Examining the relationship between social determinants of health and obesity status at a federally qualified health center

Abstract

Importance: Specific health outcomes and biomarkers are correlated with many social factors including socioeconomic status (SES) and race, but the correlation with specific social determinants of health (SDH) metrics of food security, housing security, and social integration are not as well understood.

Objective: The purpose of this study is to examine the correlation between security status for these social determinants of health and obesity status.

Design: Retrospective cross-sectional observational study, 2021

Setting: Federally Qualified Health Center

Participants: Patients aged 18 and older who have completed a PRAPARE assessment between January 20, 2021 and August 08, 2021 and have a recorded height and weight (to calculate body mass index (BMI)). Descriptive and comparative statistics were used to characterize the population and explore the relationship between obesity and SDH.

Exposures: food insecurity, housing insecurity, social integration insecurity

Main outcomes and measures: 1) Mean BMI in patients experiencing insecurity and security for food, housing, and social integration and 2) Proportion of patients experiencing insecurity with obesity and without obesity

Results: 721 patients were included in this study with a median BMI of 29.9 (IQR 26.5, 33.7). Of respondents, 57 (9.7%) reported food insecurity, 125 (18.9%) reported housing insecurity, and 97 (14.9%) reported limited social integration. Chi-square analysis revealed that obesity status and SDH security status are independent for these metrics. T-tests revealed that average BMIs were not different for patients experiencing insecurity versus security.

Conclusions and relevance: In this single-center study using a convenience sample, there was no correlation between security status and obesity status for selected SDH metrics. More research needs to be done to understand the impact of SDH on health outcomes in different patient populations.