Prevalence and Impact of Social Risk in Patients With Inflammatory Bowel Diseases: National Estimates From the United States.

Details

• Alternative Title:
  Clinical Gastroenterology and Hepatology: the Official Clinical Practice Journal of the American Gastroenterological Association, 2025, v. 23, no. 13: Prevalence and Impact of Social Risk in Patients With Inflammatory Bowel Diseases: National Estimates From the United States.
• Journal Article:
  Clinical Gastroenterology and Hepatology: the Official Clinical Practice Journal of the American Gastroenterological Association
• Personal Author:
  Kim, Seo Hyun ; Qi, Yuchen ; Banegas, Matthew P. ; Kappelman, Michael D. ; Nguyen, Nghia H. ; Boland, Brigid S. ; Hernandez, Carlos Lago ; Xu, Ronghui ; Singh, Siddharth
• Description:
  Social risks are individual-level factors associated with adverse health outcomes. We determined the prevalence and impact of social risks on healthcare use among patients with inflammatory bowel diseases (IBDs) in the United States.
  
  In the U.S. National Health Interview Survey 2023, we estimated social risks across 6 domains (food insecurity, financial hardship, housing instability, transportation needs, education and employment, discrimination) in adults with IBD. We evaluated the association between burden of social risk (0 of 6 domains none, 1 of 6 domains mild, 2 of 6 domains moderate, and ≥3 of 6 domains severe), unplanned healthcare utilization (emergency department and/or hospitalization), and medication nonadherence, accounting for differences in age, sex, race/ethnicity, insurance, income, and comorbidities.
  
  Of 572 people included in the survey (mean age 56 years; 57% female; 81% non-Hispanic White NHW, 12.9% Hispanic), 64% (95% confidence interval CI, 59%-69%) experienced social risk across 1 or more domains (food insecurity, 22%; financial hardship, 28%; housing instability, 14%; transportation needs, 9%; education and employment, 9%; discrimination, 41%). Prevalence of severe social risk was higher in racial and ethnic minority groups (non-Hispanic Black vs Hispanic vs NHW: 37% vs 28% vs 12%). A higher burden of social risk was associated with higher risk of unplanned healthcare utilization (severe vs none: odds ratio, 3.5; 95% CI, 1.2-10.2) and cost-related medication nonadherence (OR, 11.8; 95% CI, 2.7-52.1), after accounting for income and insurance status.
  
  Social risks are prevalent in adults with IBD and negatively impact healthcare utilization and medication nonadherence. Efforts to routinely identify and address social risks in patients with IBD should be part of standard clinical care.
• Content Notes:
  Author manuscript
• Subjects:
  • Humans
  • Female
  • Male
  • Middle Aged
  • Inflammatory Bowel Diseases
  • Prevalence
  • Adult
  • Aged
  • Patient Acceptance of Health Care
  • Food Insecurity
  More +
• Keywords:
  • Social determinants of health
  • health disparities
  • Crohn's disease
  • ulcerative colitis
  • financial toxicity
• Source:
  Clinical Gastroenterology and Hepatology: the Official Clinical Practice Journal of the American Gastroenterological Association, 2025, v. 23, no. 13
• DOI:
  https://doi.org/10.1016/j.cgh.2025.03.031
• ISSN:
  1542-3565 ; 1542-7714
• Pubmed ID:
  40473090
• Pubmed Central ID:
  PMC12354202
• Document Type:
  Text
• Funding:
  R01 DK135937/DK/NIDDK NIH HHSUnited States/ ; T15 LM011271/LM/NLM NIH HHSUnited States/ ; U01 DP006745/DP/NCCDPHP CDC HHSUnited States/
• Genre:
  Journal Article
• Place as Subject:
  United States
• Pages in Document:
  2588-2596 (16 pdf pages)
• Volume:
  23
• Issue:
  13
• Download URL:
  https://stacks.cdc.gov/view/cdc/261361/cdc_261361_DS1.pdf
• File Type:
  [PDF - 311.85 KB]
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:ff4a8e2a129ed69e56f98a7cbcc939eb61a6f9c93cb7152a5f87232cbaa585cde53a406276a573a3cf8c01791b1a85ea65fc4e65f2608c36db4cf36b05b348d7