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Research published in the Journal of the American Society of Plastic Surgeons finds that living in an area without access to healthy, high-quality food is associated with an increased risk of complications following breast reconstruction surgery.
Many factors far from the operating room, known as social determinants of health (SDOH), can affect how someone recovers from surgery. A newly published study from MedStar Health Research Institute finds an association between one SDOH—living in a food desert—and an increased risk of complications after breast reconstruction surgery following mastectomy.
Each year, more than 90,000 women have a mastectomy, a surgery to remove a breast, and more than 40% of them opt for reconstruction surgery. About one-third have a complication, including fluid collecting near the surgical site, tightening of scar tissue, or difficulty with wound healing.
Our research study shows that a lack of access to nutritious food can affect a patient’s likelihood of complications. Understanding this will inform interventions to help patients optimize their health before surgery to improve their chances of good outcomes.
Where you live can impact recovery.
Our observational research looked back at the health records of more than 1,500 people who had breast reconstruction surgery at MedStar Health. To compare their outcomes, we divided these patients into two groups: those in a food desert and those who did not.
For our study, a food desert was defined as a more than 1 location more than 1 mile from the nearest grocery store. While people living in a food desert can sometimes have access to non-perishable or fast food, it’s fresh, whole foods that help the body prepare for surgery.
When we compared the groups, the results were clear:
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Patients who lived in food deserts were more likely to have more existing health issues (comorbidities) before surgery.
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The rate of minor complications was significantly higher in the food desert group (28.1%) compared to the non-food desert group (21.3%).
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Most strikingly, those patients who lived in a food desert were almost twice as likely (12.3%) to have another surgery for a major complication compared to the non-food desert group (7.4%).
Additional analysis of our data revealed that patients with a low income were even more likely to need reoperation. These findings highlight a relationship among food access, overall health, and post-surgical complications. The data highlight the importance of addressing SDOH in our communities to improve ’health.
How nutrition and social context impact health.
Eating a variety of fresh, less processed foods helps your body heal. Nutrients such as protein, calcium, vitamins, zinc, and others are essential building blocks of the wound-healing process. Highly processed, convenient foods are lower in nutritional content, so it makes sense that patients who are challenged to access healthy food may also struggle to recover well after surgery.
Access to healthy food is only one example of an SDOH; how and where we live has a real impact on our health. Other examples of SDOH include:
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Access to reliable transportation
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Discrimination and violence
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Education and job opportunities
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Economic stability
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Pollution
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Safe housing and neighborhoods
Related: Read “Research: Social Connection Impacts Health Outcomes for Children and Families.”
Our commitment to health equity.
Every person deserves an equal opportunity to achieve their best health, and MedStar Health is committed to health equity.
We screen every patient for unmet needs, including food insecurity, transportation access, and more. When patients are hospitalized, we provide one-on-one support for social needs, helping them navigate and connect with community services.
When it comes to breast reconstruction and other planned procedures, our multidisciplinary teams of specialists and support staff work with patients ahead of time. By layering on additional support services, we can help patients improve their health before surgery, increasing their chances of positive outcomes and a healthy recovery.
MedStar Health Research Institute researchers are always thinking about how to improve care. Understanding the role of SDOH in surgical outcomes enables us to help patients prepare for surgery, reduce complications, and support recovery.
