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The Catalyst

Study finds disparities in bariatric surgery

A national study led by MUSC’s Arch G. Mainous III, Ph.D., Department of Family Medicine, examined trends of bariatric adult surgery focusing on race and access to health care.

The study found that despite a higher percentage of eligibility for blacks to receive surgeries, eligible whites were more likely to receive them.

Mainous and his colleagues analyzed subjects eligible for bariatric surgery in the National Hospital Discharge Survey and the National Health and Nutrition Examination Survey in the period of 1999-2010 for black and white patients aged 20 to 64 years.

A higher percentage of black than white women (22 vs. 12 percent) and of black than white men (11 vs. 8 percent) were eligible for bariatric surgery, but twice as many white men and women received the surgery. The study also found that 70 percent of white men and women had private health insurance compared to 50 percent of black men and women.

“Bariatric surgery has been shown to be an effective treatment for moderate to clinically severe obesity, and, more importantly, it has the benefit of successfully resolving or improving the important chronic conditions of diabetes and hypertension in the majority of cases,” Mainous said. “Bariatric surgery can improve quality of life, decrease the risk of premature death, and lower disability and health care costs. Consequently, this health disparity in treatment has implications for health care costs and morbidity due to common diseases like diabetes and hypertension, conditions that are highly prevalent in the African- American community.”

Given these estimates and study results, Mainous and his colleagues suggested the following summary of potential causes of this disparity, including: access-to-care issues due to differences in insurance coverage; persistent lack of trust by blacks of physicians; differences in how blacks and whites assess surgical risks; and some cultural evidence of acceptance of obesity in black populations.

August 7, 2013

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