Socioeconomic Status and Race are both Independently associated with Increased Hospitalization Rate among Crohn's Disease Patients

Caroline Walker, Chaitanya Allamneni, Jordan Orr, Huifeng Yun, Paul Fitzmorris, Fenglong Xie, Talha Malik

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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.

Original languageEnglish (US)
Article number4028
JournalScientific reports
Volume8
Issue number1
DOIs
StatePublished - Dec 1 2018
Externally publishedYes

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Poverty
Social Class
Crohn Disease
Hospitalization
African Americans
Incidence
Poisons
Cohort Studies
Retrospective Studies
Demography
Research
Population

ASJC Scopus subject areas

  • General

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Socioeconomic Status and Race are both Independently associated with Increased Hospitalization Rate among Crohn's Disease Patients. / Walker, Caroline; Allamneni, Chaitanya; Orr, Jordan; Yun, Huifeng; Fitzmorris, Paul; Xie, Fenglong; Malik, Talha.

In: Scientific reports, Vol. 8, No. 1, 4028, 01.12.2018.

Research output: Contribution to journalArticle

Walker, Caroline ; Allamneni, Chaitanya ; Orr, Jordan ; Yun, Huifeng ; Fitzmorris, Paul ; Xie, Fenglong ; Malik, Talha. / Socioeconomic Status and Race are both Independently associated with Increased Hospitalization Rate among Crohn's Disease Patients. In: Scientific reports. 2018 ; Vol. 8, No. 1.
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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.",
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