S. Timberline7, M. S. Pichardo6,7, G. Ortega5, M. F. Nunez8, E. S. Bauer5, E. Smith7, J. Tordecilla7, T. M. Fullum10, D. D. Tran10 5Howard University College Of Medicine,Clive O. Callender Howard-Harvard Health Sciences Outcomes Research Center,Washington, DC, USA 6Yale University,New Haven, CT, USA 7Howard University College Of Medicine,Washington, DC, USA 8Howard University College Of Medicine,Department Of Medicine,Washington, DC, USA 10Howard University College Of Medicine,Department Of Surgery, Center For Wellness And Weight Loss Surgery,Washington, DC, USA
Introduction:
Research suggests that individuals of racial/ethnic minority groups and of low socioeconomic status (SES) experience worse outcomes after weight loss surgery compared to their White and higher SES counterparts, respectively. Our objective is to examine the association between socioeconomic characteristics and post-operative outcomes by 12 months in Black patients from a single academic center.
Methods:
A retrospective study of Black patients who underwent bariatric surgery from 2008 to 2013 was performed. Median Household Income (MHI), obtained from census-tract level neighborhood SES data, was a proxy for patients’ SES and categorized into tertiles: $42,595-$76,674, $76,969-$100,652, and $100,704-$205,980. Insurance status at time of surgery was defined as public or private insurance. Outcomes of interest included mean weight loss, body mass index (BMI) points loss, percent excess weight loss (%EWL), and resolution of comorbidities (hypertension, diabetes, hypercholesterolemia). Adjusted multivariable regression analysis was performed to assess the association between SES characteristics and the outcomes of interest.
Results:
Of 422 Black patients, most were female (82%) and had private insurance (73.9%). The mean preoperative BMI was 48.9 kg/m2. At baseline, about half of the patients had hypertension (51.1%), and one third had diabetes (34.4%) and hypercholesterolemia (28.2%). Postoperatively, there were no statistical significant differences in %EWL (β= 0.17, 95%CI= -1.95 – 2.28), mean weight loss (β= 5.37, 95%CI=-3.88 – 14.62), BMI point difference (β= 5.39, 95%CI= -13.47 – 24.24), resolution of hypertension (OR= 1.57, 95%CI= 0.88 – 2.80), diabetes (OR= 1.29, 95%CI= 0.63 – 2.62), and hypercholesterolemia (OR= 0.81, 95%CI= 0.36 – 1.81) by insurance status. Median household income categories did not statistically differ in %EWL, mean weight loss, BMI point difference, or resolution of co-morbidities (Table 1).
Conclusion:
Among Black patients who underwent bariatric surgery, median household income level and type of insurance used was not associated with a difference in weight loss or resolution co-morbidity outcomes by 12 months post-operatively.
