Health disparities in chronic liver disease

Abstract

The syndemic of hazardous alcohol consumption, opioid use, and obesity has led to important changes in liver disease epidemiology that have exacerbated health disparities. Health disparities occur when plausibly avoidable health differences are experienced by socially disadvantaged populations. Highlighting health disparities, their sources, and consequences in chronic liver disease is fundamental to improving liver health outcomes.There have been large increases in alcohol use disorder in women, racial and ethnic minorities, and those experiencing poverty in the context of poor access to alcohol treatment, leading to increasing rates of alcoholassociated liver diseases. Rising rates of NAFLD and associated fibrosis have been observed in Hispanic persons, women aged > 50, and individuals experiencing food insecurity. Access to viral hepatitis screening and linkage to treatment are suboptimal for racial and ethnic minorities and individuals who are uninsured or underinsured, resulting in greater liver-related mortality and later-stage diagnoses of HCC. Data from more diverse cohorts on autoimmune and cholestatic liver diseases are lacking, supporting the need to study the contemporary epidemiology of these disorders in greater detail.Herein, we review the existing literature on racial and ethnic, gender, and socioeconomic disparities in chronic liver diseases using a social determinants of health framework to better understand how social and structural factors cause health disparities and affect chronic liver disease outcomes. We also propose potential solutions to eliminate disparities, outlining healthpolicy, health-system, community, and individual solutions to promote equity and improve health outcomes.

Trends in Racial and Ethnic Disparities in the Receipt of Lifesaving Procedures for Hospitalized Patients With Decompensated Cirrhosis in the US, 2009-2018

“…NIS data provide up-to-date information to guide the next steps in this analysis seeking to understand and intervene on disparities in the receipt of therapies for end-stage liver disease. Using a socioecological model as a framework to target action "from upstream to downstream," 32 we propose some next steps to understand and address these disparities. First, antiracism and unconscious bias training should be undertaken for all physicians and health care staff, followed by an evaluation of discussion rates to ensure patients of all races and ethnicities are being offered an opportunity to explore these procedures.…”

Predictors for Health-seeking Behavior in Patients with Chronic Liver Disease: A Cross-Sectional Study from Pakistan

“…2 The majority of our sample belongs to the lower middle class of Pakistani society, with an average income of less than USD 221 per month. Poorer patients of CLD suffer from dual problems of (i) not having enough money for preventive practices such as healthy eating habits and having low health literacy [49], and (ii) less nances and resources to get tested and treated which can contribute to the progression of disease [50]. Studies from the developed world stress that CLD patients with lower income and lower occupations skills are strongly associated with more severe disease at diagnosis and poorer survival [51], implying that nancially vulnerable patients need more support for health promotion and disease management.…”

Особливості Впливу Комплексу Ліводінол® У Пацієнтів З Неалкогольною Жировою Хворобою Печінки (Власне Дослідження)

“…Серед захворювань печінки останнім часом усе більшу увагу привертає неалкогольна жирова хвороба печінки (НАЖХП) [1][2][3]. Її поширеність зростає зі збільшенням вираженості ожиріння та впливу негативних факторів, сягаючи 30%, а в старших вікових групах на фоні супутньої патології -і більше [2][3][4].…”