National estimates of the burden of inflammatory bowel disease among racial and ethnic groups in the United States.
BACKGROUND
The epidemiology of inflammatory bowel disease (IBD) is poorly characterized in minorities in the U.S. We sought to enumerate the burden of IBD among racial and ethnic groups using national-level data.


METHODS
Data from the National Health Interview Survey was used to calculate prevalence and incidence of IBD among adults (≥ 18 years) in 1999. The Nationwide Inpatient Sample was queried to ascertain rates of IBD-related hospitalizations and the Underlying Cause of Death Database was accessed to quantify IBD-related mortality.


RESULTS
An estimated 1,810,773 adult Americans were affected by IBD yielding a prevalence of 908/100,000, which was higher in Non-Hispanic Whites (1099/100,000) compared with Non-Hispanic Blacks (324/100,000), Hispanics (383/100,000), and non-Hispanic Other (314/100,000). Relative to Non-Hispanic Whites, the odds ratios for having a diagnosis of IBD associated with being Non-Hispanic Black, Hispanic, and Other Non-Hispanic race after adjusting for age, sex, and geographic region were 0.33 (95% CI: 0.19 - 0.57), 0.45 (95% CI: 0.26 - 0.77), and 0.34 (95% CI: 0.12 - 0.93), respectively. IBD incidence was similarly lower in Non-Hispanic Blacks (24.9/100,000) and Hispanics (9.9/100,000) compared to Non-Hispanic Whites (70.2/100,000). The ratio of IBD hospitalizations to prevalence was disproportionately higher among Non-Hispanic Blacks (7.3%) compared with Non-Hispanic Whites (3.0%) and Hispanics (2.7%). Similarly, the ratio of IBD-related mortality was greater in Non-Hispanic Blacks (0.061%) compared to Non-Hispanic Whites (0.036%) and Hispanics (0.026%).


CONCLUSIONS
IBD disease burden is lower in ethnic minorities compared to Non-Hispanic Whites. However, IBD-related hospitalizations and deaths seem disproportionately high in Non-Hispanic Blacks.
Mount Sinai Hospital Centre for Inflammatory Bowel Disease, University of Toronto, Toronto, Ontario, Canada; Institute for Health Policy Management and Evaluation, University of Toronto, Canada; Division of Gastroenterology and Hepatology, Johns Hopkins School of Medicine, USA. Electronic address: geoff.nguyen@utoronto.ca.
Geoffrey C
GC
Nguyen
Department of Medicine, Lakeridge Health, Oshawa, Ontario, Canada.
Christopher A
CA
Chong
Department of Medicine, Lakeridge Health, Oshawa, Ontario, Canada.
Rachel Y
RY
Chong
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D044383:Black People / Q000706:statistics & numerical data; D017281:Cost of Illness; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D006306:Health Surveys; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D015212:Inflammatory Bowel Diseases / Q000453:epidemiology* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D044469:Racial Groups / Q000706:statistics & numerical data*; D044465:White People / Q000706:statistics & numerical data; D055815:Young Adult
Crohn's disease; Hospitalization; Inflammatory bowel disease; Prevalence; Race; Ulcerative colitis