Disparities in Health Care in Patients With Chronic Liver Disease

Area of Science:

• Hepatology and Public Health
• Epidemiology of Liver Disease
• Health Disparities Research

Background:

• Chronic liver disease (CLD) prevalence is rising globally, causing significant morbidity, mortality, and reduced quality of life.
• CLD disproportionately affects racial, ethnic, sexual, and gender minorities and populations with challenging social determinants of health (SDOH).
• Health disparities manifest as higher CLD prevalence, severity, adverse clinical outcomes, and poorer patient-reported outcomes.

Purpose of the Study:

• To review the epidemiology and health disparities across major CLD types: MASLD, ALD, viral hepatitis, and autoimmune liver disease.
• To discuss challenges in screening, diagnosis, risk stratification, treatment, and clinical outcomes for diverse populations.
• To outline actionable interventions for health equity in CLD, from public health to individual patient levels.

Main Methods:

• Literature review focusing on epidemiology and health disparities in CLD.
• Analysis of disparities in screening, diagnosis, noninvasive testing, treatment, and outcomes.
• Identification of interventions and future research needs for health equity.

Main Results:

• Significant health disparities exist across various CLD forms, impacting prevalence, severity, and outcomes.
• Challenges in equitable access to screening, diagnosis, and treatment for CLD are prevalent.
• Interventions are needed at multiple levels to address systemic inequities in CLD care.

Conclusions:

• Urgent action is required to address health disparities in chronic liver disease.
• Multifaceted interventions, from public health initiatives to personalized patient care, are essential for achieving health equity.
• Future research should focus on informing targeted interventions to reduce CLD-related inequities.