Residing in a Food Desert Is Associated with an Increased Risk of Complications after Breast Reconstruction

Food deserts (FDs) are areas characterized by high rates of food insecurity, limited access to healthy food, and a high concentration of unhealthy food options. This study evaluated the comorbidity burden in patients residing in FDs and assessed the impact of residing in an FD on postoperative outcomes following mastectomy.

A retrospective review was conducted of patients undergoing mastectomy between January of 2014 and November of 2018. Low food access (LFA) was defined as an area where residents lived more than 1 mile (urban) or more than 10 miles (rural) from the nearest supermarket. Primary outcomes included minor and major complications (ie, return to the operating room).

A total of 1553 patients were included. Of these, 675 (43.5%) resided in LFA areas and 878 (56.5%) in non-LFA (NLFA) areas. The mean body mass index was 28.4 ± 8.0 and 28.6 ± 7.3 kg/m 2 , respectively ( P = 0.897). The mean Charlson Comorbidity Index score was 2.6 ± 1.3 and 2.3 ± 1.2, respectively ( P < 0.001). The LFA group experienced more minor complications than the NLFA group ( n = 190 [28.1%] versus n = 187 [21.3%]; P = 0.002). The LFA group had a higher incidence of reoperation than the NLFA group ( n = 83 [12.3%] versus n = 64 [7.3%]; P = 0.001). An LFA subanalysis revealed that patients with low income had a higher incidence of reoperation ( n = 28/158 [17.7%] versus n = 55/517 [10.6%]; P = 0.018).

The findings suggest a potential relationship among food access, increased comorbidities, and postoperative complications. Further studies are warranted to assess the relationship between FDs and postoperative outcomes to address social determinants of health for patients undergoing breast reconstruction.