Impact of Social Vulnerability on Gastrointestinal Health Outcomes and Preventative Measures in the US

Document Type

Conference Proceeding

Publication Date

10-2024

Publication Title

American Journal of Gastroenterology

Abstract

Introduction: Colorectal cancer and alcohol- and obesity-induced hepatic dysfunction are major causes of mortality in the United States (US). The Social Vulnerability Index (SVI), measure of social influences on US populations, impacts many healthcare outcomes. Within the CDC PLACES dataset, prevalence of colorectal cancer screening, binge-drinking, and obesity rates are publicly available. Our study sought to investigate the impact of the SVI on gastrointestinal (GI)-related risk factors and preventative measures. Methods: We obtained GI screening/risk factor measures from the CDC PLACES dataset and linked them with the SVI data from the CDC ATSDR database using US county codes. All outcomes were adjusted for age per 100,000 population. The SVI was quantified in percentile format, with 0 being the least socially vulnerable and 1 being the most socially vulnerable. We conducted multivariable linear regression analyses evaluating the impact of county-level SVI on GI outcomes using county-level aggregates of proportions of individual races and ethnicities. Results: A total of 3,144 US counties were included in our analysis. The average age-adjusted prevalence (AAP) per 100,000 population across all US counties was 17.56 for binge-drinking, 37.42 for obesity, and 67.73 for colorectal cancer screening. In the adjusted models, increasing social vulnerability was associated with higher obesity rates (coefficient 5.91, P , 0.001), lower rates of binge-drinking (coefficient -3.00, P , 0.001), and lower colonoscopy rates (coefficient -6.59, P , 0.001). Increasing social vulnerability was associated with lower rates of being up-to-date on core clinical preventative measures which include colorectal cancer screening in males .65 years (coefficient -9.98, P , 0.001) and females .65 years (coefficient -9.02, P , 0.001). Conclusion: Our results revealed the impact of social vulnerability on GI health outcomes and preventative measures in the US. The association between the SVI and higher obesity rates and reduced colorectal cancer screening emphasizes the influence of social factors on metabolic comorbidities and barriers to accessing preventative healthcare. Our study found that increasing SVI was associated with reduced rates of binge-drinking, prompting further research to investigate the contributing factors to this paradoxical finding. Our results highlight the importance of addressing social determinants to improve disparities in healthcare utilization and risk factors related to common GI disorders (see Figure 1).

Volume

119

Issue

10S

First Page

S270

Comments

American College of Gastroenterology Annual Scientific Meeting, October 25-30, 2024, Philadelphia, PA

Last Page

S271

DOI

10.14309/01.ajg.0001030896.40473.60

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