Disparities in Diagnosis and Treatment of Inflammatory Bowel Disease (IBD)

Author: Sara Habibipour

Inflammatory Bowel Disease (IBD–a term for Crohn's disease or ulcerative colitis) has long been known as a “Caucasian” disease, as it has a higher incidence rate in the white population as compared to the Black or Hispanic population. But, in general, IBD is becoming more of a global disease. The recognition of IBD among racial groups other than whites could be due to increased research of this disease in other populations.

It wasn’t until 1966 that IBD was even studied in African Americans. In numerous diseases, including cardiac disease, obesity, and diabetes mellitus, African Americans suffer poorer outcomes, receive fewer therapeutic interventions, and often have been found to have higher mortality than Caucasians. Although there is a higher incidence rate of IBD in the Caucasian population, Blacks and Hispanics have a higher ratio of hospitalizations and IBD-related mortality compared to Caucasians. This is largely due to differences in socioeconomic status.

Increased risk factor for IBD has been linked with a diet high in animal fats and sugar and low in fruits and vegetables. Studies on IBD in Latin America and the Caribbean show that large proportions of people with IBD are from regions with higher economic and industrial development, indicating a more Western environment, including diet.

Cigarette smoking also affects the development of IBD; it’s known to increase risk in Chron’s disease, but actually decrease risk in ulcerative colitis (which I personally find interesting). In studies of surgical outcomes, African American patients with Chron’s were associated with higher rates of smoking compared to non-African American patients, which can affect the severity of the disease as well as surgical decision making, leading to potential disparities in treatment and health outcomes.

Recently there has been more research on IBD in African Americans and Hispanics, but more research needs to be done. Crohn's disease has long been considered a “Caucasian” disease, but thorough research has only started to be conducted. Even if IBD affects more people in the white population genetically, we still need to understand the disparities associated with health outcomes in Black and Hispanic individuals with IBD in order to push for change.

Sources:

https://www.worldgastroenterology.org/publications/e-wgn/e-wgn-expert-point-of-view-articles-collection/the-impact-of-racial-and-ethnic-differences-in-ibd-phenotype-in-the-us#:~:text=An%20estimated%201%2C810%2C773%20adults%20in,non%2DHispanic%20Blacks%20and%20Hispanics.

https://www.gastroenterologyadvisor.com/inflammatory-bowel-diseases-ibd/disparities-in-the-diagnosis-and-management-of-ibd-among-different-racial-and-ethnic-groups/