Residing in a Food Desert is Associated with an Increased Risk of Complications Following Breast Reconstruction.

Background: Food deserts (FD) are areas with high rates of food insecurity due to limited access to healthy food and a high concentration of unhealthy food options. This study aimed to describe the comorbidity burden in patients residing in FDs and assess the impact of residing in a FD on postoperative outcomes following mastectomy.

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

Results: A total of 1,553 patients were included. Of whom, 675 (43.5%) resided in LFA areas and 878 (56.5%) in non-low food access (NLFA) areas. Mean BMI was 28.4±8.0 and 28.6±7.3 kg/m2, respectively (p=0.897). Mean Charlson Comorbidity Index 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% vs. n=187, 21.3%; p=0.002). The LFA group had a higher incidence of reoperation than the NLFA group (n=83, 12.3% vs. n=64, 7.3%; p=0.001). A LFA sub-analysis revealed that low income patients had a higher incidence of reoperation (n=28/158, 17.7% vs. n=55/517, 10.6%; p=0.018).

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