For every 1% increase in food insecurity, cardiovascular deaths go up by 0.86% for adults ages 20 to 64 based on 2011-2017 county-level data.


 By Hannah Nelson

 – Food insecurity is linked to a higher rate of cardiovascular death for adults between the ages of 20 and 64, according to a preliminary study that analyzed county-level data from 2011 to 2017.

This comes as medical professionals increasingly recognize the importance of the social determinants of health, which include issues like food insecurity. This finding gives providers stronger basis for referring patients to food programs to mitigate downstream health consequences, like cardiovascular disease.

Researchers used data from the National Center for Health Statistics and Feeding America’s “Map the Meal Gap” study to analyze the average annual percent change in food insecurity and cardiovascular mortality trends in the US.

Counties that had the largest increase in food insecurity levels had cardiovascular death rates that increased from 82 to 87 per 100,000 people. On the other hand, counties that saw a decrease in food insecurity over the six years had a cardiovascular mortality rate that remained stable at 60 per 100,000 people.

“Our study is one of the first national analyses to look at changes in both food insecurity and cardiovascular mortality over time, and to see if changes in food insecurity impact cardiovascular health,” said study co-author Sameed Khatana, MD, MPH, instructor of cardiovascular medicine at the University of Pennsylvania’s Perelman School of Medicine.

About 10 percent of adults in the US are considered food insecure, meaning they lack immediate access to healthy, fresh, affordable food in their communities. For every one percent increase in food insecurity, there was a similar increase in the rate of cardiovascular mortality among non-elderly adults (0.83 percent).

Those suffering from food insecurity deal with the stress of not knowing where their next meal will come from or when they will get it, which may cause an adverse effect on cardiovascular health.

“This research shows food insecurity, which is a particular type of economic distress, is associated with cardiovascular disease,” said Khatana. “It illustrates that cardiovascular health is tied to many things. It’s more than doctors’ visits, screenings, medications, and procedures; what is going on outside the clinic, in society, has a significant impact on patients’ health, too.”

The researchers assessed the relationship between food insecurity and cardiovascular deaths after adjusting for variables that included changes in employment, poverty, demographics, income, health insurance, and other various factors that are already known to affect cardiovascular risk.

Mercedes R. Carnethon PhD, FAHA, a member of the American Heart Association’s Council on Epidemiology and Prevention Leadership Committee, said the analysis is comprehensive with some concerning trends.

“We know food insecurity and other social determinants of health can adversely impact heart and stroke risk factors like high blood pressure and diabetes, and this impact is disproportionately higher among traditionally underrepresented racial and ethnic groups,” said Carnethon, the vice chair of the Department of Preventive Medicine at Northwestern University’s Feinberg School of Medicine and the Mary Harris Thompson Professor.

“Social determinants of health are likely to worsen against the backdrop of the COVID-19 pandemic. The effects will extend beyond this period of time and lead to future elevations in cardiovascular diseases among vulnerable populations. Unfortunately, the outlook is not favorable, and major societal infrastructure changes are necessary to improve this situation,” Carnethon continued.

While the country’s overall rate of food insecurity decreased from 14.7 percent to 13.3 percent between 2011 and 2017, Khatana noted that growing disparities show that certain parts of the country are being left behind.

“When policy makers are thinking about the cardiovascular health of communities, they need to consider things like food insecurity, as well as the overall social and economic well-being of the community,” Khatana said. “Interventions that improve the economic well-being of a community could lead to improvements in cardiovascular health of the people living there.”

The authors of the study intend to research whether efforts that would improve food insecurity could lead to lower rates of cardiovascular mortality.


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