Wafa A Aldhaleei, Michael B Wallace, Yan Bi, Ann M Rusk, Akshaya Srikanth Bhagavathula
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We used joinpoint regression analysis to evaluate the overall temporal trends by demography.</p><p><strong>Results: </strong>The overall cause-specific mortality rate decreased from 36.0 to 34.5 deaths per 100,000 population across all groups (2000-2019). In 2019, AI/AN individuals had the highest mortality rate (86.2), followed by White (35.5), Latino and Black (both at 33.6), and API (15.6) individuals. Significant increases occurred across some of the racial and ethnic groups, with an increased average annual percentage change for 2000-2019 among AI/AN (0.87%; 95% confidence interval, 0.77%-0.97%) and White individuals (0.12%; 95% confidence interval, 0.02%-0.22%) particularly among females, while Latino, Black, and API individuals showed reduced average annual percentage change for 2000-2019. AI/AN constitutes the main race affected in the top 10 counties. Substantial state-level variation emerged, with the highest mortality rates in 2019 seen in West Virginia.</p><p><strong>Conclusions: </strong>Despite an overall decrease in digestive diseases mortality, significant disparities persist across racial and ethnic groups. AI/AN and White individuals experienced increased mortality rates, particularly among females. Targeted interventions and further research are needed to address these disparities and improve digestive health equity.</p>","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":" ","pages":"59-68.e16"},"PeriodicalIF":11.6000,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Racial, Ethnic, and Geographic Disparities in Digestive Diseases Mortality in the United States, 2000-2019.\",\"authors\":\"Wafa A Aldhaleei, Michael B Wallace, Yan Bi, Ann M Rusk, Akshaya Srikanth Bhagavathula\",\"doi\":\"10.1016/j.cgh.2024.07.035\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background and aims: </strong>The global burden of digestive diseases mortality has been increasing over the last 3 decades. However, little is known about disparities in digestive diseases-specific mortality in the United States. This study aimed to examine racial, ethnic, and state- and county-level disparities in digestive diseases mortality rate in the United States between 2000 and 2019.</p><p><strong>Methods: </strong>We used the Institute of Health Metrics and Evaluation Global Health Data Exchange to gather digestive diseases age-standardized mortality rates for 5 racial and ethnic groups (White, Black, Latino, American Indian/Alaska Native [AI/AN], and Asian/Pacific Islander [API]) by sex, state, and county between 2000 and 2019. We used joinpoint regression analysis to evaluate the overall temporal trends by demography.</p><p><strong>Results: </strong>The overall cause-specific mortality rate decreased from 36.0 to 34.5 deaths per 100,000 population across all groups (2000-2019). In 2019, AI/AN individuals had the highest mortality rate (86.2), followed by White (35.5), Latino and Black (both at 33.6), and API (15.6) individuals. Significant increases occurred across some of the racial and ethnic groups, with an increased average annual percentage change for 2000-2019 among AI/AN (0.87%; 95% confidence interval, 0.77%-0.97%) and White individuals (0.12%; 95% confidence interval, 0.02%-0.22%) particularly among females, while Latino, Black, and API individuals showed reduced average annual percentage change for 2000-2019. AI/AN constitutes the main race affected in the top 10 counties. Substantial state-level variation emerged, with the highest mortality rates in 2019 seen in West Virginia.</p><p><strong>Conclusions: </strong>Despite an overall decrease in digestive diseases mortality, significant disparities persist across racial and ethnic groups. AI/AN and White individuals experienced increased mortality rates, particularly among females. 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引用次数: 0
摘要
背景和目的：在过去三十年中，全球消化系统疾病的死亡率不断上升。然而，人们对美国消化系统疾病死亡率的差异知之甚少。本研究旨在探讨 2000-2019 年间美国消化系统疾病死亡率在种族、民族、州和县层面的差异：我们利用卫生计量与评估研究所（Institute of Health Metrics and Evaluation, Global Health Data Exchange）收集了 2000-2019 年间按性别、州和县划分的五个种族和民族群体（白人、黑人、拉丁裔、美籍印地安人/阿拉斯加原住民 [AIAN] 和亚太岛民 [API]）的消化系统疾病年龄标准化死亡率。我们使用连接点回归分析来评估人口统计学的总体时间趋势：所有群体的总死亡率从每 10 万人 36.0 例降至 34.5 例（2000-2019 年）。2019 年，亚裔美国人的死亡率最高（86.2），其次是白人（35.5）、拉丁裔和黑人（均为 33.6）以及亚裔美国人（15.6）。一些种族和族裔群体的死亡率显著上升，亚裔美国人（0.87%，95% CI：0.77-0.97）和白人（0.12%，0.02-0.22）的年均百分比变化（AAPC2000-2019）有所增加，尤其是女性，而拉丁裔、黑人和亚裔美国人的 AAPC2000-2019 有所下降。亚裔美国人是受影响最大的十个县中的主要种族。州一级出现了很大的差异，2019年死亡率最高的是西弗吉尼亚州：尽管消化系统疾病死亡率总体下降，但不同种族和族裔群体之间仍存在显著差异。亚裔美国人和白人的死亡率上升，尤其是女性。需要采取有针对性的干预措施并开展进一步研究，以解决这些差异并提高消化系统健康的公平性。
Racial, Ethnic, and Geographic Disparities in Digestive Diseases Mortality in the United States, 2000-2019.
Background and aims: The global burden of digestive diseases mortality has been increasing over the last 3 decades. However, little is known about disparities in digestive diseases-specific mortality in the United States. This study aimed to examine racial, ethnic, and state- and county-level disparities in digestive diseases mortality rate in the United States between 2000 and 2019.
Methods: We used the Institute of Health Metrics and Evaluation Global Health Data Exchange to gather digestive diseases age-standardized mortality rates for 5 racial and ethnic groups (White, Black, Latino, American Indian/Alaska Native [AI/AN], and Asian/Pacific Islander [API]) by sex, state, and county between 2000 and 2019. We used joinpoint regression analysis to evaluate the overall temporal trends by demography.
Results: The overall cause-specific mortality rate decreased from 36.0 to 34.5 deaths per 100,000 population across all groups (2000-2019). In 2019, AI/AN individuals had the highest mortality rate (86.2), followed by White (35.5), Latino and Black (both at 33.6), and API (15.6) individuals. Significant increases occurred across some of the racial and ethnic groups, with an increased average annual percentage change for 2000-2019 among AI/AN (0.87%; 95% confidence interval, 0.77%-0.97%) and White individuals (0.12%; 95% confidence interval, 0.02%-0.22%) particularly among females, while Latino, Black, and API individuals showed reduced average annual percentage change for 2000-2019. AI/AN constitutes the main race affected in the top 10 counties. Substantial state-level variation emerged, with the highest mortality rates in 2019 seen in West Virginia.
Conclusions: Despite an overall decrease in digestive diseases mortality, significant disparities persist across racial and ethnic groups. AI/AN and White individuals experienced increased mortality rates, particularly among females. Targeted interventions and further research are needed to address these disparities and improve digestive health equity.
期刊介绍：
Clinical Gastroenterology and Hepatology (CGH) is dedicated to offering readers a comprehensive exploration of themes in clinical gastroenterology and hepatology. Encompassing diagnostic, endoscopic, interventional, and therapeutic advances, the journal covers areas such as cancer, inflammatory diseases, functional gastrointestinal disorders, nutrition, absorption, and secretion.
As a peer-reviewed publication, CGH features original articles and scholarly reviews, ensuring immediate relevance to the practice of gastroenterology and hepatology. Beyond peer-reviewed content, the journal includes invited key reviews and articles on endoscopy/practice-based technology, health-care policy, and practice management. Multimedia elements, including images, video abstracts, and podcasts, enhance the reader's experience. CGH remains actively engaged with its audience through updates and commentary shared via platforms such as Facebook and Twitter.
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