Actionable Solutions to Achieve Health Equity in Chronic Liver Disease

Authors

Patricia D Jones
Jennifer C Lai
Jasmohan S Bajaj
Fasiha Kanwal

Publication Date

7-1-2023

Journal

Clinical Gastroenterology and Hepatology

DOI

10.1016/j.cgh.2023.03.043

PMID

37061105

PMCID

PMC10330625

PubMedCentral® Posted Date

7-1-2024

PubMedCentral® Full Text Version

Author MSS

Published Open-Access

yes

Keywords

Humans, Health Equity, Healthcare Disparities, Hispanic or Latino, Non-alcoholic Fatty Liver Disease, Racial Groups, United States, Liver Diseases, Chronic Disease, Asian, Black People, American Indian or Alaska Native, Cost of Illness, Health Services Accessibility, Black or African American, Health Equity, Quality Improvement, Social Determinants, Health Disparities, Diversity, Chronic Liver Disease

Abstract

There are well-described racial and ethnic disparities in the burden of chronic liver diseases. Hispanic persons are at highest risk for developing nonalcoholic fatty liver disease, the fastest growing cause of liver disease. Hepatitis B disproportionately affects persons of Asian or African descent. The highest rates of hepatitis C occur in American Indian and Alaskan Native populations. In addition to disparities in disease burden, there are also marked racial and ethnic disparities in access to treatments, including liver transplantation. Disparities also exist by gender and geography, especially in alcohol-related liver disease. To achieve health equity, we must address the root causes that drive these inequities. Understanding the role that social determinants of health play in the disparate health outcomes that are currently observed is critically important. We must forge and/or strengthen collaborations between patients, community members, other key stakeholders, health care providers, health care institutions, professional societies, and legislative bodies. Herein, we provide a high-level review of current disparities in chronic liver disease and describe actionable strategies that have potential to bridge gaps, improve quality, and promote equity in liver care.