S1707 Beyond the Scope: Viewing Clinical Outcomes of Minorities With Inflammatory Bowel Disease

Introduction: Despite the increasing incidence of inflammatory bowel disease (IBD) among populations around the world, aside from Non-Hispanic Whites (NHWs), other ethnoracial groups remain grossly underrepresented in studies of IBD in the United States. Research in this area is essential to understanding potential differences in clinical presentation and outcomes, as well as possible disparities in care among various ethnoracial groups with IBD. We utilized one of the largest and most comprehensive datasets of IBD patients to evaluate this question. Methods: The University of California Health Data Warehouse (UCHDW) was utilized to create an observational cohort study with cross-sectional and longitudinal analyses using de-identified data. UCHDW is a large dataset including almost 10 million patients seen at one of 5 University of California medical centers and clinics since 2012. IRB exemption was obtained. Multivariate regression models using R and Python were used to evaluate clinical outcomes, socioeconomic conditions via area of deprivation index (ADI), hospital usage, and medication among different ethnoracial groups from 2012 to 2024. Results: In total, 50,307 patients with Ulcerative Colitis (UC) or Crohn’s Disease (CD) were included in the study. Among both UC and CD populations, when compared to other groups, Black and Latino groups had the lowest proportion of individuals with private insurance, the highest Area of Deprivation Index (ADI), and the shortest duration of time in days from their index diagnosis to visiting the emergency room, as well as shortest duration from diagnosis to their first inpatient admission (P < 0.01). NHWs had the longest duration of time from their index diagnosis to first surgery in both the UC and CD populations (P < 0.01). Within the UC population, Black individuals had the highest mortality rate, longest time between index diagnosis to starting biologics, and fewer number of days from their index diagnosis to first surgery when compared to other ethnoracial groups (P < 0.01). Conclusion: In one of the largest US studies of IBD to date with substantial ethnoracial diversity, we saw that Black and Latino patients with IBD live in more socioeconomically under-resourced areas based on their ADI, and worryingly, these populations showed multiple worse clinical outcomes. Future research will examine the healthcare disparities that may limit access to care for minority IBD patients, to address these gaps and improve outcomes, and reduce complications.