{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T14:12:17Z","timestamp":1760969537714,"version":"build-2065373602"},"reference-count":39,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,9,10]],"date-time":"2024-09-10T00:00:00Z","timestamp":1725926400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To assess differences in obstructive sleep apnea (OSA)\u2010related health parameters between residents of low income\/low access (LILA) census tracts\u2014food deserts\u2014and non\u2010LILA residents<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Retrospective review.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Single institution serving a large region in Southern California from 2017 to 2023.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>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\u2010year follow\u2010up body mass index (BMI) and vitals were collected and compared based on food access and other demographic variables.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 379 patients in the LILA+ group and 2281 patients in the LILA\u2212 group met inclusion criteria. BMI was higher in the LILA group (36.6\u2009\u00b1\u20099.4 vs 35.2\u2009\u00b1\u20098.9; <jats:italic>P<\/jats:italic>\u2009=\u2009.006). The effect of food access was most significant in certain demographic groups: patients aged\u2009&lt;\u200965, males, Asian\/Pacific Islanders, Hispanics, and patients with Medicaid coverage all had a higher BMI when in the LILA+ group compared to the LILA\u2212 group. When considering insurance, LILA+ patients with Medicaid coverage had a significantly higher BMI than LILA\u2212 patients with non\u2010Medicaid coverage (40.4\u2009\u00b1\u200910.3 vs 34.2\u2009\u00b1\u20098.4, <jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001. Blood pressure, heart rate, and apnea\u2010hypopnea index were also significantly higher in LILA+\/Medicaid group. BMI change across all demographic groups was minimal at 1\u2010year follow\u2010up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Living in a LILA census tract may result in worse OSA\u2010related health parameters. When accounting for insurance status, the effects are even more profound. Intensive counseling on the importance of weight management should begin at the diagnosis of OSA.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ohn.969","type":"journal-article","created":{"date-parts":[[2024,9,10]],"date-time":"2024-09-10T05:08:58Z","timestamp":1725944938000},"page":"321-328","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Impact of Living in a Low Food Access\/Low Income Area on Obstructive Sleep Apnea"],"prefix":"10.1002","volume":"172","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-2472-7126","authenticated-orcid":false,"given":"Nihal","family":"Punjabi","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Loma Linda University Medical Center Loma Linda California USA"},{"name":"Case Western Reserve University School of Medicine Cleveland Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7268-7065","authenticated-orcid":false,"given":"WayAnne","family":"Watson","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Loma Linda University Medical Center Loma Linda California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-1678-035X","authenticated-orcid":false,"given":"Alexandra","family":"Vacaru","sequence":"additional","affiliation":[{"name":"Loma Linda University School of Medicine Loma Linda California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9409-0267","authenticated-orcid":false,"given":"Samuel","family":"Martin","sequence":"additional","affiliation":[{"name":"Loma Linda University School of Medicine Loma Linda California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erica","family":"Levy\u2010Licorish","sequence":"additional","affiliation":[{"name":"Loma Linda University School of Medicine Loma Linda California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0318-578X","authenticated-orcid":false,"given":"Jared C.","family":"Inman","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Loma Linda University Medical Center Loma Linda California USA"},{"name":"Loma Linda University School of Medicine Loma Linda California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,9,10]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.3949\/ccjm.86.s1.02"},{"issue":"9","key":"e_1_2_8_3_1","first-page":"298","article-title":"Clinical manifestations of sleep apnea","volume":"7","author":"Stansbury RC","year":"2015","journal-title":"J Thorac Dis"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.291.16.2013"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.284.23.3015"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2013.05.045"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/164_2021_558"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu15092078"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.sleep.2023.05.007"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.numecd.2023.02.010"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph14070718"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.3945\/jn.109.112573"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph14111366"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10900-018-00601-w"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2023.0634"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2022.16406"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1177\/1559827618765097"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1017\/S136898001900363X"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12890-021-01485-8"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/FCH.0000000000000183"},{"key":"e_1_2_8_21_1","unstructured":"United States Census Bureau. California remained most populous state but growth slowed last decade.2021. Accessed April 26 2024.https:\/\/www.census.gov\/library\/stories\/state-by-state\/california-population-change-between-census-decade.html"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.3389\/fnut.2024.1348456"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0287593"},{"issue":"2","key":"e_1_2_8_24_1","first-page":"75","article-title":"Impact of aging on eating behaviors, food choices, nutrition, and health status","volume":"5","author":"Drewnowski A","year":"2001","journal-title":"J Nutr Health Aging"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.advnut.2023.05.006"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1177\/0046958019838118"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.122.029094"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.5664\/jcsm.9834"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.5664\/jcsm.27497"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201807-1326ST"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.202007-2906ED"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.1097\/MCP.0b013e328358be05"},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11325-010-0426-4"},{"key":"e_1_2_8_34_1","doi-asserted-by":"publisher","DOI":"10.1159\/000218143"},{"key":"e_1_2_8_35_1","doi-asserted-by":"publisher","DOI":"10.1183\/20734735.021910"},{"key":"e_1_2_8_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0954-6111(98)90386-9"},{"key":"e_1_2_8_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(03)15268-3"},{"key":"e_1_2_8_38_1","doi-asserted-by":"publisher","DOI":"10.1590\/S0100-879X2008000800015"},{"key":"e_1_2_8_39_1","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00200510"},{"key":"e_1_2_8_40_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-199912000-00007"}],"container-title":["Otolaryngology\u2013Head and Neck Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ohn.969","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T13:29:28Z","timestamp":1760966968000},"score":1,"resource":{"primary":{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/10.1002\/ohn.969"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9,10]]},"references-count":39,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2025,1]]}},"alternative-id":["10.1002\/ohn.969"],"URL":"https:\/\/doi.org\/10.1002\/ohn.969","archive":["Portico"],"relation":{},"ISSN":["0194-5998","1097-6817"],"issn-type":[{"type":"print","value":"0194-5998"},{"type":"electronic","value":"1097-6817"}],"subject":[],"published":{"date-parts":[[2024,9,10]]},"assertion":[{"value":"2024-04-29","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-08-24","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-09-10","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}