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Racial, Ethnic, and Geographic Disparities in Digestive Diseases Mortality in the United States, 2000–2019
Abstract
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.
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The NH American Indian population had the highest AAMRs, reflecting broader socioeconomic factors such as limited access to care and economic disparities.
“The Non‐Hispanic American Indian population had the highest AAMRs, reflecting broader socioeconomic factors such as limited access to care and economic disparities.”
From Trends and Demographics of Vascular Intestinal Diseases‐Related Mortality Among Adults Living in United States From 1999 to 2020; A CDC Wonder Analysis (2025) · cites this paper as [17]
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Shahzad, M., Maryam, K. U. E., Hashim, A., Khan, A. Z., Ali, M. A., Khan, A. Y., Younas, M., Bokhari, S. S. S., Khalid, W., Shahzad, F., et al. (2025) · JGH Open · doi:10.1002/jgh3.70267 · Cited by 4
“This may be attributed to the paucity of access to sub-specialty healthcare by virtue of distance and transportation barriers [17].”
Metadata
- Authors
- Aldhaleei, W. A., Wallace, M. B., Bi, Y., Rusk, A. M., & Bhagavathula, A. S.
- Affiliations
- Mayo Clinic (US)
- Corresponding author
- Bhagavathula, Akshaya Srikanth
- Venue
- Clinical Gastroenterology and Hepatology
- Publisher
- Elsevier BV
- Published
- 2025-01
- Volume
- 23
- Issue
- 1
- Pages
- 59-68.e16
- ISSN
- 1542-3565 (ISSN-L)
- OpenAlex
- W4401972643
- Cited by
- 11
- References
- 25
- Citations by year
- 2026: 6 · 2025: 4
- FWCI
- 1.87
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Gastroenterology and Hepatology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Oncology › Global Cancer Incidence and Screening
- Social Sciences › Health › Health disparities and outcomes
- Health Sciences › Medicine › Epidemiology › Healthcare Systems and Public Health
- Keywords
- racial and ethnic disparities, health disparities, American Indians and Alaska Natives, Hispanic Americans, black, Asian/Pacific Islanders, sex differences, temporal trends, state-level variation, county-level variation, health equity, United States
- MeSH terms
- Adult, Aged, Aged, 80 and over, Digestive System Diseases, Ethnicity, Female, Humans, Male, Middle Aged, Mortality, United States, Racial Groups, Health Status Disparities, Young Adult
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