Study reveals stark racial disparities in IBD care across the united states

Black Americans with IBD over 65 had higher emergency department use; Asian and Hispanic adults had lower use of advanced IBD therapies compared to white counterparts

Crohn's & Colitis Foundation of America

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New York, NY – April 1, 2025-  A study published today in the American Journal of Gastroenterology reveals significant disparities in healthcare utilization among racial and ethnic groups with inflammatory bowel disease (IBD) in the United States. The research, funded by the Centers for Disease Control and Prevention (CDC), led by investigators from the University of Pennsylvania, the University of North Carolina at Chapel Hill, and the Crohn's & Colitis Foundation provides crucial insights into the challenges faced by underrepresented communities in accessing and utilizing IBD care. This is the first study to address racial and ethnic disparities in healthcare utilization for inflammatory bowel disease in a nationally representative sample across all age groups.

The full paper, “Association of Race and Ethnicity with Healthcare Utilization for Inflammatory Bowel Disease in the United States: A Retrospective Cohort Study” is available here.

Key findings from the study show that Black Americans with IBD over 65 had nearly 1.5 times higher use of emergency department services compared to their White counterparts. Among working-age adults, Asian Americans and Hispanic Americans had lower use of advanced therapies for IBD compared to White adults. Some of the findings were associated with household income, suggesting that race was a surrogate marker for access barriers in certain socioeconomic groups. This highlights that socioeconomic disparities can play a significant role in healthcare utilization patterns among patients with inflammatory bowel disease.

The study analyzed data from two national datasets, including Optum's Clinformatics® Data Mart Database and Medicare, covering 2016 to 2017. The researchers examined healthcare utilization patterns across different racial and ethnic groups, including Asian, Black, Hispanic, and White Americans with IBD, spanning various age groups from children to older adults. Hispanic children showed increased healthcare utilization for IBD compared to White children, though these results did not meet statistical significance.

"This comprehensive evaluation of healthcare utilization patterns across racial and ethnic groups is a critical step in understanding and addressing the disparities in IBD care," said Andrés Hurtado-Lorenzo, PhD, Senior Vice President of Translational Research and IBD Ventures at the Crohn's & Colitis Foundation and study co-author. "Everyone affected by these chronic, relapsing conditions deserves the opportunity to lead active, healthy lives. Our findings highlight the critical work needed to achieve health equity for all patients with inflammatory bowel disease.”

"Our findings confirm healthcare access challenges in the long-term management of inflammatory bowel disease in historically underserved racial and ethnic groups," said lead investigator Abraham Segura, MD, MD, MSCE, Instructor of Medicine at the University of Pennsylvania. "This study provides crucial data to inform healthcare policy, resource allocation, and future research priorities in addressing health disparities in IBD care."

The study authors note that while this research provides valuable insights, further investigation is needed to identify and address patient, clinician, and healthcare system barriers to achieve health equity in the management of IBD.

The research was funded by the Centers for Disease Control and Prevention (CDC) through grant U01-DP006369.

About the Crohn’s & Colitis Foundation
The Crohn’s & Colitis Foundation is the leading nonprofit organization focused on both research and patient support for inflammatory bowel disease (IBD), with the mission of curing Crohn’s disease and ulcerative colitis and improving the quality of life for the millions of Americans living with IBD. The Foundation’s work is dramatically accelerating the research process, while also providing extensive educational and support resources for patients and their families, medical professionals, and the public.

 

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Journal

The American Journal of Gastroenterology

DOI

10.14309/ajg.0000000000003438 

Method of Research

Data/statistical analysis

Subject of Research

People

Article Title

Association of Race and Ethnicity with Healthcare Utilization for Inflammatory Bowel Disease in the United States: A Retrospective Cohort Study

Article Publication Date

1-Apr-2025

 

Study finds higher cardiac deaths in combined day-night heatwaves

Heart-related deaths were significantly higher in both compound and nonlinearly linked heatwaves

Peer-Reviewed Publication

American College of Cardiology

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Cardiac deaths increase significantly during compound heatwaves—heatwaves where temperatures are elevated both during the day and overnight—according to a new study in JACC, the flagship journal of the American College of Cardiology. The study also found that some types of heart disease are more sensitive to heatwaves than others and that different types of heatwaves may impact heart health in distinct, nonlinear ways.

The research highlights the special risks of compound heatwaves and potential nonlinear relationships between different heatwave types and cardiac mortality. It finds that previous studies using traditional binary definitions—without accounting for different types of heatwaves and their cumulative heat load—may have underestimated this risk by as much as 54%. The findings could help improve clinical guidelines for cardiovascular patients and could also be used to improve public health adaptations to climate change, researchers said.

“Compound heatwaves impose a significantly higher risk to cardiac health than either daytime-only or nighttime-only heatwaves,” said coauthor Renjie Chen, PhD, of Fudan University. “Traditional heatwave definitions fail to capture the full scope of these risks.”

Previous research has found a link between short-term exposure to heatwaves and an increase in heart disease mortality using conventional binary definitions, but the shape of the risk curve and the role of different heatwave patterns were not well understood.

For the new study, researchers analyzed data for nearly 2.4 million heart disease deaths across mainland China over six years. They compared deaths across daytime-only, nighttime-only, and day-night compound heatwaves and introduced a new metric for measuring heatwave impact called Excess Cumulative Temperatures in Heatwaves, or ECT-HW.

“Unlike traditional binary indicators, ECT-HW captures the full spectrum of heatwave characteristics, including intensity, duration and timing within the season,” Chen explained. This provides more precise risk assessment, especially for high-intensity, high-duration and compound heatwaves.

Researchers found that the mortality risk associated with compound heatwaves increased steadily with exposure, without a clear threshold. Daytime-only and nighttime-only heatwaves displayed nonlinear patterns, with effects emerging only beyond specific thresholds and plateauing at moderate intensities.

They also found that risk was not equal across different heart disease subtypes. Sudden cardiac arrest, acute myocardial infarction and heart failure were especially sensitive to compound heatwaves, while pulmonary heart disease only showed elevated risk under high-intensity exposures.

Conventional studies of heatwave deaths that look only at whether a heatwave is present or not significantly underestimate mortality risks, they said.

The findings have several clinical and public health implications, Chen said.

Since different types of heatwaves affect cardiac conditions differently, prevention measures should consider heatwave type and intensity. In addition, given their higher impact, compound heatwaves should be explicitly considered in risk assessment and early warning systems for cardiovascular patients.

The findings also highlight the importance of urban heat mitigation strategies, such as cooling shelters and improved housing infrastructure to protect vulnerable populations.

“As climate change accelerates, the shifting and emerging heatwave exposure pattern demands better metrics and targeted interventions,” Chen said. “Given the increasing frequency and intensity of compound heatwaves due to climate change, our findings highlight the need for disease-specific prevention strategies and revised public health guidelines to better protect at-risk populations.”

Next, the team is planning follow-up research, including studies to project the future burden of heatwave-related cardiac mortality under different climate change scenarios.

The study, “Nonlinear Relation between Cardiac Mortality and Excess Temperature in Heatwaves: Exposure Response in 2.39 Million Patients,” was published in JACC.

 

The American College of Cardiology (ACC) is the global leader in transforming cardiovascular care and improving heart health for all. As the preeminent source of professional medical education for the entire cardiovascular care team since 1949, ACC credentials cardiovascular professionals in over 140 countries who meet stringent qualifications and leads in the formation of health policy, standards and guidelines. Through its world-renowned family of JACC Journals, NCDR registries, ACC Accreditation Services, global network of Member Sections, CardioSmart patient resources and more, the College is committed to ensuring a world where science, knowledge and innovation optimize patient care and outcomes. Learn more at www.ACC.org.

The ACC’s JACC Journals rank among the top cardiovascular journals in the world for scientific impact. The flagship journal, the Journal of the American College of Cardiology (JACC) — and specialty journals consisting of JACC: Advances, JACC: Asia, JACC: Basic to Translational Science, JACC: CardioOncology, JACC: Cardiovascular Imaging, JACC: Cardiovascular Interventions, JACC: Case Reports, JACC: Clinical Electrophysiology and JACC: Heart Failure — pride themselves on publishing the top peer-reviewed research on all aspects of cardiovascular disease. Learn more at JACC.org.

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Journal

Journal of the American College of Cardiology

DOI

10.1016/j.jacc.2025.01.034 

Article Title

Nonlinear Relation Between Cardiac Mortality and Excess Temperature in Heatwaves: Exposure Response in 2.39 Million Patients

 

AI propaganda: prolific and persuasive

PNAS Nexus

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A study of the use of AI by a Russian-backed propaganda outlet shows how AI allows propagandists to increase their production capacity without any loss in persuasive power. In December 2023, journalists at the BBC and Clemson University’s Media Forensics Hub published an investigation revealing that the site DCWeekly.org was a Russian propaganda outlet, part of a broader network disseminating pro-Kremlin and anti-Ukrainian narratives. Morgan Wack and colleagues found that prior to September 20, 2023, much of the content on the site was simply lifted from other right-leaning outlets. After that date, however, the stories were generally rewritten by AI, allowing the site to use a broader range of sources but with the tone and emphasis tweaked to better suit likely aims of the propagandists. The authors examined 22,889 articles published on the site before and after the shift—but before the site’s true motives were exposed. By leveraging the timing of its adoption, the research team shows how AI allowed the propagandists behind the site to more than double their rate of publication, as compared to their most active pre-AI period. The use of AI by DCWeekly also corresponded with an increase in the breadth of topics covered on the site, which ranged from Russia’s purported successes in Ukraine to the tyranny of gun control legislation in the United States. As a final step, the authors conducted a survey of 880 American adults recruited through the online survey platform Prolific and found that the content in the post-adoption period maintained the same level of persuasiveness as the pre-AI period. According to the authors, immediate action should be taken to mitigate the influence of AI-assisted propaganda campaigns.

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Journal

PNAS Nexus

Article Title

Generative propaganda: Evidence of AI’s impact from a state-backed disinformation campaign

Article Publication Date

1-Apr-2025\

 

New study refocuses research on mysterious falcon decline

Raptor Research Foundation

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image: 

A female American Kestrel nestling with its recently attached VHF back-pack style transmitter in the Virginia Piedmont study area. Feathers cover all but the antenna.

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Credit: Joseph Kolowski

North America’s smallest falcon, the American Kestrel (Falco sparverius), has declined across the continent since the 1970s, yet the causes continue to stump raptor biologists. A new study published in the Journal of Raptor Research adds a piece to the puzzle with the discovery that in the Northeast, where declines are most alarming, fledglings demonstrate a relatively high survival rate. This paper, titled “Juvenile and Adult Survival Estimates of American Kestrels Throughout the Full Annual Cycle in Eastern North America,” is the first of its kind. No other study has assessed winter survival rates for kestrels at northern latitudes, fledgling survival following nest departure for both males and females, or tracked individual kestrels through multiple seasons in migratory and residential populations. These breakthroughs may help redirect future studies to untapped arenas of inquiry.  

 

American Kestrels are small colorful falcons native to the western hemisphere, ranging from Southeast Alaska south to Argentina. Most previous kestrel studies have focused on the birds’ nesting season. Breeding birds face many challenges given the high energetic demand required to successfully raise chicks. However, not all members of a population are breeders. Young, non-breeding raptors experience high mortality rates in the first months outside of the nest, and birds of all ages face a multitude of risks during migration, as well as on their overwintering grounds. These are important threads to follow for a holistic assessment of a species-wide decline.

 

Lead author Dr. Mercy Melo and a team of experts from Hawk Mountain Sanctuary, The Smithsonian, and the University of Massachusetts-Amherst, followed some of these threads by fitting 202 kestrels with radio transmitter backpacks that collected data on their whereabouts for six months. They tagged 146 fledglings, all from the Northeast United States, and 56 adults from Pennsylvania and Florida, between 2021 to 2023.

 

Of their tagged birds, overwintering adults demonstrated a lower survival rate in Pennsylvania than in Florida, and most confirmed adult deaths across sites were human caused. Mechanisms of these mortalities included vehicle collisions and entrapment in buildings.

 

The most surprising finding was that during the first weeks outside of the nest, juvenile survival was much higher than expected across sites. With any bird species, juveniles are anticipated to have lower survival rates due to lack of experience in foraging and evading risks. "Our study documented very high survival rates for juveniles across the eastern states, with some sites even boasting one hundred percent survival," says Melo. Although these young birds could not be tracked once they left the nesting area, and therefore their fates following migration and overwintering are unknown, the confirmation of their success during that first stage of initial independence fills an important knowledge gap.

 

When wildlife species falter, the reasons can be overwhelmingly complex. Studies like this focus research efforts towards probable realms of discovery and fuel a necessary process of elimination — if fledgling survival is high at these study sites, then the next step is to ask new questions about adults. “Understanding the factors influencing the American Kestrel population decline will help kestrels but will also improve our understanding of other declining species,” says Melo. She points to grassland songbirds as one such group. “We hope this article entices researchers to adopt collaborative approaches across geographical regions.” Though they are pint-sized, kestrels are top predators and therefore pack an ecological punch. Their absence would be felt across the Americas, especially within open habitats where fewer and fewer species are maintaining a foothold.

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Paper

Melo et al. (2025). Juvenile and Adult Survival Estimates of American Kestrels Throughout the Full Annual Cycle in Eastern North America. Journal of Raptor Research, 59(2): 1-12.

DOI: 10.3356/jrr2414

Notes to Editor: 

1. The Journal of Raptor Research (JRR) is an international scientific journal dedicated entirely to the dissemination of information about birds of prey. Established in 1967, JRR has published peer-reviewed research on raptor ecology, behavior, life history, conservation, and techniques. JRR is available quarterly to members in electronic and paper format. 

2. The Raptor Research Foundation (RRF) is the world’s largest professional society for raptor researchers and conservationists. Founded in 1966 as a non-profit organization, our primary goal is the accumulation and dissemination of scientific information about raptors. The Foundation organizes annual scientific conferences and provides competitive grants & awards for student researchers & conservationists. The Foundation also provides support & networking opportunities for students & early career raptor researchers. 

Three America Kestrel fledglings wearing VHF transmitters and alpha-numeric color bands at the Hawk Mountain site.

Credit

Mercy Melo

A male American Kestrel nestling with its recently attached VHF back-pack style transmitter n the Virginia Piedmont study area. Feathers cover all but the antenna. 

Credit

Joseph Kolowski

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Journal

Journal of Raptor Research

DOI

10.3356/jrr2414 

Method of Research

Data/statistical analysis

Subject of Research

Animals

Article Title

Juvenile and Adult Survival Estimates of American Kestrels Throughout the Full Annual Cycle in Eastern North America

 SPAGYRIC HERBALISM

A step toward plant-based gelatin

Replacing gelatin with plant-based alternatives reduces animal-based content in food, drugs, and packaging

American Institute of Physics

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image: 

Gels were created with different ratios of gum tragacanth to gelatin (top) to compare their properties to those of gum tragacanth (bottom left) on its own and of gelatin (bottom right) on its own.

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Credit: Ezgi Pulatsu

WASHINGTON, April 1, 2025 – With increased awareness about food sources and their environmental impacts, replacing animal-derived products in food and drugs is a significant research area. One common — but often overlooked — animal protein is gelatin, found everywhere from candy to plastic-free packaging.

In Physics of Fluids, by AIP Publishing, researchers from the University of Ottawa present gum tragacanth as a plant-based alternative to gelatin for creating edible films.

“Gelatin has unique properties and its use is versatile,” said author Ezgi Pulatsu. “To fully replace gelatin, we must replicate its microstructure and understand its function in different applications.”

Gelatin’s gel-like structure and its transparency are just two of its qualities that a plant-based alternative must replicate. Gum tragacanth, a byproduct of the sap in certain legume plants, is promising in both of these characteristics.

To test just how promising it is, Pulatsu’s team developed films containing different concentrations of gelatin and gum tragacanth — some constructed with alternating layers, others a mixture of the two — and monitored their survivability in water and saline solutions. They found the optimal combination of gum tragacanth and gelatin for maintaining the gelatin’s gel-like behavior was a 3-to-1 ratio of the two, respectively. However, gum tragacanth’s inclusion leads to a more porous film, making it prone to penetration by water or saline solutions.

Though gum tragacanth cannot replace gelatin completely just yet, the researchers continue their work on developing a fully plant-based alternative. Pulatsu said one path forward is to improve gum tragacanth’s suitability on its own through various chemical and structural modifications that can increase its mechanical and barrier properties, but noted that even a partial replacement is a step forward.

“Partial replacement of gelatin will reduce animal-based product use,” Pulatsu said. “Our efforts in the full replacement of gelatin are ongoing.”

Specific applications will each have their own challenges to consider. For example, replacing gelatin in candy requires special attention to gum tragacanth’s impacts on sweetness, texture, and transparency, while brittleness and flexibility are key factors for food packaging.

“We are very excited to see the outcomes and share them with the community,” Pulatsu said.

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The article “Edible films based on gum tragacanth and gelatin” is authored by Ezgi Pulatsu, Jiaqian Xie, Qinling Wang, and Chibuike C. Udenigwe. It will appear in Physics of Fluids on April 1, 2025 (DOI: 10.1063/5.0253890). After that date, it can be accessed at https://doi.org/10.1063/5.0253890.

ABOUT THE JOURNAL

Physics of Fluids is devoted to the publication of original theoretical, computational, and experimental contributions to the dynamics of gases, liquids, and complex fluids. See https://pubs.aip.org/aip/pof.

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Journal

Physics of Fluids

DOI

10.1063/5.0253890 

Article Title

Edible films based on gum tragacanth and gelatin

Article Publication Date

1-Apr-2025