ArticleJournal of general internal medicine2024
Food Environment Quality and Cardiovascular Disease Mortality in the United States: a County-Level Analysis from 2017 to 2019.
Article in Journal of general internal medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed.
- Food environment and cardiovascular kidney metabolic diseases mortality.NPJ science of food · 2026Article
- Environmental Influences on Food Addiction and Cardiometabolic Profiles in Law Enforcement Officers.International journal of environmental research and public health · 2026Article
- A social determinants-based county-level cardiovascular mortality index to identify high-risk counties in the USA.BMC medicine · 2025Article
- Ethnic-Racial Disparities in Food Environments: A Systematic Review and Meta-analyses of Inequities in Food Access and Availability.Journal of racial and ethnic health disparities · 2025Review
- The role of environmental access to exercise opportunities in cardiovascular mortality: evidence from a nationwide study.BMC medicine · 2025Article
- Food Insecurity Is Associated With Current Asthma, Wheeze, and Lung Function in Children and Adults.The clinical respiratory journal · 2025Article
- Social and Environmental Determinants of Health and Cardio-Kidney-Metabolic Syndrome-Related Mortality.JAMA network open · 2024Article
- Big Data, Big Insights: Leveraging Data Analytics to Unravel Cardiovascular Exposome Complexities.Methodist DeBakey cardiovascular journal · 2024Review
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Authors and funding
6 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundUpstream socioeconomic circumstances including food insecurity and food desert are important drivers of community-level health disparities in cardiovascular mortality let alone traditional risk factors. The study assessed the association between differences in food environment quality and cardiovascular mortality in US adults.
designRetrospective analysis of the association between cardiovascular mortality among US adults aged 45 and above and food environment quality, measured as the food environment index (FEI), in 2615 US counties. FEI was measured by equal weights of food insecurity (limited access to a reliable food source) and food desert (limited access to healthy food), ranging from 0 (worst) to 10 (best). Age-adjusted cardiovascular mortality rates per 100,000 adults aged 45 and above in the calendar year 2017-2019. County-level association between CVD mortality rate and FEI was modeled using generalized linear regression. Data were weighted using county population.
resultMedian CVD deaths per 100,000 population were 645.4 (IQR 561.5, 747.0) among adults aged 45 years and above across US counties in 2017-2019. About 12.8% (IQR 10.7%, 15.1%) of residents were food insecure and 6.3% (IQR 3.6%, 9.9%) were living in food desert areas. Comparing counties by FEI quartiles, the CVD mortality rate was higher in the least healthy FE counties (704.3 vs 598.6 deaths per 100,000 population) compared to the healthiest FE counties. One unit increase in FEI was associated with - 12.95 CVD deaths/100,000 population. In the subgroup analysis of counties with higher income inequality, the healthiest food environment was associated with 46.4 lower CVD deaths/100,000 population than the least healthy food environment. One unit increase in FEI in counties with higher income inequality was associated with a fivefold decrease in CVD mortality difference in African American counties (- 18.4 deaths/100,000 population) when compared to non-African American counties (- 3.63 deaths/100,000 population).
conclusionIn this retrospective multi-county study in the USA, a higher food environment index was significantly associated with lower cardiovascular mortality.
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