Race and Inflammatory Bowel Disease in an Urban Healthcare System

Sewell, Justin L.; Inadomi, John M.; Yee, Hal F.

doi:10.1007/s10620-010-1442-8

Cited by 51 publications

(40 citation statements)

References 29 publications

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“…Differences in UC disease extent and upper gastrointestinal CD involvement have each been shown in a single study, but other studies, including ours, have not redemonstrated these differences [1, 7, 12, 13, 15]. In addition, we identified differences in IBD extraintestinal manifestations in AA patients compared to Ca patients in both our UC and CD populations, which is similar with what has been reported in previous studies [7, 8].…”

Section: Discussionsupporting

confidence: 91%

“…While there is less data regarding differences in disease extent by race in patients with ulcerative colitis (UC), Moore et al [12] recently reported increased distal colitis and less pancolitis in AA patients with UC. In contrast, two recent comparably sized studies found no significant differences in disease location by race for either UC or CD [1, 13]. In agreement, a systematic review by Mahid et al [9] found that the overall evidence suggests that AA patients with IBD have similar symptoms, extraintestinal manifestations, disease location, and behavior to Ca patients.…”

Section: Introductionmentioning

confidence: 77%

“…The majority of these evaluations, however, were limited by small sample sizes [5–7, 10, 11, 13]. The largest comprehensive multi-center study comparing 127 AA patients to 830 Ca patients found that AA with Crohn’s disease (CD) were more likely to have upper gastrointestinal involvement, perianal disease, uveitis, and sacroiliitis [8].…”

Section: Introductionmentioning

confidence: 99%

“…Four retrospective studies have demonstrated no difference in overall rates of surgery by race [10, 12, 13, 16]. However, a nationwide analysis of hospital discharges over a 6-year period concluded that AA with CD were less likely to undergo surgery [17].…”

Section: Introductionmentioning

confidence: 99%

“…During this time, investigations have varied in their reports of utilization of medical therapy by race. AA IBD patients have been found in several analyses to receive less corticosteroids, azathioprine, 5-aminosalicylates (5-ASA), and infliximab [12, 13, 15]. However, these results have not been consistently reproduced in other study populations as two retrospective studies demonstrated no differences in medication utilization by race [7, 14].…”

Section: Introductionmentioning

confidence: 99%

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Clinical Presentation and Disease Course of Inflammatory Bowel Disease Differs by Race in a Large Tertiary Care Hospital

et al. 2014

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Background While the incidence of inflammatory bowel disease (IBD) among African-Americans (AAs) is increasing, there is limited understanding of phenotypic differences and outcomes by race. Aim To describe disease characteristics of AA patients compared to Caucasian (Ca) patients in a tertiary care population. Methods We performed a cross-sectional review of the IBD registry at the University of Chicago from January 2008 to January 2013. Data regarding race, phenotype, disease onset, disease duration, medical therapy, and surgical treatment were abstracted from the database, then compared via Pearson’s chi-square analysis, Kruskal–Wallis analysis, and logistic regression with a significance level of p < 0.05. Results A total of 1,235 patients with Crohn’s disease (CD) and 541 patients with ulcerative colitis (UC) included 108 AA CD patients and 28 AA UC patients. AA CD patients had an increased rate of IBD-related arthralgias (36.5 vs. 23.9 %, p < 0.01) and surgery (p < 0.01), less ileal involvement (57.8 vs. 71.0 %, p < 0.01), and no differences for other extraintestinal manifestations or disease locations compared to Ca CD patients. AA UC patients were older at diagnosis, had an increased rate of arthralgias (28.6 vs. 14.6 %, p = 0.047) and ankylosing spondylitis/sacroiliitis (7.1 vs. 1.6 %, p = 0.035), with no differences for disease extent or rate of IBD-related surgeries compared to Ca UC patients. There were no differences in medication usage by race for CD and UC patients. Conclusion We identified significant differences in disease characteristics and extraintestinal manifestations between AA and Ca IBD patients in a large tertiary care population. These results have implications for future genotype-phenotype studies.

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Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 77%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Clinical Presentation and Disease Course of Inflammatory Bowel Disease Differs by Race in a Large Tertiary Care Hospital

et al. 2014

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Diversity, equity, and inclusion in gastroenterology and hepatology: A survey of where we stand

et al. 2022

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Background and Aims In the setting of increasing attention to representation in medicine, we aimed to assess current perspectives of racial and ethnic workforce diversity and health care disparities among gastroenterology (GI) and hepatology professionals in the United States. Approach and Results We developed and administered a 33‐item electronic cross‐sectional survey to members of five national GI and hepatology societies. Survey items were organized into thematic modules and solicited perspectives on racial and ethnic workforce diversity, health care disparities in GI and hepatology, and potential interventions to enhance workforce diversity and improve health equity. Of the 1219 survey participants, 62.3% were male, 48.7% were non‐Hispanic White, and 19.9% were from backgrounds underrepresented in medicine. The most frequently reported barriers to increasing racial and ethnic diversity in GI and hepatology were insufficient representation of underrepresented racial and ethnic minority groups in the education and training pipeline (n = 431 [35.4%]), in professional leadership (n = 340 [27.9%]), and among practicing GI and hepatology professionals (n = 324 [26.6%]). Suggested interventions were to increase career mentorship opportunities (n = 545 [44.7%]), medical student opportunities (n = 520 [42.7%]), and program and professional society leadership roles for underrepresented racial and ethnic minority groups (n = 473 [38.8%]). Conclusions Our survey explored imperative and timely perspectives on racial and ethnic representation and health equity among professionals in GI and hepatology. The findings should inform future interventions to address workforce diversity and establish priorities toward improving health equity, ultimately serving as a springboard for professional societies, academic institutions, and other organizations that aim to increase diversity, equity, and inclusion in our field.

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Systematic Review

Sewell

Velayos

2013

Inflammatory Bowel Diseases

Self Cite

108

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Introduction Race and socioeconomic status (SES) significantly affect the content and delivery of healthcare for multiple chronic disease states. Inflammatory bowel disease (IBD) is a set of complex, chronic diseases with the potential for significant morbidity if the content or delivery of healthcare is suboptimal. However, the literature related to race, SES, and IBD remains fragmented. Methods Using guidelines published by the Centre for Reviews and Dissemination, we performed a systematic review of the world's literature to identify studies related to: (1) IBD, (2) race/ethnicity, (3) SES, (4) healthcare delivery, and (5) healthcare effectiveness. Results We identified 40 studies that met inclusion criteria. Twenty-four studies (60%) assessed the role of SES, and 21 (53%) evaluated race. Topics addressed by these studies included: (1) Utilization of Medical and Surgical Therapy; (2) Adherence to Medical Therapy; (3) Clinical Outcomes; (4) Healthcare Access and Utilization; (5) Disease Perception and Knowledge; and (6) Employment/Insurance. We identified race- and SES-based disparities in the content of medical and surgical healthcare, utilization of inpatient and ambulatory medical care, adherence to medical therapy, and disease perceptions and knowledge. Several studies also identified race- and SES-based disparities in outcomes for IBD, including in-hospital mortality rates and health-related quality of life. Discussion Race- and SES-based disparities in the delivery and effectiveness of healthcare for patients with IBD exist in numerous domains, yet studies remain limited in their scope and breadth. Concerted, prospective, multicenter efforts are needed to address underlying causes for disparities and to identify methods of reducing and eliminating disparities.

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Race and Inflammatory Bowel Disease in an Urban Healthcare System

Cited by 51 publications

References 29 publications

Clinical Presentation and Disease Course of Inflammatory Bowel Disease Differs by Race in a Large Tertiary Care Hospital

Clinical Presentation and Disease Course of Inflammatory Bowel Disease Differs by Race in a Large Tertiary Care Hospital

Diversity, equity, and inclusion in gastroenterology and hepatology: A survey of where we stand

Systematic Review

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