  Scientific evidence confirm that significant racial disparities exist in
healthcare, including surgery outcomes. However, the causal pathway underlying
disparities at preoperative physical condition of children is not
well-understood. This research aims to uncover the role of socioeconomic and
environmental factors in racial disparities at the preoperative physical
condition of children through multidimensional integration of several data
sources at the patient and population level. After the data integration process
an unsupervised k-means algorithm on neighborhood quality metrics was developed
to split 29 zip-codes from Memphis, TN into good and poor-quality
neighborhoods. An unadjusted comparison of African Americans and white children
showed that the prevalence of poor preoperative condition is significantly
higher among African Americans compared to whites. No statistically significant
difference in surgery outcome was present when adjusted by surgical severity
and neighborhood quality. The socioenvironmental factors affect the
preoperative clinical condition of children and their surgical outcomes.
