Disparities in Eosinophilic Esophagitis Diagnosis and Care, with Benjamin Gold, MD

New research is shedding light on the growing clinical burden of eosinophilic esophagitis (EoE), highlighting longstanding disparities in diagnosis and care driven by social determinants of health.

Findings from the retrospective, longitudinal cohort study of US health insurance claims data were presented at Digestive Disease Week (DDW) 2025 by Benjamin Gold, MD, a staff physician of pediatric gastroenterology at Children's Healthcare of Atlanta and a pediatric gastroenterologist and partner of GI Care for Kids.

In an interview with HCPLive, Gold describes increases in EoE incidence and prevalence across all age groups, with a significant burden on patients ranging from social limitations in children to frequent healthcare utilization and missed work in adults. He notes diagnosis remains dependent on endoscopy with biopsy, contributing to this burden. He also describes how appropriate testing is not done in all patient populations, contributing to misconceptions about who is truly affected by EoE, which is widely regarded as a disease that only affects White males.

“In order to understand what social determinants of health are and their impact, you need to look at large populations,” Gold explained, describing the 2 large databases retrospectively examined in this research. “It was able to look at two large different types of populations that had definitive EoE and then look at where they came from and what might be barriers in order for them to get care.”

Looking ahead, Gold says future research should focus on populations that may not have access to health care, may not have the literacy, but may also have an incredible burden of EoE.

“I can't tell you how many African American children I see who have horrible eczema, horrible asthma, and never get to the gastroenterologist because nobody asks them about GI symptoms,” Gold said.

He also describes the importance of defining the natural history of EoE, suggesting that enrolling clinical trials be used for follow up to help address this gap in knowledge. Gold additionally calls attention to the importance of expanding education and outreach in underrepresented communities, breaking down structural barriers to care, and conducting more inclusive research to understand how EoE may manifest differently across racial and ethnic groups.

Reference

1. Gold BD, Jensen ET, Goodwin B, et al. DEMOGRAPHICS AND SOCIAL DETERMINANTS OF HEALTH FOR PATIENTS WITH EOSINOPHILIC ESOPHAGITIS: A RETROSPECTIVE COHORT STUDY OF US HEALTH INSURANCE CLAIMS DATA. Abstract presented at Digestive Disease Week 2025 in San Diego, CA, from May 3 - May 6, 2025.