Abstract 006: Neighbourhood Deprivation And Morbid Obesity: Insights From Houston Methodist Outpatient Learning Health System Registry

Introduction: Area Deprivation Index (ADI), a proxy measure for neighbourhood socioeconomic context, is informative for prioritizing limited resources in improving health outcomes. With emerging therapeutic options to improve cardiometabolic health among individuals with morbid obesity, whether available measures, such as ADI, for integrated health systems can identify this subpopulation at risk is unknown. Methods: This cross-sectional study analyzed data from 865,995 adult patients in the Houston Methodist Outpatient Learning Health System Registry between June 1 st , 2016 and July 20 th , 2021. Using University of Wisconsin-Madison School of Medicine’s ADI dataset, each patient was assigned an ADI rank according to the census block group of their geocoded residential address. BMI was calculated based on recorded height and weight. Patients with non-geocoded addresses (n=9 855), missing and abnormal BMI values (n=107 037) were excluded. Multinomial logistic regression models were used to examine the association between ADI and morbid obesity (BMI≥40 kg/m 2 ). Results: A total of 751,174 adults with an ADI ranking were included in the analysis. Overall, the prevalence of morbid obesity was 6.9% (n=51,609). The age-adjusted prevalence of morbid obesity increased across worsening neighborhood deprivation in overall population and across racial/ethnic subgroups (Figure 1). Each ADI rank increase in neighborhood disadvantage was associated with an unadjusted odds ratio (OR) of 1.022 (95% CI, 1.022-1.023) for morbid obesity compared to normal weight. After adjusting for age, sex and race/ethnicity, we found a statistically significant association of worst vs least level of neighborhood deprivation with patients with morbid obesity compared to normal weight (aOR, 3.75; 95% CI, 3.60-3.89). Conclusion: The study highlights utility of census-based measures to identify patients living in socioeconomically deprived areas for comprehensive morbid obesity management strategies.