Relation of Living in a “Food Desert” to Recurrent Hospitalizations in Patients With Heart Failure

Abstract

Food deserts (FD), low-income areas with low-access to healthful foods, are associated with higher burden of cardiovascular risk factors. Few studies have examined the impact of FD on clinical outcomes in heart failure (HF). FD status was assessed in 457 HF patients (mean age 55.9 ± 12.5 years; 50.3% Black) using the Food Desert Research Atlas. The Andersen-Gill extension of Cox model was used to examine the association of living in a FD with risk of repeat hospitalization (all-cause and HF-specific). Patients living in a FD were younger (P=0.01), more likely to be Black (P<0.0001), less educated (P=0.003), and less likely to have commercial insurance (P=0.003). During a median follow-up of 827 (506, 1379) days, death occurred in 60 (13.1%) subjects, and hospitalizations occurred in 262 (57.3%) subjects. There was no difference in the risk of death based on FD status. The overall frequency of all-cause (94.1 vs. 63.6 per 100 patient-years) and HF-specific (59.6 vs. 30.5 per 100 patient-years) hospitalizations was higher in subjects who lived in a FD. After adjustment for covariates, living in a FD was associated with an increased risk of repeat all-cause (hazard ratio [HR] 1.39, 95% confidence interval [Cl] 1.19-1.63; P=0.03) and HF-specific (HR 1.30, 95% Cl 1.02-1.65; P=0.03) hospitalizations. In conclusion, patients living in a FD have a higher risk of repeat all-cause and HF-specific hospitalization.

Disparities in access to food and chronic obstructive pulmonary disease (COPD)-related outcomes: a cross-sectional analysis

“…There is increasing recognition that the neighborhood environment can impact chronic disease risk and outcomes [ 37 – 39 ]. In fact, studies have shown that living in food deserts has been associated with adverse outcomes focusing on obesity, diabetes and heart diseases [ 19 – 22 , 40 , 41 ]. In this current study, we show that living in a food desert area is also associated with several worse COPD outcomes, including lower lung function, higher odds of COPD exacerbations, and worse quality of life and CT evidence of gas trapping, even after adjusting for smoking status and individual income.…”

The Socioeconomic Determinants of Health and Their Impact on African American Healthcare Delivery

“…This is where 23.5 million people reside in the United States, including large numbers of blacks and other minorities [15]. If we examine the relationship between living in a food desert and heart failure, which results in over one million hospitalizations a year at a cost to the nation of $15 billion dollars per year [16], we find that there is documentation of such an association, with a very high risk of hospitalization and increased mortality being found in FD areas [17]. This vividly demonstrates the impact that environmental and neighborhood factors such as the absence of grocery stores and food markets and the presence of liquor stores and fast-food restaurants can have on the health of residents in these areas.…”

Introducing an innovative design to examine human-environment dynamics of food deserts responding to COVID-19

“…The disparities in diet and diet-related health outcomes between food desert and non-food desert communities (including the disparities in prevalence of chronic diseases) have been a subject of significant research (Abeykoon, Engler-Stringer, & Muhajarine, 2017;Hanson et al, 2018;Morris et al, 2019;Testa, 2019). Multiple studies ask questions about the effectiveness of the policy interventions aiming to improve the access to healthy, affordable food for the people living in and around food desert areas (Freedman et al, 2016;Hsiao et al, 2019;Smith, Miles-Richardson, Dill, & Archie-Booker, 2013).…”