Social barriers impact inflammatory bowel disease care and are disproportionately higher in non-Hispanic Blacks and Hispanics in the United States, according to a new study published in Therapeutic Advances in Gastroenterology.
There is a dearth of data on the impact of social determinants of health in inflammatory bowel disease (IBD). Oriana Damas and colleagues at the University of Miami Miller School of Medicine performed a cross-sectional study on 316 adult IBD patients with an established diagnosis of IBD [ulcerative colitis (UC) or Crohn’s disease (CD)] seen at one of the three gastroenterology clinics between 1 April 2019 and 1 March 2021. These clinic sites included a tertiary referral center, private gastroenterology (GI) community practice, and a safety-net county hospital-affiliated GI clinic.
The researchers assessed known social determinants of health in these patients. These determinants of health included education level, financial strain or hardship, paying for basics such as food and medications, food insecurity, social isolation, overall health literacy, access to health care, and housing security. Furthermore, they also calculated the total prevalence of these barriers in the sample as a whole and within each ethnic group.
The researchers found greater disparities in the prevalence of social barriers in non-Hispanic Blacks and Hispanics compared to other ethnic groups. Social barriers associated with poor IBD outcomes identified in the study include financial strains (38.4%), such as food insecurity, medical care delays (~30%), and low educational attainment (26.8%).
Furthermore, the researchers observed greater ulcerative colitis (UC) disease activity in patients with higher social barrier scores (SBS). They also found no associations between SBS and IBD surgeries, hospitalizations, or disease location.
“Our study identifies social barriers that may impact IBD care and are disproportionately higher in non-Hispanic Blacks and Hispanics in the United States. Therefore, future studies should focus on implementing interventions to reduce these barriers and improve delivery of care.” the authors wrote.