Impact of socioeconomic and geographic disparities on demographic and clinical characteristics in slipped capital femoral epiphysis

Introduction: Obesity is a well-established risk factor for slipped capital femoral epiphysis (SCFE), a common adolescent hip disorder. However, the influence of socioeconomic and geographic factors, such as food accessibility and rural-urban locality, remains poorly understood. This study evaluates how disparities in food access and locality affect the demographic, clinical, and socioeconomic characteristics of patients with SCFE to help guide targeted interventions. Methods: A retrospective review included all twenty-eight SCFE patients treated at our institution. Patients were stratified by residence in food deserts (n=10) versus nonfood deserts (n=18), low-food access areas (n=13), low-income areas (n=17), and rural (n=11) versus urban (n=17) localities. Variables analyzed included age at diagnosis, SCFE grade, poverty rate, and median family income. Results: Twenty-eight patients with SCFE were included. Compared with the general Texas and New Mexico population, patients were more likely to reside in food deserts (35.71% vs. 20.89%) and low-income census tracts (60.71% vs. 47.89%), with low-income residence representing the more prevalent socioeconomic disparity. Overall, 46.43% of patients lived in low-food access areas and 39.29% resided in rural communities. Despite these socioeconomic differences, no significant differences in age at diagnosis, SCFE laterality, slip severity, or obesity were observed between food desert versus nonfood desert or rural versus urban groups. Patients from low-food access areas had significantly lower median family income in 2024 than those from areas without low-food access ($72,783 vs. $95,473; P =0.030). Similarly, patients residing in low-income census tracts had significantly higher neighborhood poverty rates (20.77% vs. 7.57%; P =0.001) and lower median family income in both 2020 and 2024 ( P <0.001). All patients met criteria for obesity (BMI >95th percentile) at diagnosis. Conclusions: Significant socioeconomic disparities in income and neighborhood poverty were observed among patients with SCFE despite similar clinical presentation across groups. Universal obesity reinforces its established role in SCFE pathogenesis, while the observed socioeconomic differences warrant further investigation into their influence on disease burden and healthcare disparities.