Daniyal Raza<\/b><\/strong><\/p>\n<\/div>\n \u201cIBD mortality worsened for everyone during COVID \u2014 overall age-adjusted mortality rose from 0.93 to 1.17 per 100,000, and both white and Black patients saw their numbers go up. No group was spared,\u201d <\/b>Daniyal Raza, MD<\/b>, <\/b>assistant professor of medicine and hospitalist at LSU Health Shreveport, told Healio.<\/p>\n
\u201cWhat was intriguing was what happened beyond that overall rise,\u201d he added.<\/p>\n
Raza and colleagues looked at results from the CDC WONDER Multiple Cause of Death database from 2018 to 2023 to identify deaths with IBD as an underlying or contributing cause.<\/p>\n
Using age-adjusted mortality rates per 100,000 population, they looked at results by states and race. Five had 20 or fewer IBD-related deaths and were excluded from analysis, so 45 states were included Of those 45, nine states had complete paired data.<\/p>\n
Raza and colleagues divided the study into two time periods, with pre-COVID years defined as 2018 to 2019 and COVID-era years defined as 2020 to 2023.<\/p>\n
For both time periods combined, 7,000 deaths were recorded as IBD-related across the U.S. Overall IBD mortality increased from 0.93 to 1.17 per 100,000. Researchers found that white mortality rose from 0.96 to 1.24, while Black mortality rose from 0.57 to 0.41. The white\/Black mortality gap widened from 0.27 to 0.41. <\/p>\n
At this point, results were intriguing, he said.<\/p>\n
\u201cEight of nine states showed widening white-Black mortality gaps, validating the national finding,\u201d Raza said. \u201cBut the magnitude differed dramatically \u2014 North Carolina saw the largest increase at + 0.4, California the smallest at + 0.1 \u2014 a fourfold difference during the same pandemic.<\/p>\n
\u201cNorth Carolina spent the entire study period without Medicaid expansion, raising a compelling hypothesis about insurance access.\u201d<\/p>\n
California, in contrast, had expansion of Medicaid throughout the pandemic time studied. However, states including Illinois and New York also had Medicaid expansion early in the pandemic yet still had moderate widening of the race\/geographic gap. Those results show that insurance is likely not the only factor driving health disparities in the IBD population, Raza pointed out. <\/p>\n
\u201cNorth Carolina raises the hypothesis. The other states tell you the answer is more complex than one variable,\u201d Raza said. <\/p>\n
The study had another intriguing finding, Raza said. White individuals had a larger absolute rise in mortality, yet the gap between white and Black individuals still widened. \u201cBlack patients were already starting from a lower baseline of care access,\u201d Raza said. \u201cA smaller rise on top of an already disadvantaged starting point was enough to keep the gap growing.\u201d<\/p>\n
Study limitations included the exclusion of Alaska, Hawaii, Montana, Vermont and Wyoming because they were under the 20-deaths threshold, and that Raza and colleagues could not adjust for factors such as comorbidities, insurance coverage or disease severity, and treatment type.<\/p>\n
Next steps for research include examining Medicaid coverage during the pandemic and whether if having it earlier in specific U.S. states meant protection against widening racial mortality gaps in IBD.<\/p>\n
\u201cNorth Carolina is a compelling natural experiment for that question, given it only expanded Medicaid in December 2023, after our study period had already ended,\u201d Raza said. \u201cThat next study would let us move from simply describing the problem to identifying concrete, policy-relevant levers that actually make a difference in IBD outcomes.\u201d<\/p>\n
For more information:<\/h2>\n Daniyal Raza, MD<\/b>, <\/b>can be reached at <\/b>daniyal.raza@lsuhs.edu.<\/p>\n\n
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Published by:<\/span>\n
Sources\/Disclosures<\/h3>\n Source: <\/h2>\n Raza D, et al. The pandemic\u2019s uneven toll: Widening racial gaps in IBD mortality across the United States. Presented at: Digestive Disease Week; May 2-5, 2026; Chicago.<\/default:p><\/p>\n\n
\n Disclosures: <\/strong>\n
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