The incidence of inflammatory bowel disease (IBD) is on the rise among racial and ethnic minority groups in the United States, and social determinants of health (SDOH) contribute to disparities in IBD care and outcome, say the authors of a new paper on the topic.
It's an "overdue priority to acknowledge the weight and influence of the SDOH on health disparities in IBD care," write Adjoa Anyane-Yeboa, MD, PhD, with Massachusetts General Hospital, Boston, and co-authors.
"Only after this acknowledgement can we begin to develop alternative systems that work to rectify the deleterious effects of our current policies in a more longitudinal and effective manner," they say.
Their paper was published online in Clinical Gastroenterology and Hepatology.
Upstream Factors Propagate Downstream Outcomes
The authors found multiple examples in the literature of how upstream SDOH (eg, racism, poverty, neighborhood violence, and under-insurance) lead to midstream SDOH (eg, lack of social support, lack of access to specialized IBD care, poor housing conditions, and food insecurity) that result in poor downstream outcomes in IBD (eg, delayed diagnosis, increased disease activity, IBD flares, and suboptimal medical management).
The IBD literature shows that Black/African American adults with IBD often have worse outcomes across the IBD care continuum than White peers, with higher hospitalization rates, longer stays, increased hospitalization costs, higher readmission rates, and more complications after IBD surgery.
