Income, Not Food Desert, Major Driver of Higher Cardiovascular Risk

Individual income status, hence capacity to afford healthy food, and area income are the major drivers of the higher risk of cardiovascular disease seen in people living in food deserts, according to a study published Sept. 13 in Circulation: Cardiovascular Quality and Outcomes.

Using data from 1,421 participants from both the META-Health and the Predictive Health studies conducted in metropolitan Atlanta, GA, Heval M. Kelli, MD, et al., examined the impact of living in food deserts, neighborhoods defined as low income with less access to healthy food. Investigators examined demographic data, metabolic profiles, high-sensitivity C-reactive protein (hs-CRP) levels, oxidative stress markers and arterial stiffness. Mean age was 49.4 years, 38.5 percent were men and 36.6 percent were black. Annual household income in 11.2 percent was less than $25,000, and 47.9 percent had an income less than $75,000.

Results showed that participants living in food deserts (n = 187; 13.2 percent), compared with those who did not, more often were black (52 percent vs. 34 percent) with less college education and lower income levels. Their cardiovascular risk profile was more unfavorable, with a higher prevalence of hypertension and smoking, higher levels of body mass index and fasting glucose, and a higher atherosclerotic cardiovascular disease score (p = 0.007).

Systemic oxidative stress, inflammation and arterial stiffness were also found to be increased in participants living in food deserts.

In a multivariate analysis including food access, area income and individual income, both low-income area and low individual household income were independent predictors of a higher 10-year risk for cardiovascular disease. Only low individual income was an independent predictor of higher hs-CRP and augmentation index.

“The present study is the first to report the relationship between living in a food desert, cardiovascular risk factors and subclinical vascular disease,” the study authors write. “This understanding may help to better tailor resources to affected communities and improve utilization of public health resources.”


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