{"doi":"10.1002/jpn3.70185","title":"Referral to pediatric gastroenterology for chronic abdominal pain differs by patients' individual, family, and community characteristics","abstract":"Abdominal pain disorders of gut–brain interaction (AP-DGBIs) are prevalent, with approximately 10%–15% of school-aged children meeting criteria for at least one of these conditions.1 Biopsychosocial factors contribute to visceral and somatic symptoms and functional disability in patients with AP-DGBIs.2 Persistent abdominal pain is associated with a higher risk of co-occurring mental health conditions. Thus, a multidisciplinary care approach utilizing a primary care provider partnered with a pediatric gastroenterologist, pain specialist, and behavioral health professional can reduce healthcare utilization and improve care for DGBI patients.3 Inequities in healthcare for historically marginalized racial and ethnic communities are well known.4, 5 There is evidence that youth of color do not receive adequate abdominal pain evaluation, subspecialty care, or pain treatment despite presenting with similar rates of abdominal pain as White children.5 Additionally, it has been shown through experimental models that Black patients may experience more intense pain and lower pain thresholds compared to non-Hispanic White patients.6 Despite these findings, medical professionals express false beliefs about African-Americans' pain experiences and provide suboptimal treatment recommendations for Black patients compared to White patients.7 False beliefs may therefore affect patient access to effective multidisciplinary pain care. Disproportionate access to healthcare has detrimental effects on patients from marginalized communities and ultimately leads to increased healthcare costs.8-10 There is limited data on individual, family, and community level factors, as well as healthcare systemic factors, that contribute to multidisciplinary care access for patients with AP-DGBIs of varying racial and ethnic identities.9, 10 Black, compared to White, patients receive less subspecialty care for AP-DGBIs due to a relatively lower rate of referral to tertiary centers. The primary objective of this study was to compare referrals of Black and White patients to a large, urban pediatric gastroenterology program for treatment of AP-DGBIs against expected referrals based on demographic representation in the Chicago metropolitan area (CMA).11, 12 We also compared referral rates of patients of other historically minoritized racial and ethnic groups to White patient referrals in the same cohort, and evaluated whether other patient factors (e.g., sex assigned at birth) and family factors (e.g., health insurance type) of the referral sample were significantly different than what would be expected given the broader metropolitan area. We conducted a retrospective review of patient referrals to our tertiary pediatric gastroenterology center from September 1, 2018, to September 1, 2021. The Lurie Children's Office of Research Integrity and Compliance approved an Institutional Review Board exemption. Of the patients aged 6–18 years old, 10,866 referrals had International Classification of Diseases (ICD)-10 diagnostic codes aligned with chronic abdominal pain. We excluded patients <6 and ≥18 years of age, duplicate referrals to our clinics, referrals from pediatric gastroenterologists, and patients with ICD-10 diagnostic codes for primary inflammatory, structural, and/or motility gastrointestinal diseases. We collected: (1) patient factors: sex assigned at birth, age, race, and ethnicity; (2) family factors: parent primary language, and health insurance type; (3) community factors: zip code of primary residence; and (4) systemic factors: referring clinician type, from medical records and referral databases. We accessed the United States (US) Census Bureau's Adjusted 2020 estimated median family income per zip code and substituted the figure corresponding to a patient referral's zip code as a proxy for that patient's family income. Descriptive statistics were used to characterize the demographics of the referral sample. Chi-square (X2) analyses were used to determine sta","journal":"Journal of Pediatric Gastroenterology and Nutrition","year":2025,"id":572181,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9544,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1214680,"name":"John E. Fortunato","orcid":"0000-0002-3052-2913","position":1,"is_corresponding":false},{"id":1478407,"name":"Stella Karuri","orcid":"0000-0001-7544-9345","position":2,"is_corresponding":false},{"id":1478829,"name":"Bonnie S. Essner","orcid":null,"position":3,"is_corresponding":false},{"id":1478406,"name":"Shaunte McKay","orcid":"0000-0002-6464-7263","position":0,"is_corresponding":true}],"reference_count":11,"raw_metadata":null,"created_at":"2026-07-19T02:57:23.653298Z","pmid":"40798908","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}