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Association of County-Level Food Deserts and Food Swamps with Hepatopancreatobiliary Cancer Outcomes

  • Original Article
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Journal of Gastrointestinal Surgery

Abstract

Background

Malnutrition has been linked to the development of hepatopancreatobiliary (HPB) cancer. We sought to examine the association between food swamps and food deserts on surgical outcomes of patients with HPB cancer.

Methods

Patients who underwent surgery for HPB cancer between 2014 and 2020 were identified from the Medicare Standard Analytic Files. Patient-level data were linked to the United States Department of Agriculture data on food swamps and deserts. Multivariable regression was performed to examine the association between the food environment and outcomes.

Results

Among 53,426 patients, patients from the worse food environment were more likely to be Black, have a higher Charlson Comorbidity Index, and reside in areas with high social vulnerability. Following surgery, the overall incidence of textbook outcome (TO) was 41.6% (n = 22,220). Patients residing in the worse food environments less often achieved a TO versus individuals residing in the healthiest food environments (food swamp: 39.4% vs. 43.9%; food desert: 38.5% vs 42.2%; p < 0.05). On multivariable analysis, individuals residing in the poorest food environments were associated with lower odds of achieving TO compared with individuals living in healthiest food environments (food swamp: OR 0.83, 95%CI 0.75–0.92, food desert: OR 0.86, 95%CI 0.76–0.97; both p < 0.05).

Conclusion

The surrounding food environment of patients may serve as a modifiable socio-demographic risk factor that contributes to disparities in surgical outcomes of HPB cancer.

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Acknowledgements

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Funding

The authors declare no funding or financial support.

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Authors and Affiliations

  1. Department of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA

    Mujtaba Khalil MD, Muhammad Musaab Munir MD, Yutaka Endo MD, Selamawit Woldesenbet MD, Vivian Resende MD, Karol Rawicz-Pruszyński MD, Muhammad Muntazir Mehdi Khan MD, Usama Waqar MD, Erryk Katayama MD, Mary Dilhoff MD, Jordan Cloyd MD, Aslam Ejaz MD & Timothy M. Pawlik MD, PhD, MPH, MTS, MBA

  2. Federal University of Minas Gerais School of Medicine, Belo Horizonte, Brazil

    Vivian Resende MD

  3. Department of Surgical Oncology, Medical University of Lublin, Lublin, Poland

    Karol Rawicz-Pruszyński MD

  4. Medical College, Aga Khan University, Karachi, Pakistan

    Usama Waqar MD

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  1. Mujtaba Khalil MD
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Correspondence to Timothy M. Pawlik MD, PhD, MPH, MTS, MBA.

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Data Sharing Statement

The data for this study were obtained from the Medicare database. There are restrictions to the availability of this data, which is used under license for this study. Data can be accessed with permission from the Centers for Medicare and Medicaid Services.

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Khalil, M., Munir, M.M., Endo, Y. et al. Association of County-Level Food Deserts and Food Swamps with Hepatopancreatobiliary Cancer Outcomes. J Gastrointest Surg 27, 2771–2779 (2023). https://doi.org/10.1007/s11605-023-05879-3

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