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Assessing Racial and Ethnic Health Disparities in a Diverse Cohort with Pediatric Inflammatory Bowel Disease
Ashleigh Watson1, Chelsea Young1, Faith D Ihekweazu1
1Department of Pediatric Gastroenterology, Hepatology, and Nutrition, Baylor College of Medicine, Texas Children's Hospital, Houston, TX.
Insights
Racial and ethnic disparities exist in pediatric inflammatory bowel disease (IBD). Hispanic children with IBD face higher hospitalization and emergency department use, highlighting the need for equitable care.
Area of Science:
- Pediatric Gastroenterology
- Health Disparities Research
- Inflammatory Bowel Disease (IBD) Etiology
Background:
- Pediatric inflammatory bowel disease (IBD) affects diverse populations.
- Understanding racial and ethnic variations in IBD presentation and outcomes is crucial for equitable healthcare.
- Previous research indicates potential disparities in disease management and patient outcomes across different demographic groups.
Purpose of the Study:
- To investigate racial and ethnic disparities in disease phenotype, treatment, and outcomes among children with pediatric IBD.
- To compare demographic factors, disease characteristics, and healthcare utilization across racial and ethnic groups in a pediatric IBD cohort.
Main Methods:
- A cohort of 97 pediatric patients (ages 7-18) diagnosed with IBD between March 2020 and June 2021 was analyzed.
- Patients self- or parent-identified as non-Hispanic (NH) Black, NH-White, or Hispanic.
- Data on demographics, Social Vulnerability Index, Childhood Opportunity Index, disease phenotype, time to diagnosis, treatment, and healthcare utilization were compared between groups.
Main Results:
- Hispanic patients had a higher prevalence of ulcerative colitis compared to non-Hispanic White patients.
- Hispanic children with IBD were significantly more likely to be hospitalized at diagnosis.
- Hispanic patients experienced more emergency department visits within two years of diagnosis compared to NH-White patients.
Conclusions:
- Race and ethnicity appear to influence the diagnosis and treatment of pediatric IBD.
- Findings suggest a need for further research in larger cohorts to validate these disparities.
- Establishing equitable care practices for pediatric IBD patients is essential, informed by these observed differences.
Objective:
To identify racial and ethnic disparities in disease phenotype, treatment, and outcome in a diverse cohort of children with pediatric inflammatory bowel disease (IBD).
Study Design:
Patients aged 7 through 18 with IBD diagnosed at a single institution between March 2020 and June 2021 with self- or parent-identified race and ethnicity of non-Hispanic (NH) Black, NH-White, or Hispanic were included. Demographics, Centers for Disease Control/Agency for Toxic Substances and Disease Registry Social Vulnerability Index, Childhood Opportunity Index, disease phenotype, time to diagnosis, treatment, and health care utilization were compared between the racial and ethnic groups.
Results:
Ninety-seven patients were included. A total of 18.6% of the cohort self- or parent-identified as NH-Black, 53.6% as NH-White, and 27.8% as Hispanic. Ulcerative colitis was found to be significantly more common in Hispanic patients. Hispanic patients were also significantly more likely to be hospitalized at time of diagnosis and have more emergency department visits within 2 years of diagnosis compared with non-Hispanic White patients.
Conclusions:
Race and ethnicity may affect the diagnosis and treatment of pediatric IBD, and these findings should serve as a foundation for establishing equitable care. Larger cohorts are needed to validate these findings.
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