Community Income, Healthy Food Access, and Repeat Surgery for Kidney Stones.

Abstract Objectives : To determine if limited food access census tracts (LFACTs) and food swamp census tracts (FSCTs) are associated with increased risk for repeat kidney stone surgery. And to elucidate the relationship between community-level food retail environment relative to community-level income on repeat stone surgery over time. Methods : Data were abstracted from the UCSF Information Commons. Adult patients were included if they underwent at least one urologic stone procedure. Census tracts from available geographical data were mapped using Food Access Research Atlas data from the USDA Economic Research Service. Kaplan-Meier curves were employed to illustrate time to a second surgical procedure over five years, and log-rank tests were used to test for statistically significant differences. A multivariate Cox regression model was used to generate hazard ratios for undergoing second surgery by group. Results : A total of 1496 patients were included in this analysis. Repeat stone surgery occurred in 324 patients. Kaplan-Meier curves demonstrated a statistically significant difference in curves depicting patients living in low income census tracts (LICTs) vs those not living in LICTs (p Conclusions : Income more so than food access associates with increased risk of repeat kidney stone surgery. Further research is needed to explore the interaction between low SES and kidney stone outcomes.