ArticleBMJ open2021
Healthy food retail availability and cardiovascular mortality in the United States: a cohort study.
Article in BMJ open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The Association between Community Food Environments and Health Outcomes in High-Income Countries: A Systematic Literature Review.Current nutrition reports · 2025Pooled it
- Association between the food environment and the risk of ischemic stroke.American journal of preventive medicine · 2026Article
- Food environment and cardiovascular kidney metabolic diseases mortality.NPJ science of food · 2026Article
- Built Environment and Cardiovascular Diseases - Insights from a Global Review.Current atherosclerosis reports · 2025Review
- Time-varying exposure to food retailers and cardiovascular disease hospitalization and mortality in the netherlands: a nationwide prospective cohort study.BMC medicine · 2024Article
- Racial/Ethnic Residential Segregation, Neighborhood Health Care Provision, and Choice of Pediatric Health Care Provider Across the USA.Journal of racial and ethnic health disparities · 2024Article
- Associations of neighbourhood food retail with disability and death in older adults: Cardiovascular Health Study.BMJ nutrition, prevention & health · 2024Article
- Article
- Time-Varying Food Retail and Incident Disease in the Cardiovascular Health Study.American journal of preventive medicine · 2023Article
- Concepts, Characterizations, and Cautions: A Public Health Guide and Glossary for Planning Food Environment Measurement.The open public health journal · 2023Article
- Risk Factors for Heart Disease in Working Railwaymen.American journal of men's healthArticle
Corrections and comments
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Authors and funding
10 authors.
Funding
Abstract
objectivesWe investigated the association of healthy food retail presence and cardiovascular mortality, controlling for sociodemographic characteristics. This association could inform efforts to preserve or increase local supermarkets or produce market availability.
designCohort study, combining Mortality Disparities in American Communities (individual-level data from 2008 American Community Survey linked to National Death Index records from 2008 to 2015) and retail establishment data.
settingAcross the continental US area-based sociodemographic and retail characteristics were linked to residential location by ZIP code tabulation area (ZCTA). Sensitivity analyses used census tracts instead, restricted to urbanicity or county-based strata, or accounted for non-independence using frailty models.
participants2 753 000 individuals age 25+ living in households with full kitchen facilities, excluding group quarters. PRIMARY AND SECONDARY OUTCOME MEASURES: Cardiovascular mortality (primary) and all-cause mortality (secondary).
results82% had healthy food retail (supermarket, produce market) within their ZCTA. Density of such retail was correlated with density of unhealthy food sources (eg, fast food, convenience store). Healthy food retail presence was not associated with reduced cardiovascular (HR: 1.03; 95% CI 1.00 to 1.07) or all-cause mortality (HR: 1.05; 95% CI 1.04 to 1.06) in fully adjusted models (with adjustment for gender, age, marital status, nativity, Black race, Hispanic ethnicity, educational attainment, income, median household income, population density, walkable destination density). The null finding for cardiovascular mortality was consistent across adjustment strategies including minimally adjusted models (individual demographics only), sensitivity analyses related to setting, and across gender or household type strata. However, unhealthy food retail presence was associated with elevated all-cause mortality (HR: 1.15; 95% CI 1.11 to 1.20).
conclusionsIn this study using food establishment locations within administrative areas across the USA, the hypothesised association of healthy food retail availability with reduced cardiovascular mortality was not supported; an association of unhealthy food retail presence with higher mortality was not specific to cardiovascular causes.
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