Impact of Income-to-Poverty Ratio on Long-Term Mortality of Persons with Chronic Liver Disease in the USA, 1999-2018.
Dig Dis
; : 1-13, 2024 Jun 17.
Article
in En
| MEDLINE
| ID: mdl-38885622
ABSTRACT
INTRODUCTION:
Chronic liver disease (CLD) is associated with increased morbidity and mortality. Understanding health disparities can inform appropriate interventions. We aimed to study mortality outcomes of those with CLD by the income level (income-to-poverty ratio <5 as lower income and ≥5 as higher income).METHODS:
In this retrospective cohort study, we analyzed data of adults from the National Health and Nutrition Examination Survey, 1999-2018. CLD included viral hepatitis, nonalcoholic fatty liver disease (NAFLD), and alcohol-associated liver disease (ALD).RESULTS:
We analyzed 59,204 adults 47,224 without CLD and 11,980 with CLD. The CLD group was older, more likely male, racial/ethnic minority groups or foreign-born, and had lower educational and income levels (p < 0.001). Most (80.02%) CLD participants did not have college degrees and had lower income (79.18%). Among CLD participants, similar differences were observed between lower and higher income groups. Lower income participants with CLD had significantly higher 10-year cumulative mortality compared to higher income CLD participants (15.26 vs. 8.00%, p < 0.001), with consistent findings in viral hepatitis and NAFLD subgroups (p < 0.001) but not ALD (p = 0.71). Adjusting for age, sex, race, birthplace, lower income CLD participants were 2.01 (hazard ratio [HR] 2.01; 95% CI 1.79-2.26) times more likely to die overall and in viral hepatitis (HR 2.05; 95% CI 1.31-3.24) and NAFLD subgroups (HR 2.32; 95% CI 1.69-3.18) but not ALD (HR 1.17; 95% CI 0.55-2.51).CONCLUSION:
Lower income, foreign-born, and racial/ethnic minority groups were disproportionately represented among those with CLD, with lower income and CLD individuals having double the mortality risk compared to their higher income counterparts. Interventions should be culturally appropriate and address socioeconomic barriers.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Language:
En
Journal:
Dig Dis
Journal subject:
GASTROENTEROLOGIA
Year:
2024
Document type:
Article
Affiliation country:
Estados Unidos
Country of publication:
Suiza