Thread by @AdjoaGIMD

@MondayNightIBD @DCharabaty @BonumCe @pfizer @JanssenUS @TakedaPharma 3/ Social determinants of health #SDOH
👉Conditions in places where people live, learn, work, & play shaped by 💰wealth, power, & resources that affect a wide range of health risks/outcomes
📌SDOH can lead to unfair & avoidable differences in health status w/in pops #disparities

@MondayNightIBD @DCharabaty @BonumCe @pfizer @JanssenUS @TakedaPharma 4/ #SDOH impact health outcomes
📌Unemployed >6yrs👉2x⬆️mortality
📌Chicago area👉16yrs⬇️ life expectancy
📌Social isolation👉2x⬆️ risk of CAD
📌Unsafe childhood👉5x⬆️risk mental health disorder
📌Dual M/M ins👉24%-67% ⬆️readmission
📌Language services👉60% ⬆️risk ED utilization

@MondayNightIBD @DCharabaty @BonumCe @pfizer @JanssenUS @TakedaPharma 5/ How do #SDOH impact pts w/ #IBD?

📌 Low socioeconomic status (SES) in pts w/ IBD 👉
⬆️ICU admissions
⬆️hospitalizations 🏥
⬆️mortality risk
⬆️use of steroids >2,000mg/yr
⬆️outpatient visits
⬆️narcotic/psych med use

#MondayNightIBD

@MondayNightIBD @DCharabaty @BonumCe @pfizer @JanssenUS @TakedaPharma 6/🧩 #IBD is a risk factor for which of the following #SDOH?

@MondayNightIBD @DCharabaty @BonumCe @pfizer @JanssenUS @TakedaPharma 7/ Survey data:
📌14% of #IBD pop👉food insecure (limited/uncertain access of adequate, safe, acceptable food)
📌53% reported NO social support🤝
⬆️food insecurity & ⬇️social support correlated w/ ⬆️financial toxicity&⬇️healthcare utilization
🚨Low SES & minority pops @⬆️risks🚨

@MondayNightIBD @DCharabaty @BonumCe @pfizer @JanssenUS @TakedaPharma 8/ Racial/ethnic #disparities majorly contribute to #SDOH in pts w/ #IBD

📊Cross-sectional study 316 pts w/ IBD @ 3⃣ practice sites in FL:
⬆️ Social barrier scores (SBS) assoc ⬆️ depression, ⬆️ stress, ⬇️IBD med use

📌Every 1pt ⬆️SBS👉⬆️ UC disease activity by 0.45 (P=.03)

@MondayNightIBD @DCharabaty @BonumCe @pfizer @JanssenUS @TakedaPharma 9/ Racial/ethnic #disparities #SDOH
⬇️healthcare utilization &
⬆️poor outcomes in #minorities vs White pts w/ IBD

Black pts w/ IBD
📌~57% ⬇️likelihood to be under regular GI care
📌2x ⬆️risk IBD-related ED visit
📌2x ⬆️risk of hospitalizations
📌2x ⬇️likelihood to receive TNFi

@MondayNightIBD @DCharabaty @BonumCe @pfizer @JanssenUS @TakedaPharma 10/ 🧩 On average, what proportion of #IBD study participants are Black?

@MondayNightIBD @DCharabaty @BonumCe @pfizer @JanssenUS @TakedaPharma 11/ Racial/ethnic #disparities #SDOH

⬇️ representation in #IBD RCT 👉 lack of generalizability across IBD pop

Of 51 pubs re: IBD drugs:
📌Only 31 (61%) incl race
📌86% White pop, 3% Black pop, 1% Am.Ind. pop

📌Only 10 (20%) incl ethnicity
📌5% Hispanic/Latino pop

@MondayNightIBD @DCharabaty @BonumCe @pfizer @JanssenUS @TakedaPharma 12/ 🧩 Which of the following is the newest vital sign and considered to be the most important #SDOH?

@MondayNightIBD @DCharabaty @BonumCe @pfizer @JanssenUS @TakedaPharma 13/ #SDOH
Low #HealthLiteracy affects 36% Americans & 🚨Black pts @ ⬆️risk🚨

📊Study: 175 pts w/ #IBD (59% ♀️, 23% Black pts, 91% CD)
📌47% Black pts vs 17% White pts have low health literacy
📌⬆️risk if older age & Black race

#MondayNightIBD

@MondayNightIBD @DCharabaty @BonumCe @pfizer @JanssenUS @TakedaPharma 14/ Now that we know #SDOH impact pts w/ #IBD 👉 poor outcomes.

🤷What can we do?
📌Addressing #disparities requires🪜multi-level approach involving
✅Policy makers
✅Communities
✅Healthcare organizations
✅Healthcare workers
✅Addressing bias

#MondayNightIBD

@MondayNightIBD @DCharabaty @BonumCe @pfizer @JanssenUS @TakedaPharma 15/ ⬆️ workforce diversity is a great step to addressing #disparities #SDOH!

Diversity in medicine 👉⬆️ access to care & positively influences healthcare delivery, patient outcomes, & public policy

#MondayNightIBD

@MondayNightIBD @DCharabaty @BonumCe @pfizer @JanssenUS @TakedaPharma 16/ 🗓️ July 2020 @AmerGastroAssn 👉 6-Point Commitment to Equity 🥳👏 AGA Equity Project
Read more ➡️ bit.ly/35x6Jx9 🔗

@MondayNightIBD @DCharabaty @BonumCe @pfizer @JanssenUS @TakedaPharma @AmerGastroAssn 17/ 📰 Read our recent work on #SDOH & achieving #HealthEquity in #IBD 📰
@SophieBalzoraMD @IBDMD @SandraQuezadaMD & @AGA_CGH 👏

https://twitter.com/AdjoaGIMD/status/1506640129624092676

@MondayNightIBD @DCharabaty @BonumCe @pfizer @JanssenUS @TakedaPharma @AmerGastroAssn @SophieBalzoraMD @IBDMD @SandraQuezadaMD @AGA_CGH 18/ 🫶Share your experience!
🤔What steps have you and/or your org 🏩 taken to reduce #disparities in #SDOH?

#MondayNightIBD

@MondayNightIBD @DCharabaty @BonumCe @pfizer @JanssenUS @TakedaPharma @AmerGastroAssn @SophieBalzoraMD @IBDMD @SandraQuezadaMD @AGA_CGH 19/ 🔑 TAKEAWAYS 🔑
📌#SDOH #disparities 👉poor outcomes in #IBD
📌Racial/ethnic disparities have improved but much work remains to be done to achieve #HealthEquity
📌Must incorporate SDOH considerations in pt care to ⬆️outcomes for all 😊

#MondayNightIBD

@MondayNightIBD @DCharabaty @BonumCe @pfizer @JanssenUS @TakedaPharma @AmerGastroAssn @SophieBalzoraMD @IBDMD @SandraQuezadaMD @AGA_CGH 20/⭐TU for joining this #MNIBDtweetorial w me,
@DCharabaty, & @BonumCe ⭐

✅Answer #PostConvo #IBDPoll 🔢👇
🏆Don't leave ur 🆓 #CME behind 👉 bit.ly/3iOBtNq

🚨#PostConvo #IBDPoll 1️⃣

#IBD is a risk factor for which of the following #SDOH?

@MondayNightIBD @DCharabaty @BonumCe @pfizer @JanssenUS @TakedaPharma @AmerGastroAssn @SophieBalzoraMD @IBDMD @SandraQuezadaMD @AGA_CGH 21/ 🚨#PostConvo #IBDPoll 2️⃣
#MondayNightIBD
🏆🆓 #CME 👉bit.ly/3iOBtNq

🧩 On average, what proportion of #IBD study participants are Black?

@MondayNightIBD @DCharabaty @BonumCe @pfizer @JanssenUS @TakedaPharma @AmerGastroAssn @SophieBalzoraMD @IBDMD @SandraQuezadaMD @AGA_CGH 22/ 🚨#PostConvo #IBDPoll 3️⃣
#MondayNightIBD
🏆🆓 #CME 👉 bit.ly/3iOBtNq

🧩 Which of the following is the newest vital sign and considered to be the most important #SDOH?

@MondayNightIBD @DCharabaty @BonumCe @pfizer @JanssenUS @TakedaPharma @AmerGastroAssn @SophieBalzoraMD @IBDMD @SandraQuezadaMD @AGA_CGH 24/ Don’t forget 🎙️ 🔜 MONDAY, APRIL 4
Join us on @MondayNightIBD and continue the 💬 conversation w/ me & @DCharabaty

Even more #CME 🧠 on #disparities and action towards #healthequity 💕