Lower socioeconomic status (SES) can affect systemic lupus erythematosus (SLE) outcomes by several possible mechanisms, such as inadequate access to quality care services, communication barriers, and malnutrition. SES should be systematically measured at the individual level (education, income, and occupation), as well as at the household and neighborhood levels. Lower SES has been associated with higher disease activity, mainly over the disease course, higher damage accrual, mortality, and disability. Furthermore, outcome differences between Caucasians and non-Caucasians are partially explained by socioeconomic factors. The association between non-Caucasian ethnicities and lower SES makes genetic and environmental risks difficult to disentangle.