{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,27]],"date-time":"2026-06-27T09:09:54Z","timestamp":1782551394555,"version":"3.54.5"},"reference-count":23,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2025,5,1]],"date-time":"2025-05-01T00:00:00Z","timestamp":1746057600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,5,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background and Aims<\/jats:title>\n                  <jats:p>Inflammatory bowel disease (IBD) poses significant challenges to healthcare systems, with rising prevalence globally. To address challenges of health resource allocation and understand the geographic distribution of disease in Canada, we explored spatial mapping of IBD across Canada.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Data from 2009 to 2018 Canadian Community Health Survey identified individuals with IBD. Crude and adjusted prevalence rates were calculated, and spatial dependencies were analyzed using Moran\u2019s I. Local indicators of spatial association identified hot-spots where the prevalence of IBD was significantly different than neighboring areas. Spatial autoregressive models assessed the influence of sociodemographic factors on spatial dependencies.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Across 109 health regions, 492\u2005560 individuals were included, representing 29\u2005846\u2005350 Canadians. Crohn\u2019s disease and ulcerative colitis were reported in 0.38% and 0.47% of Canadians, respectively. Age and sex-standardized prevalence ranged from 742 to 1267 per 100\u2005000. Significant dependencies among health regions were found, but dependencies were explained by the distribution of sociodemographic characteristics in a region.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Results demonstrated significant geographic variations in the prevalence of IBD in Canada. Evidence suggests that differences in prevalence between regions are primarily driven by individual demographics rather than geographical characteristics.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ecco-jcc\/jjaf079","type":"journal-article","created":{"date-parts":[[2025,5,6]],"date-time":"2025-05-06T09:55:51Z","timestamp":1746525351000},"source":"Crossref","is-referenced-by-count":3,"title":["Spatial mapping and geographic variation of inflammatory bowel disease in Canada: a population-based study"],"prefix":"10.1093","volume":"19","author":[{"given":"Shane W","family":"Goodwin","sequence":"first","affiliation":[{"name":"Department of Medicine, Lawson Health Research Institute, London Health Science Centre , London, ON ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4942-7841","authenticated-orcid":false,"given":"Michael","family":"Haan","sequence":"additional","affiliation":[{"name":"Department of Sociology, Western University , London, ON ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4374-3042","authenticated-orcid":false,"given":"Yuhong","family":"Yuan","sequence":"additional","affiliation":[{"name":"Department of Medicine, Lawson Health Research Institute, London Health Science Centre , London, ON ,","place":["Canada"]},{"name":"Departments of Medicine, Western University , London, ON ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1363-2280","authenticated-orcid":false,"given":"Piotr","family":"Wilk","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Maastricht University , Maastricht ,","place":["the Netherlands"]},{"name":"Department of Epidemiology and Biostatistics, Western University , London, ON ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1092-0033","authenticated-orcid":false,"given":"Vipul","family":"Jairath","sequence":"additional","affiliation":[{"name":"Department of Medicine, Lawson Health Research Institute, London Health Science Centre , London, ON ,","place":["Canada"]},{"name":"Departments of Medicine, Western University , London, ON ,","place":["Canada"]},{"name":"Department of Epidemiology and Biostatistics, Western University , London, ON ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,5,6]]},"reference":[{"key":"2025060311003849000_CIT0001","doi-asserted-by":"crossref","first-page":"1275","DOI":"10.1038\/s41588-022-01156-2","article-title":"Large-scale sequencing identifies multiple genes and rare variants associated with Crohn\u2019s disease susceptibility","volume":"54","author":"Sazonovs","year":"2022","journal-title":"Nat Genet."},{"key":"2025060311003849000_CIT0002","doi-asserted-by":"crossref","first-page":"647","DOI":"10.1053\/j.gastro.2019.04.016","article-title":"Environmental risk factors for inflammatory bowel diseases: an umbrella review of meta-analyses","volume":"157","author":"Piovani","year":"2019","journal-title":"Gastroenterology."},{"key":"2025060311003849000_CIT0003","doi-asserted-by":"crossref","first-page":"105676","DOI":"10.1016\/j.envint.2020.105676","article-title":"Ambient air pollution and the risk of pediatric-onset inflammatory bowel disease: a population-based cohort study","volume":"138","author":"Elten","year":"2020","journal-title":"Environ Int."},{"key":"2025060311003849000_CIT0004","doi-asserted-by":"crossref","first-page":"347","DOI":"10.14309\/ajg.0000000000000990","article-title":"Residential greenspace in childhood reduces risk of pediatric inflammatory bowel disease: a population-based cohort study","volume":"116","author":"Elten","year":"2021","journal-title":"Am J Gastroenterol."},{"key":"2025060311003849000_CIT0005","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1097\/MPG.0000000000003500","article-title":"The role of the urban exposome in the increasing global rates of pediatric inflammatory bowel disease","volume":"75","author":"Kuenzig","year":"2022","journal-title":"J Pediatr Gastroenterol Nutr."},{"key":"2025060311003849000_CIT0006","doi-asserted-by":"crossref","first-page":"2769","DOI":"10.1016\/S0140-6736(17)32448-0","article-title":"Worldwide incidence and prevalence of inflammatory bowel disease in the 21st century: a systematic review of population-based studies","volume":"390","author":"Ng","year":"2017","journal-title":"Lancet."},{"key":"2025060311003849000_CIT0007","doi-asserted-by":"crossref","first-page":"S6","DOI":"10.1093\/jcag\/gwy054","article-title":"The impact of inflammatory bowel disease in Canada 2018: epidemiology","volume":"2","author":"Kaplan","year":"2019","journal-title":"J Can Assoc Gastroenterol."},{"key":"2025060311003849000_CIT0008","doi-asserted-by":"crossref","first-page":"S9","DOI":"10.1093\/jcag\/gwad004","article-title":"The 2023 impact of inflammatory bowel disease in Canada: epidemiology of IBD","volume":"6","author":"Coward","year":"2023","journal-title":"J Can Assoc Gastroenterol."},{"key":"2025060311003849000_CIT0009","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1111\/apt.15512","article-title":"Fine-scale geographic distribution and ecological risk factors for Crohn\u2019s disease in France (2007-2014)","volume":"51","author":"Genin","year":"2020","journal-title":"Aliment Pharmacol Ther."},{"key":"2025060311003849000_CIT0010","doi-asserted-by":"crossref","first-page":"984","DOI":"10.1002\/ibd.20417","article-title":"Geographic distribution and ecological studies of inflammatory bowel disease in southeastern Norway in 1990-1993","volume":"14","author":"Aamodt","year":"2008","journal-title":"Inflamm Bowel Dis."},{"key":"2025060311003849000_CIT0011","doi-asserted-by":"crossref","first-page":"630","DOI":"10.1136\/gutjnl-2012-303661","article-title":"Geographic variability and environmental risk factors in inflammatory bowel disease","volume":"62","author":"Ng","year":"2013","journal-title":"Gut."},{"key":"2025060311003849000_CIT0012","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1186\/1476-072X-9-22","article-title":"Geographical variation of Crohn\u2019s disease residual incidence in the Province of Quebec, Canada","volume":"9","author":"Michel","year":"2010","journal-title":"Int J Health Geogr."},{"key":"2025060311003849000_CIT0013","author":"Statistics Canada","year":"2024","journal-title":"Canadian Community Health Survey \u2013 Annual Component (CCHS)"},{"key":"2025060311003849000_CIT0014","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1111\/j.1538-4632.1995.tb00338.x","article-title":"Local indicators of spatial association","volume":"27","author":"Anselin","year":"1995","journal-title":"Geogr Anal"},{"key":"2025060311003849000_CIT0015","doi-asserted-by":"crossref","first-page":"442","DOI":"10.1111\/cdoe.12308","article-title":"Sociodemographic determinants of spatial disparities in early childhood caries: an ecological analysis in Braunschweig Germany","volume":"45","author":"Meyer","year":"2017","journal-title":"Commun Dent Oral Epidemiol."},{"key":"2025060311003849000_CIT0016","volume-title":"R Core Team. R: A Language and Environment for Statistical Computing","author":"R4.3","year":"2021"},{"key":"2025060311003849000_CIT0017","doi-asserted-by":"crossref","first-page":"488","DOI":"10.1111\/gean.12319","article-title":"R packages for analyzing spatial data: a comparative case study with areal data","volume":"54","author":"Bivand","year":"2022","journal-title":"Geograph Anal."},{"key":"2025060311003849000_CIT0018","first-page":"9","article-title":"Classes and methods for spatial data in R","volume":"5","author":"Pebesma","year":"2005","journal-title":"R News"},{"key":"2025060311003849000_CIT0019","doi-asserted-by":"crossref","first-page":"439","DOI":"10.32614\/RJ-2018-009","article-title":"Simple features for R: standardized support for spatial vector data","volume":"10","author":"Pebesma","year":"2018","journal-title":"R J"},{"key":"2025060311003849000_CIT0020","doi-asserted-by":"crossref","first-page":"1","DOI":"10.18637\/jss.v084.i06","article-title":"tmap: thematic maps in R","volume":"84","author":"Tennekes","year":"2018","journal-title":"J Stat Softw"},{"key":"2025060311003849000_CIT0021","author":"RColorBrewer","journal-title":"ColorBrewer palattes. R package version 1.1-2"},{"key":"2025060311003849000_CIT0022","doi-asserted-by":"crossref","first-page":"1686","DOI":"10.21105\/joss.01686","article-title":"Welcome to the Tidyverse","volume":"4","author":"Wickham","year":"2019","journal-title":"J Open Source Softw"},{"key":"2025060311003849000_CIT0023","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.1093\/jcag\/gwad003","article-title":"The 2023 impact of inflammatory bowel disease in Canada: executive summary","volume":"6","author":"Windsor","year":"2023","journal-title":"J Can Assoc Gastroenterol."}],"container-title":["Journal of Crohn's and Colitis"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ecco-jcc\/advance-article-pdf\/doi\/10.1093\/ecco-jcc\/jjaf079\/63067256\/jjaf079.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ecco-jcc\/article-pdf\/19\/5\/jjaf079\/63067256\/jjaf079.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ecco-jcc\/article-pdf\/19\/5\/jjaf079\/63067256\/jjaf079.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,3]],"date-time":"2025-06-03T15:02:34Z","timestamp":1748962954000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ecco-jcc\/article\/doi\/10.1093\/ecco-jcc\/jjaf079\/8125609"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5]]},"references-count":23,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2025,5,8]]}},"URL":"https:\/\/doi.org\/10.1093\/ecco-jcc\/jjaf079","relation":{},"ISSN":["1873-9946","1876-4479"],"issn-type":[{"value":"1873-9946","type":"print"},{"value":"1876-4479","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,5]]},"published":{"date-parts":[[2025,5]]},"article-number":"jjaf079"}}