Literature review: impacts of socioeconomic status on the risk of inflammatory bowel disease and its outcomes

Abstract

The relationship between socioeconomic status (SES) and inflammatory bowel disease (IBD) is controversial. To date, research has focused on effects on incidence and prevalence, disease management and clinical outcomes; however, conclusions remain uncertain. This review examines current evidence, identifies what remains to be understood and explores the practical implications this has for today. A structured literature search in Ovid, Medline, the Cochrane library, Google Scholar and clinicaltrials.gov was performed using defined key words, including all articles up until 5 October 2016 assessing SES as a primary or secondary outcome measure. Twenty-one studies were identified, investigating incidence and prevalence (n=13), disease outcomes (n=5) and mortality (n=3). Data linking SES with IBD incidence are conflicting, with studies citing both positive and negative trends. Patients with low SES, particularly those with Crohn's disease, show higher rates of hospitalization, service usage and IBD-associated mortality. On the basis of the available study data, it is difficult to relate SES with the risk of IBD. For Crohn's disease, in particular, the link between deprivation and increased hospitalization and mortality observed from world-wide studies is alarming. It seems most likely that the cause links to well-documented behavioural, materialistic, psychosocial and life-course models used to explain social class inequalities in other diseases.

Poor engagement and adherence predict neoplasia in inflammatory bowel disease: a case‐control study

“…Although the data on this are conflicting, there is evidence of an inverse correlation between socioeconomic status and rates of disease complications in IBD. [28][29][30][31] However, in our cohort there was no correlation between socioeconomic disadvantage and neoplasia, which reflects and celebrates the equity of access to public healthcare in the tertiary centre in which this study was conducted.…”

Association Between Socioeconomic Status and Erectile Dysfunction in Japanese Patients With Ulcerative Colitis: A Cross-Sectional Study

“…Similarly, the poor socioeconomic status is associated with the clinical outcomes in patients with UC ( Kitahata et al, 2022 ; Nordenvall et al, 2021 ; Wardle et al, 2017 ). The close association between UC and ED was observed in some previous studies ( Friedman et al, 2018 ; Kao et al, 2016 ; Wu et al, 2022 ).…”

Impact of sex and socioeconomic status on risk of surgery, hospitalization, and use of medications in inflammatory bowel disease: A systematic review and meta-analysis

“…Individual treatment is highly dependent on the disease's severity and activity (3,4). However, sociodemographic characteristics, such as education, income level and sex, may also affect disease outcomes impacting healthcare utilisation, access or need (5)(6)(7)(8). For example, low-income and economic deprivation have been associated with higher hospitalization for patients with an IBD diagnosis (9,10).…”