ArticleHealthcare (Basel, Switzerland)2025
Food Insecurity, Walkability, and Social Determinants of Health: A Cross-Sectional, County-Level Study of Associations with Maternal and Infant Mortality in the United States.
Article in Healthcare (Basel, Switzerland), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundCompared to other high-income countries, US women face higher maternal and infant mortality rates.
methodsThis study used structural equation modeling (SEM) to examine cross-sectional, county-level associations between structural and intermediary social determinants of health (SDOHs) and maternal and infant mortalities, based on the World Health Organization's Commission on Social Determinants of Health framework.
resultsOur findings suggest maternal mortality may be linked to increased food insecurity, food assistance, distance to obstetric care, and decreased walkability and marriage rates. Our modeling also points toward a connection between infant mortality and increased food insecurity, food assistance, Black race, mental distress, and decreased walkability, education, and income. SEM revealed significant direct and indirect effects of these SDOHs. Notably, food insecurity and walkability had direct associations with both maternal and infant mortality in both SEM models.
conclusionsThe findings underscore the need for policy, practice, and research efforts to address key SDOHs and reduce mortality disparities in the US.
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