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Obese Poor Shut Out From Weight-Loss Surgeries


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Socioeconomic disparities in health care are common in other types of medical conditions, including cancer and cardiovascular treatments. Lack of access to health care is one reason why the poor tend to have worse health overall than the rest of the population, Martin said.

Obesity seems to strike lower-income people more than the more affluent. About 35 percent of the morbidly obese had a household income that was less than two times the poverty level, the study found, compared to 28 percent of the general population.

About 15 percent of the morbidly obese had incomes below the poverty level, a benchmark that varies depending on household size and geographic region.

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The morbidly obese were also more likely to have no insurance of be underinsured, defined as having coverage from Medicaid or other government-subsidized healthcare. About 20 percent of the morbidly obese were underinsured, compared with 8 percent of the general population.

Women and blacks also made up a disproportionate amount of the morbidly obese compared to their proportion of the population as a whole.

Nearly 30 percent of those who had bariatric surgery also had diabetes, 52 percent had hypertension and 19 percent had chronic pulmonary disease. The morbidly obese took twice as many sick days per year (5.4 vs. 2.8) and missed more work days (8 vs. 5).

"Increasing access and breaking down the socioeconomic barriers to bariatric surgery among the underserved population has the potential to significantly impact the health and well-being of millions of people throughout the U.S," Martin said.

While Medicaid and government-run medical plans do cover bariatric surgery, patients often have long wait times for approval and often are denied coverage for seemingly arbitrary reasons, added ASMBS President Dr. Scott Shikora.

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Last updated 6/25/2009

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SOURCES: Matthew J. Martin, M.D., assistant professor, surgery, Madigan Army Medical Center, Tacoma, Wash.; Scott Shikora, M.D., president, American Society for Metabolic and Bariatric Surgery; June 24, 20009, presentation, annual meeting, American Society for Metabolic & Bariatric Surgery,Dallas


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