Background

To assess the associations between social determinants of health and bariatric surgery outcomes.Background Social determinants of health (SDOH) include 5 key domains: economics, education, healthcare, social context, and the built environment. These aspects have been found to influence bariatric surgery utilization, yet its association with outcomes after bariatric surgery has not been well studied.

Methods

We included patients that underwent bariatric surgery at the Howard University Hospital between August 2008 to February 2021. The distressed communities index (DCI) was used to represent SDOH. The DCI examines economic well-being at the zip code level and provides a detailed view of the divided landscape of American prosperity. Baseline characteristics, length of stay, percent excess body weight loss (%EBWL) after 6 months, and readmission rates were examined. Logistic and linear regression were utilized.

Results

We identified 800 patients. Median age was 43 years. Majority were female (85%). The cohort was 92% Black, 5% White, 2% Hispanic, and 1% other. Regarding the most distressed communities, there was a statistically significant increased proportion of females (90%; p<0.05) and Blacks (99%; p<0.05). The mean %EBWL was 20 +- 8. %EBWL and readmission rates were not associated with SDOH; however, after adjusting for gender, living in a distressed community was independently associated with length of stay>1 day after bariatric surgery (OR 1.13, p=0.041).

Conclusions

SDOH could impact length of stay after bariatric surgery, but do not influence weight loss or readmission rates. Increasing access to bariatric surgery will be beneficial for all socioeconomic groups.