S1931 Social Determinants of Health and Adverse Outcomes in Inflammatory Bowel Disease: Examining Disparities Among Marginalized Populations

Introduction: Inflammatory bowel disease (IBD) requires early intervention and proper care to prevent complications and maintain quality of life. Evidence shows significant disparities in IBD care among racial, ethnic, and socioeconomically marginalized groups. Social Determinants of Health (SDOH), such as economic stability, healthcare access, and social context, affect chronic disease outcomes yet their role in IBD remains poorly understood. This study aims to highlight disparities in IBD care and explores the impact of SDOH. Methods: A comprehensive literature review was conducted using 5 major medical databases. From an initial pool of 3,137 articles, studies were included if they addressed SDOH in the context of IBD and reported adverse health outcomes. Exclusion criteria included pediatric populations, lack of SDOH or IBD focus, and modeling-based studies, resulting in an analysis of 77 articles. Initial statistical analysis was conducted using the All-Payer Claims Databases (APCD) from 3 Northeastern U.S. states. Patient race and ethnicity were compared across key clinical and administrative variables. Results: Among the 77 included studies, economic stability, healthcare access, and social and cultural context were the most frequently addressed SDOH domains. However, many lacked deeper analysis of systemic drivers, revealing a gap in how social and cultural factors are integrated into multidimensional research. Preliminary analysis of the APCDs highlights racial and ethnic disparities in hospital utilization. Race had a modest effect on length of stay (P = 0.044), with severity of illness having stronger impact (P < 0.001). A significant interaction suggests race affects length of stay differently across severity levels. Race and insurance type independently influenced total charges (P < 0.001), with no significant interaction. Chi-squared tests showed strong associations between both race and ethnicity with type of hospital admission (P < 0.001), with non-White and Hispanic patients more likely to be admitted via emergency services. Conclusion: Economic stability and healthcare access were the most frequently discussed SDOH, often connected through issues of insurance and cost. Social and cultural factors remain poorly understood. Next steps include geospatial analysis of IBD care access among marginalized populations and development of a public-facing database to support informed decisions by patients, clinicians, and policy stakeholders.