people, among Hispanic and White people under the age of 25, the prevalence is similar. MS-related disability accrues faster, and mortality is higher at younger ages among Black compared to White people. But these differences are not due to genetics because: 1) race and ethnicity are social constructs rather than genetically or biologically distinct entities; 2) MS prognosis is not driven by genetics; 3) MS susceptibility is mostly due to environmental factors, including Epstein Barr (EBV) infection and pediatric obesity; and 4) there is a far more plausible explanation - embodied racism.
Keywords: Genetics; Multiple sclerosis; Racial/ethnic disparities; social determinants of health.