S48 Health Disadvantage Is Associated With Persistent GI Symptoms in Adults With Crohn’s Disease in Endoscopic Remission

CD, there is a scarcity of health disparities research beyond the associations with race, ethnicity, and insurance coverage. We herein examine the relationship between the symptomatic and in ﬂ ammatory burden of CD and social determinantsofhealth(SDOH)compassingencompassneighborhoodenvironmentsandcommunity conditions, including access to education, job opportunities, transportation, and dietary resources. Methods: We performed a retrospective cohort study on adults with CD enrolled in a tertiary referral center biobank in Southern California from 2014-2021. We included patients with stan- dardized clinical disease activity assessments (2-item patient-reported outcome [PRO-2] for ab-dominal pain [AP] and stool frequency [SF]; remission: AP # 3 and SF # 1) within 7 days of an ileocolonoscopy scored by the Simple Endoscopic Score for Crohn Disease (remission , 3). Health disadvantage wasassessed using the California HealthyPlaces Index (SDOH index), a zip code-based system that ranks communities ’ SDOH domains using weighted z-scores (0-100 percentile) from the most health disadvantage (low score) to the most health advantaged (high score) in 8 subdomains: economy, education, healthcare access, housing, neighborhoods, clean environment, transportation, and social environment. Multivariate regression models were created from patient/SDOH factors (dependent variable) that were statistically signi ﬁ cant (P , 0.05) on univariate logistic regression to compare the di ﬀ erences between patient with and without active GI symptoms (independent vari- able)despiteendoscopicremission.SDOHsubdomainswereclassi ﬁ edasbelow(healthdisadvantage) or above the median (reference) on the SDOH Index. Results