'Social Risk in Patients with Inflammatory Bowel Diseases'

Seo Hyun Kim1 ∙ Yuchen Qi2 ∙ Matthew P. Banegas3,4 ∙ … ∙ Carlos Lago Hernandez9 ∙ Ronghui Xu2,10,11 ∙ Siddharth Singh8,12 sis040@ucsd.edu 

ABSTRACT

Background and Aims

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 (IBD) in the United States (US).

Methods

In the US National Health Interview Survey 2023, we estimated social risks across six 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 (0/6 domains [none], 1/6 domains [mild], 2/6 domains [moderate] and ≥3/6 domains [severe]) and unplanned healthcare utilization (emergency department and/or hospitalization) and medication non-adherence, accounting for differences in age, sex, race/ethnicity, insurance, income and comorbidities.

Results

Of 572 people included in the survey (mean age, 56y; 57% female; 81% non-Hispanic Whites [NHWs], 12.9% Hispanic), 64% (95% CI, 59-69%) experienced social risk across one 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 Blacks vs. Hispanics vs. NHWs: 37% vs. 28% vs. 12%). Higher burden of social risk was associated with higher risk of unplanned healthcare utilization (severe vs. none: OR, 3.5 [1.2-10.2) and cost-related medication non-adherence (OR, 11.8 [2.7-52.1]), after accounting for income and insurance status.

Conclusions

Social risks are prevalent in adults with IBD and negatively impact healthcare utilization and medication non-adherence. Efforts to routinely identify and address social risks in patients with IBD should be part of standard clinical care.

https://www.cghjournal.org/article/S1542-3565(25)00460-4/abstract