The Current State of Care for Black and Hispanic Inflammatory Bowel Disease Patients

Abstract

Research on the care of inflammatory bowel disease (IBD) patients has been primarily in populations of European ancestry. However, the incidence of IBD, which comprises Crohn’s disease and ulcerative colitis, is increasing in different populations around the world. In this comprehensive review, we examine the epidemiology, clinical presentations, disease phenotypes, treatment outcomes, social determinants of health, and genetic and environmental factors in the pathogenesis of IBD in Black and Hispanic patients in the United States. To improve health equity of underserved minorities with IBD, we identified the following priority areas: access to care, accurate assessment of treatment outcomes, incorporation of Black and Hispanic patients in therapeutic clinical trials, and investigation of environmental factors that lead to the increase in disease incidence.

Examining the Accuracy and Reproducibility of Responses to Nutrition Questions Related to Inflammatory Bowel Disease by Generative Pre-trained Transformer-4 (GPT-4)

“…Barriers to care, such as lengthy wait times and inaccessibility to a dietician or IBD specialist, are even more pronounced in patients of minority backgrounds, which can further exaggerate disparities and lead to delays in diagnosis and treatment. (30) LLMs may empower these patients with knowledge regarding their disease, giving them a tool which helps them proactively engage with their healthcare providers. LLMs may also prove beneficial to patients who have language discordance with their healthcare providers, given disparities in healthcare outcomes based on language preference have been previously shown.…”

Predictors of Intestinal Obstruction in Hospitalized Patients with Inflammatory Bowel Disease: A Retrospective Analysis

“…Though IBD has historically been associated with patients of European ancestry, recent studies have shown that the incidence of IBD is increasing in other populations as well (20). Studies have also shown a difference in clinical presentation between races, particularly between Hispanic and non-Hispanic White patients.…”

Achieving Health Equity: Advancing Colorectal Surgery among Racial and Ethnic Minorities in America

“…11 Access to care, disease assessment, clinical trial enrollment, and evaluation of environmental factors have all been prioritized for future research in this population. 12…”

“…11 Access to care, disease assessment, clinical trial enrollment, and evaluation of environmental factors have all been prioritized for future research in this population. 12 It is estimated that a large percentage of patients with IBD will require surgery in their lifetime; 15.2% of patients with ulcerative colitis and 47% of patients with Crohn's disease will require intestinal surgery within 10 years of diagnosis. 13,14 Following IBD surgery, NHB patients have been associated with more complicated postoperative recoveries as illustrated by longer lengths of stay, higher readmission rates, and higher odds of death or serious morbidity.…”