Neighborhood social determinants of health and postoperative weight loss

New publication – Pratt, K.J., Hanks, A.S., Miller, H.J., Outrich, M., Breslin, L., Blalock, J., Noria, S., Brethauer, S., Needleman, B. and Focht, B. (2022) “The BARI-hoods Project: Neighborhood social determinants of health and postoperative weight loss using integrated EHR, Census, and county data,” Surgery for Obesity and Related Diseases, online first.

(I may be the first geographer to co-author a paper in Surgery for Obesity and Related Diseases, but I am willing to be corrected.)

HIGHLIGHTS

  • While living in close proximity to foods stores does not ensure utilization, in this study, patients who lived within a 10-minute walk to food stores had better weight loss two years after bariatric surgery.
  • Black patients with access to more food stores within a 10-minute walk and White patients with more access within a 5-minute walk had greater %TWL (percent total weight loss)  over 24 months.
  • Living in areas with lower poverty levels did not negatively affect weight loss for Black patients.
  • There were no significant associations for weight loss based on unemployment rate or proximity to fitness/recreational facilities and percent open area.

ABSTRACT
Background.  While social determinants of health (SDoH) have gained attention for their role in weight loss following bariatric surgery; electronic health record (EHR) data provides limited information beyond demographics associated with disparities in weight loss.

Objective. To integrate EHR, Census, and county data to explore disparities in SDoH and weight loss among patients in the largest populous county of Ohio.

Setting. 772 patients (82.1% female; 37.0% Black) who had primary bariatric surgery (48.7% gastric bypass) from 2015-2019 at The Ohio State University.

Methods. EHR variables included race, insurance, procedure, and %TWL at 2/3, 6, 12, and 24 months. Census variables included poverty and unemployment rates. County variables included food stores, fitness/recreational facilities, and open area within a 5- and 10-minute walk from home. Two mixed multilevel models were conducted with %TWL over 24 months, with visits as the between subjects factor; race, Census, county, insurance, and procedure variables were covariates. Two additional sets of models determined within group differences for Black and White patients.

Results. Access to more food stores within a 10-minute walk was associated with greater %TWL over 24 months (p=0.029). Black patients with access to more food stores within a 10-minute (p=0.017) and White patients with more access within a 5-minute walk (p=0.015) had greater %TWL over 24 months. Black patients who lived in areas with higher poverty rates (p=0.036) experienced greater %TWL over 24 months. No significant differences were found for unemployment rate or proximity to fitness/recreational facilities and open area.

Conclusion. Close proximity to food stores is associated with better weight loss two years after bariatric surgery. Lower poverty levels did not negatively affect Black patient weight loss.

How SUVs conquered the world – at the expense of its climate

I was interviewed by The Guardian (UK) newspaper about Sport Utility Vehicles (SUVs): how they came to dominate the US market, and their damage to the environment, cities and people:

How SUVs conquered the world – at the expense of its climate,”  The Guardian, 1 September 2020.

The article was also reprinted in Slate:

C U, SUV: The hulking car has become the world’s most dominant form of transportation—and one of its biggest climate threats,” Slate, 8 September 2020.