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Racial variation in baseline characteristics and wait times among patients undergoing bariatric surgery

  • 2021 SAGES Oral
  • Published:
Surgical Endoscopy Aims and scope Submit manuscript

Abstract

Background

Although bariatric surgery is the most effective treatment for obesity and weight-related comorbid diseases, utilization rates are disproportionately low among non-white patients. We sought to understand if variation in baseline characteristics or access to care exists between white and non-white patients.

Methods

Using a statewide bariatric-specific data registry, we evaluated all patients who underwent bariatric surgery between 2006 and 2020 and completed a preoperative baseline questionnaire, which included a question about self-identification of race. Patient characteristics, co-morbidities, and time from initial preoperative clinic evaluation to date of surgery were compared among racial groups.

Results

A total of 73,141 patients met inclusion criteria with 18,741 (25.5%) self-identified as non-white. These included Black/African American (n = 11,904), Hispanic (n = 3448), Asian (n = 121), Native Hawaiian/Pacific Islander (n = 41), Middle Eastern (n = 164), Multiple (n = 2047) and other (n = 608). Non-white males were the least represented group, accounting for only 4% of all bariatric cases performed. Non-white patients were more likely to be younger (43.0 years vs. 46.6 years, p < 0.0001), disabled (16% vs. 11.4%, p < 0.0001) and have Medicaid (8.4% vs. 3.8%, p < 0.0001) when compared to white patients, despite having higher rates of college education (78.0% vs. 76.6, p < 0.0001). In addition, median time from initial evaluation to surgery was also longer among non-white patients (157 days vs. 127 days, p < 0.0001), despite having higher rates of patients with a body mass index above 50 kg/m2 (39.0% vs. 33.2%, p < 0.0001).

Conclusions

Non-white patients undergoing bariatric surgery represent an extremely diverse group of patients with more socioeconomic disadvantages and longer wait times when compared to white patients despite presenting with higher rates of severe obesity. Current guidelines and referral patterns for bariatric surgery may not be equitable and need further examination when considering the management of obesity within diverse populations to reduce disparities in care—of which non-white males are particularly at risk.

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Authors and Affiliations

  1. University of Michigan, Ann Arbor, MI, USA

    Mary R. Shen, Shannon Jiang, M. Andrew Millis, Sidra N. Bonner, Aaron J. Bonham, Jonathan F. Finks, Amir Ghaferi & Oliver A. Varban

  2. Henry Ford Health System, Detroit, USA

    Arthur Carlin

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  1. Mary R. Shen
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  2. Shannon Jiang
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Corresponding author

Correspondence to Mary R. Shen.

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Disclosures

Drs. Varban, Finks, and Ghaferi receive salary support from Blue Cross Blue Shield of Michigan for leadership and participation in the Michigan Bariatric Surgery Collaborative. Dr. Ghaferi is President of the Association of Academic Surgery. Ms. Jiang, Mr. Bonham, and Drs. Shen, Bonner, and Millis have no conflict of interest or financial ties to disclose.

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Shen, M.R., Jiang, S., Millis, M.A. et al. Racial variation in baseline characteristics and wait times among patients undergoing bariatric surgery. Surg Endosc 37, 564–570 (2023). https://doi.org/10.1007/s00464-022-09292-w

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  • DOI: https://doi.org/10.1007/s00464-022-09292-w

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