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Symposia

Eating Disorders

Advocating for Comprehensive and Innovative Solutions Toward Equitable Eating Disorder Treatment

5 - (SYM 18) Examining Associations Among Access to Eating Disorder Care, Outcomes, and Childhood Neighborhood Opportunity

Friday, November 15, 2024
10:30 AM – 12:00 PM EST
Location: Grand Ballroom E, Level 5, Downtown Marriott
Abstract Body
Anorexia nervosa (AN) is a psychiatric condition with onset during early adolescence. Early access to care is critical to achieving a good prognosis, as delays in care can contribute to greater psychological and medical complications and impairments in functioning. However, access to care is variable based on many sociodemographic factors including race, ethnicity, insurance status, and sex, particularly considering the highly stigmatized perception of who is impacted by AN. Evidence suggests that neighborhood characteristics, as measured by the Childhood Opportunity Index (COI), may significantly impact an individual’s physical or mental health outcomes. However, the specific impact of COI on access to specialist eating disorder (ED) care is not yet known. This study had two primary objectives: to examine: 1) associations between access to ED care (measured by time-to-treatment and weight suppression at presentation) and COI, and 2) the relation between COI and prognosis at 6-month follow-up. We conducted a retrospective chart review of patients presenting to a large academic medical center between 2017 and 2023 for assessment and treatment of their ED (AN, atypical AN, and subclinical AN). The sample included 131 youth and was predominantly cisgender females (n=113; 86%) and White (n=112, 85%) with a mean age of 15.0 years. The mean standardized COI was 77.5 (suggesting a high COI, 60-80). We used Pearson correlations to explore links between COI and time-to-treatment (in months) as well as weight suppression (change in BMI z-score from highest weight pre-ED to lowest weight), as an additional proxy for time to presentation). We used an independent t-test to examine differences in COI across youth with a good and not good prognosis at six-month follow up. We did not find a significant association between time-to-treatment and COI (r = -.05, p=.55) or weight suppression and COI (r= -.06, p=.48). We also saw no significant difference in COI across prognostic groups at 6-six-month follow up (good prognosis: M COI: 76.82, poor prognosis M COI: 77.90, p=.81). Our lack of significant findings may reflect the broad access to care overall the greater Philadelphia area due to the wide-reaching network of Children’s Hospital of Philadelphia throughout Pennsylvania and New Jersey. Results are encouraging and indicate that treatment seeking youth do not differ in outcome irrespective of their geography within this health system. Future research should replicate these findings in populations with sparser treatment access and with lower average COIs.