Race may play a role in outcomes for children and teens with Crohn's disease, with black patients faring worse than whites, a new study suggests.
Digestive system disease
"We found racial inequalities exist among children and adolescents with Crohn's disease, likely due to a combination of genetic and environmental differences," Dr. Jennifer Dotson, a gastroenterologist at Nationwide Children's Hospital and principal investigator in the Centre for Innovation and Paediatric Practice, said in a hospital news release.
Researchers analysed data from more than 4,000 white and black patients with moderate to severe Crohn's disease. They were all aged 21 or younger. All had been hospitalised due to the digestive system disease between 2004 and 2012.
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Black patients were 1.5 times more likely to be readmitted to the hospital and required readmission sooner than white patients, according to the study published recently in the IBD Journal.
Black patients were also more likely to have anaemia and vitamin D deficiency, according to the researchers. And they were more likely to undergo endoscopic procedures, blood product transfusions and treatment with steroids and biologic agents. However, race did not affect the risk of bowel surgery, which is common in youngsters with Crohn's disease.
Disparities in care
"A physician or other clinical staff may not readily identify these racial differences at a single-practice level, but these gaps may be important on a larger scale," Dotson said.
Some of the differences, such as increased procedures for blacks, likely stem from differences in the way the disease affects blacks and whites, she explained. But, she also noted, "Other differences may reflect disparities in care, although biologic differences can't be excluded."
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"Black children were slightly older at the first admission than white children, which could represent a subtle marker of diminished access to medical care or a delay in disease recognition," Dotson said.
She said more studies need to be done to better pinpoint the causes of these racial differences. Once the causes are known, "we can design interventions for hospitals and physician offices that can reduce population-level disparities," she concluded.
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