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, 8 (1), 4028

Socioeconomic Status and Race Are Both Independently Associated With Increased Hospitalization Rate Among Crohn's Disease Patients

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Socioeconomic Status and Race Are Both Independently Associated With Increased Hospitalization Rate Among Crohn's Disease Patients

Caroline Walker et al. Sci Rep.

Abstract

Racial disparities are observed clinically in Crohn's Disease (CD) with research suggesting African Americans (AA) have worse outcomes than Caucasian Americans (CA). The aim of this study is to assess whether socioeconomic status (SES) rather than race is the major predictor of worse outcomes. We designed a retrospective cohort study of 944 CD patients seen at our center. Patients' billing zip codes were collected and average income and percent of population living above or below poverty level (PL) for each zip code calculated. Patients were separated by quartiles using average state income level and federal PL. Demographics and hospitalization rates were collected. Poison regression models estimated incidence rate ratios (IRR) for CD-related hospitalizations. Incidence rate (IR) of hospitalization per 100-person years for the lowest income group was 118 (CI 91.4-152.3), highest income group was 29 (CI 21.7-38.9), Above PL was 26.9 (25.9-28.9), Below PL was 35.9 (33.1-38.9), CA was 25.3 (23.7-27), and AA was 51.4 (46.8-56.3). IRR for a CD-related hospitalization for lowest income group was 2.01 (CI 1.34-3.01), for Below PL was 1.26 (CI 1.12-1.42), and for AAs was 1.88 (CI 1.66-2.12). SES and race are both associated with hospitalization among CD patients and need further investigation.

Conflict of interest statement

The authors declare no competing interests.

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References

    1. Ganz ML, Sugarman R, Wang R, Hansen BB, Håkan-Bloch J. The Economic and Health-related Impact of Crohn’s Disease in the United States. Inflammatory Bowel Diseases. 2016;22:1032–1041. doi: 10.1097/MIB.0000000000000742. - DOI - PubMed
    1. Crohn BB, Ginzburg L, Openheimer GD. Regional ileitis: a pathologic and clinical entity. JAMA. 1932;99:1323–1329. doi: 10.1001/jama.1932.02740680019005. - DOI
    1. Klionsky DJ. Crohn’s Disease, Autophagy, and the Paneth Cell. New England Journal of Medicine. 2009;360:1785–1786. doi: 10.1056/NEJMcibr0810347. - DOI - PMC - PubMed
    1. Schwartz DA, Pemberton JH, Sandborn WJ. Diagnosis and Treatment of Perianal Fistulas in Crohn Disease. Annals of Internal Medicine. 2001;135:906–918. doi: 10.7326/0003-4819-135-10-200111200-00011. - DOI - PubMed
    1. Lichtenstein GR, Hanauer SB, Sandborn WJ. Management of Crohn’s Disease in Adults. Am J Gastroenterol. 2009;104:465–483. doi: 10.1038/ajg.2008.168. - DOI - PubMed
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