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November 25, 2022
Food insecurity — lacking adequate access to nutritious foods — is linked to the risk of dying in people with heart failure, according to a new study published in the journal Circulation: Heart Failure.
Food insecurity appears to be a growing problem in the United States, including in people with cardiovascular disease such as heart failure (inability to pump blood adequately to meet the body’s needs). Sadly, one driver of food insecurity is medical debt — meaning that the health care system, in some cases, may actually be making people sicker. Food insecurity has previously been linked to several poor health outcomes, including greater diabetes-related distress, worse blood glucose control in people with diabetes, a higher risk for obesity independent of diet quality, and greater difficulty losing weight.
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For the latest study, researchers examined the relationship between food insecurity and the risk of dying from heart failure in 2,956 counties throughout the United States (the vast majority of the country’s 3,143 counties). To do this, they used data from the National Vital Statistics System and the USDA Food Environment Atlas, looking at how two different measures of food access were related to heart failure death rates — the percentage of people in each county with food insecurity, and a composite measure called the food environment index (FEI) that also took access to healthy food into account. The food environment index has a scale of 0 to 10, with 10 meaning the best access to food in general and healthy food in particular.
The average percentage of residents with food insecurity across all counties was 13%, and the average food environment index was 7.8. Compared with counties that were below the median level of food insecurity, those above the median also had a higher death rate from heart failure — 30.7 compared with 26.7 deaths per 100,000 people each year. When the researchers looked at the data from the other direction — sorting counties based on their heart failure death rate — they found that counties with a heart failure death rate above the median level tended to have a higher percentage of people with food insecurity, a lower food environment index, a lower density of grocery stores, and a lower participation rate in the Supplemental Nutrition Assistance Program (SNAP, also known as food stamps), the federal food assistance program.
After adjusting for various factors at the county level that could affect heart failure outcomes — including the makeup of residents by age, race or ethnicity, income, and health status — the researchers found that the percentage of residents with food insecurity and the food environment index were both still significantly linked to the risk of dying from heart failure. These measures of food insecurity were more closely linked to the risk of dying from heart failure than to the risk of dying from cardiovascular disease in general, or to the risk of dying from all causes. Perhaps not surprisingly, the link between food insecurity and heart failure mortality was strongest in counties that had the highest levels of poverty and income inequality.
The researchers concluded that this study reinforces the link between food insecurity and cardiovascular outcomes, demonstrating the particular vulnerability of people with heart failure. These results suggest that efforts to reduce food insecurity could play a substantial role in reducing deaths from cardiovascular disease.
Want to learn more about food insecurity and resources for affording food? Read “Six Ways to Save Money on Groceries” and “Resources for Affording Food.”
Quinn Phillips on social media
A freelance health writer and editor based in Wisconsin, Phillips has a degree from Harvard University. He is a former Editorial Assistant for Diabetes Self-Management and has years of experience covering diabetes and related health conditions. Phillips writes on a variety of topics, but is especially interested in the intersection of health and public policy.
Disclaimer of Medical Advice: Statements and opinions expressed on this Web site are those of the authors and not necessarily those of the publishers or advertisers. The information, which comes from qualified medical writers, does not constitute medical advice or recommendation of any kind, and you should not rely on any information contained in such posts or comments to replace consultations with your qualified health care professionals to meet your individual needs.
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