The News About IBD Among Historically Marginalized People Is Not Good

Inflammatory bowel disease (IBD), which includes Crohn’s disease and ulcerative colitis (UC), affects close to 3 million adults in the United States, according to the Centers for Disease Control and Prevention The prevalence among U.S. adults and children is 0.8% in the White non-Hispanic (W/NH) population, 0.5% in the Black population, and 0.5% in the Hispanic population, Some studies have found that the prevalence of IBD in minority groups is rising.

Access to necessary care and treatment can vary based on sociodemographic factors, with historically marginalized populations facing more barriers to appropriate treatment. In a study published in the September 2024 issue of Inflammatory Bowel Diseases, Shamita Shah, M.D., from the department of gastroenterology at Ochsner Health in New Orleans, and her colleagues evaluated care access and outcomes among a diverse population of adults with IBD.

Shah and colleagues conducted an online survey of patients receiving IBD treatment at Ochsner Health between August 2019 and December 2021. Ochsner Health is a large, nonprofit healthcare system serving a diverse population across Louisiana and Mississippi. Using survey results and electronic medical records, the reserachers conducted an analysis comparing Black/Indigenous/People of Color or Hispanic (BIPOC/H) individuals with White non-Hispanic patients.

The survey assessed IBD symptoms, health-related quality of life, barriers to care, medication adherence and beliefs about medications. Data from medical records yielded healthcare resource utilization information.

The results showed that BIPOC/H patients with IBD were more likely to report poor symptom control compared with W/NH patients (35% versus 18%). BIPOP/H patients also reported more difficulty accessing care from specialists (26% versus 11%) and were twice as likely to have an IBD-related emergency department visit compared to W/NH individuals (42% versus 22%).

No significant differences were found in access to medication or a clinician who listens to and respects them. Responses related to receiving understandable explanations or care without delays were also similar between the two groups.

Both groups also had similar responses regarding the belief that IBD medications were necessary for supporting and maintaining health. However, BIPOC/H patients scored higher in concerns about the long-term effects of the treatments and the potential for dependency on the medications.

Shah and her colleagues concluded that people from historically marginalized communities living with IBD have worse outcomes, lower health-related quality of life, and more barriers to accessing specialists and social and emotional support for their IBD compared with W/NH patients.

The authors wrote, “These findings underscore disparities and outcomes for BIPOC/H individuals with IBD, emphasizing a need for targeted interventions and support.”