The Impact of Living in a Low Food Access/Low Income Area on Obstructive Sleep Apnea

Abstract

Objective: To assess differences in obstructive sleep apnea (OSA)-related health parameters between residents of low income/low access (LILA) census tracts—food deserts—and non-LILA residents. Study Design: Retrospective review. Setting: Single institution serving a large region in Southern California from 2017 to 2023. Methods: Census tracts are defined as LILA if a significant proportion of residents live below the poverty threshold and far from healthy food vendors. Adults newly diagnosed with OSA on polysomnography were included. Food access status was determined by searching patient addresses in the US Department of Agriculture Food Access Research Atlas. Baseline and 1-year follow-up body mass index (BMI) and vitals were collected and compared based on food access and other demographic variables. Results: A total of 379 patients in the LILA+ group and 2281 patients in the LILA− group met inclusion criteria. BMI was higher in the LILA group (36.6 ± 9.4 vs 35.2 ± 8.9; P =.006). The effect of food access was most significant in certain demographic groups: patients aged < 65, males, Asian/Pacific Islanders, Hispanics, and patients with Medicaid coverage all had a higher BMI when in the LILA+ group compared to the LILA− group. When considering insurance, LILA+ patients with Medicaid coverage had a significantly higher BMI than LILA− patients with non-Medicaid coverage (40.4 ± 10.3 vs 34.2 ± 8.4, P