Disparities in MR enterography utilization stratified by social drivers of health (SDOH): a zip code-based analysis

Social drivers of health (SDOH) are nonmedical factors that influence health outcomes. We aim to evaluate if there are differences in MR enterography (MRE) utilization among the various zip codes surrounding UMass Memorial Medical Center in Worcester, MA stratified by various SDOH.

In this HIPAA compliant IRB approved retrospective population-based study, MRE utilization for patient zip codes within a 10 mile radius of UMass Memorial Medical Center was determined by dividing the number of MREs performed from 01/08/2018 to 07/27/2022 by the population for each zip code. Data on median household income (MHI), population in poverty (PIP), health insurance status, race and ethnicity, and transportation access was collected from the United Census Bureau and data on social vulnerability index (SVI) was collected from the Centers of Disease Control for each zip code. Disadvantaged zip codes for each SDOH were defined as zip codes in the bottom quartile for MHI and the top quartile for the remaining SDOH. MRE utilization was compared between the two groups for each SDOH by one-way analysis.

The mean MRE utilization for the included zip codes was 1.1 MRE per 1000 capita over the study period of 55 months. The MRE utilization was lower for the disadvantaged zip codes stratified by each studied SDOH. The largest difference in MRE utilization was identified between disadvantaged zip codes and non-disadvantaged zip codes stratified by SVI and percentage of population without a car, at 0.5 MRI per 1000 capita.

Individuals living in disadvantaged areas have lower rates of MRE utilization, which is commonly used in the evaluation of inflammatory bowel disease (IBD). Disparate utilization of MRE could lead to disparities in outcome for those with IBD.