ASSOCIATION BETWEEEN SOCIAL DETERMINANTS OF HEALTH AND INFLAMMATORY BOWEL DISEASE: A NATIONALLY REPRESENTATIVE ANALYSIS
Author(s)
Omobolanle Adekoya, PhD1, Ami Vyas, MBA, MS, PhD2;
1University of Rhode Island, Graduate Assistant, Kingston, RI, USA, 2The University of Rhode Island, Kingston, RI, USA
1University of Rhode Island, Graduate Assistant, Kingston, RI, USA, 2The University of Rhode Island, Kingston, RI, USA
OBJECTIVES: We examined the association between social determinants of health (SDOH) and inflammatory bowel disease (IBD) in a multivariable framework, using nationally representative data from United States.
METHODS: We conducted a retrospective population-based study using 2018-2020 Medical Expenditure Panel Survey data. IBD patients were identified using the ICD-10-CM codes K50 and K51. SDOH domains were healthcare access and quality (HAQ), economic stability (ES), social and community context (SCC), neighborhood and built environment (NBE), and education. We used a matched cohort design by matching one IBD patient to eight patients without IBD, on age, sex and US region. We conducted separate adjusted multivariable logistic regressions to examine the association between each SDOH and IBD, controlling confounders and other SDOH.
RESULTS: In the HAQ domain, adults with usual source of healthcare had significantly higher odds of IBD than those without usual source of healthcare (adjusted odds ratio (AOR)=2.374, 95% confidence intervals (CI):1.516-4.929, p=0.0009). Also, adults who had unmet prescription medication needs had significantly higher odds of IBD (AOR=1.972, 95%CI:1.071-3.636, p=0.035) than those without such needs. Adults who had private insurance coverage compared to those with Medicare (AOR=1.457, p>0.05), whose provider helped decide on treatments (AOR=1.467, 95%CI:0.815-2.639) and asked about other treatment options (AOR=1.766, 95%CI:1.040-2.998, p=0.0355) had higher odds of IBD. In the SCC domain, Hispanics, Blacks, and adults from other racial/ethnic groups had lower odds of IBD than non-Hispanic Whites (AORs were in the range of 0.534 to 0.693, p>0.05.). In the NBE domain, adults who engaged in regular physical activity had significantly lower odds of IBD (AOR=0.710; 95%CI:0.493-1.021, p=0.006) than those who didn’t, while adults with psychological distress had higher odds of IBD than those who did not report psychological distress (AOR= 1.160; 95%CI:0.820-1.642, P=0.41)
CONCLUSIONS: Our study highlighted subgroups of patients with higher prevalence of IBD, especially those with higher socioeconomic and medical disadvantage
METHODS: We conducted a retrospective population-based study using 2018-2020 Medical Expenditure Panel Survey data. IBD patients were identified using the ICD-10-CM codes K50 and K51. SDOH domains were healthcare access and quality (HAQ), economic stability (ES), social and community context (SCC), neighborhood and built environment (NBE), and education. We used a matched cohort design by matching one IBD patient to eight patients without IBD, on age, sex and US region. We conducted separate adjusted multivariable logistic regressions to examine the association between each SDOH and IBD, controlling confounders and other SDOH.
RESULTS: In the HAQ domain, adults with usual source of healthcare had significantly higher odds of IBD than those without usual source of healthcare (adjusted odds ratio (AOR)=2.374, 95% confidence intervals (CI):1.516-4.929, p=0.0009). Also, adults who had unmet prescription medication needs had significantly higher odds of IBD (AOR=1.972, 95%CI:1.071-3.636, p=0.035) than those without such needs. Adults who had private insurance coverage compared to those with Medicare (AOR=1.457, p>0.05), whose provider helped decide on treatments (AOR=1.467, 95%CI:0.815-2.639) and asked about other treatment options (AOR=1.766, 95%CI:1.040-2.998, p=0.0355) had higher odds of IBD. In the SCC domain, Hispanics, Blacks, and adults from other racial/ethnic groups had lower odds of IBD than non-Hispanic Whites (AORs were in the range of 0.534 to 0.693, p>0.05.). In the NBE domain, adults who engaged in regular physical activity had significantly lower odds of IBD (AOR=0.710; 95%CI:0.493-1.021, p=0.006) than those who didn’t, while adults with psychological distress had higher odds of IBD than those who did not report psychological distress (AOR= 1.160; 95%CI:0.820-1.642, P=0.41)
CONCLUSIONS: Our study highlighted subgroups of patients with higher prevalence of IBD, especially those with higher socioeconomic and medical disadvantage
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
EPH55
Topic
Epidemiology & Public Health
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, SDC: Gastrointestinal Disorders