Racial Differences in the Predictors of Interest in Bariatric Surgery in the Rural, Southeastern USA

J Racial Ethn Health Disparities. 2019 Jun;6(3):481-486. doi: 10.1007/s40615-018-00546-9. Epub 2018 Nov 26.

Abstract

Background: Although African-Americans have a higher prevalence of severe obesity than Whites, they are less likely to have bariatric surgery. Demographic, healthcare, and knowledge variables contribute to this racial disparity but have not been examined separately by race.

Objectives: Examine the role of demographic, healthcare, and knowledge variables in African-Americans' versus Whites' interest in bariatric surgery.

Methods: A random sample of 293 African-American and 259 White adults were surveyed door-to-door in the rural south. The survey assessed weight, height, demographics, access to healthcare, and knowledge of and interest in bariatric surgery.

Results: African-Americans had significantly lower knowledge of bariatric surgery than Whites but there were no racial differences in interest in the surgery. The logistic regression predicting African-Americans' interest in the surgery from demographic, healthcare, obesity, and knowledge variables revealed that obesity (OR = 4.7) and the health benefits (OR = 3.3) were the only predictors. The same regression for Whites found that knowing someone who had the surgery (OR = 3.7) was the sole predictor.

Conclusions: Knowledge variables may be stronger than healthcare and demographic variables as predictors of interest in bariatric surgery among rural, southern, African-Americans and Whites. Whites' willingness to consider the surgery might be enhanced by favorable stories/blogs by those who had the surgery, whereas African-Americans' interest might be increased by information on the additional health benefits of the surgery. These culturally tailored messages from healthcare providers might increase utilization of and reduce racial disparities in bariatric surgery.

Keywords: Bariatric surgery; Disparities; Race and ethnicity.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Bariatric Surgery / psychology
  • Bariatric Surgery / statistics & numerical data*
  • Black or African American / psychology
  • Black or African American / statistics & numerical data*
  • Female
  • Health Knowledge, Attitudes, Practice*
  • Health Services Accessibility / statistics & numerical data*
  • Healthcare Disparities / statistics & numerical data
  • Humans
  • Male
  • Middle Aged
  • Rural Population / statistics & numerical data*
  • Southeastern United States
  • White People / psychology
  • White People / statistics & numerical data*
  • Young Adult