Social Determinants of Health Affect the Care Experience of Overweight Patients

overweight woman and doctor
Patients reported barriers to care including social determinants of health in obesity management by their healthcare provider.

Lower income and education levels may negatively affect the experience and expectations of patients who are obese who receive care for weight management, according to study results presented at the at the 28th Annual Congress of the American Association of Clinical Endocrinologists, held April 24 to 28, 2019, in Los Angeles, California.

Researchers aimed to assess whether key social determinants of health such as economic stability and education influence perceptions of weight management care in patients who are overweight/obese. Using the Learning Health System Network, researchers mailed a total of 19,964 surveys to patients identified as overweight/obese; 2799 surveys were returned. Of these, 305 (10.9%) were excluded because of incomplete data and 155 (5.5%) were excluded because the respondent had a body mass index <25 kg/m2. Of the 2339 respondents included in the study, 671 (28.7%) were overweight, while the remainder were classified as obese (27.5% obesity class 1; 20.9% class 2; 23.2% class 3).

Patients with an annual income of <$50,000 reported that their clinician was less likely to have a current role in their weight management and that they were less likely to be treated as an equal by their healthcare provider.

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With regard to education, patients who reported an educational level at or below a high school/general education diploma and/or <4-year college degree were also less likely to feel respected by their clinician. These patients were less likely to believe that their current clinician should have a role in their weight management or that their clinician spent enough time providing weight loss advice.

“In this large survey of overweight and obese patients, we found that patients’ perceptions of their experiences and expectations regarding weight management differed according to their degree of economic stability and educational status, even when controlling for ethnicity/race,” the researchers concluded. “More resources need to be made available to eliminate these barriers.”

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Taufeeq M, Porter K, Haller I, et al. Social determinants of health strongly influence the patient-health care provider experience in overweight/obesity. Presented at: American Association of Clinical Endocrinologists 28th Annual Scientific & Clinical Congress; April 24-28, 2019; Los Angeles, CA.