An Exploration of Food Deserts and Acute Biliary Disease in Emergency General Surgery Patients

Living in a food desert may increase the risk of health conditions related to biliary disease, such as obesity. However, there is limited understanding of food deserts' relationship with biliary disease. In this retrospective study, we explored food deserts in our region and examined the relationship between food deserts and biliary severity and outcomes using food census tracts.

We performed a retrospective review of 1609 patients presenting to our urban safety-net hospital that underwent cholecystectomy for acute cholecystitis, acute biliary pancreatitis, and choledocholithiasis between 2020 and 2021. Patients undergoing elective or outpatient cholecystectomy were excluded. Our primary end point was the association between living in a low-income and low-access to food (LILA) census tract and severity of biliary disease. Secondary end points included assessing associations between body mass index (BMI) and 30-d readmission, and geospatial patterns of BMI, severity of disease, and readmission. Statistical tests and the Getis-Ord Global Gi and local G statistic were performed for intergroup differences and geospatial mapping.

The median age was 39 y (29-49); 76% of patients were female, 84% identified as Hispanic, and 8.5% Black. Geospatial hotspots in LILA census tracts were identified and were significant for patients with higher BMI (P < 0.001) but not significant for 30-d readmissions (P = 0.12). Hotspots of patients with greater median disease severity were not in LILA census tracts and were not significant (P = 0.3). Overweight and/or obese patients undergoing cholecystectomy were more likely to reside in LILA census tracts. There was no association with disease severity or readmission and residing in a LILA census tract.

Higher BMI was more prevalent in LILA census tracts in this single-center study. There was no significant association between patient severity of disease and 30-d readmission, but there was overlap between readmission hot spots and LILA census tracts in geospatial analysis. We will continue to explore the relationship between food deserts and our patients' outcomes for targeted interventions to address any disparities.