Rising Food Insecurity Connected to Higher Cardiovascular Mortality, Study Finds

For years, researchers have studied the effects of food insecurity on certain important health outcomes. When adults don’t have access to reliable and healthy food options, they may experience nutrition deficiencies, mental health problems, diabetes, oral health problems, and more. Now, researchers have found a link between food insecurity and cardiovascular health.

In the new, large-scale study, researchers found that in counties where food insecurity increased between 2011 and 2017, there was an associated increase in cardiovascular death rates for adults ages 20 to 64. The study was presented at the American Heart Association’s Scientific Sessions 2020 and is published in the journal Circulation: Cardiovascular Quality and Outcomes.

According to the U.S. Department of Agriculture, 13.7 million Americans were estimated to be food insecure in 2019. Though that figure represents a decline from 2018, some experts expect that more people will experience food insecurity due to the effects of the COVID-19 pandemic. Feeding America predicts that the proportion of food insecure Americans will increase to 15.6% in 2020, up from 10.5% in 2019.

Experts say being mindful of the ways such shifts in food insecurity rates impact certain components of people’s health may be helpful when addressing cardiovascular issues in medical settings.

“I think it’s important for healthcare providers to know that a lot of what is happening to our patients and to our health is beyond what’s happening in a clinic,” Sameed Khatana, MD, MPH, a cardiologist and instructor of cardiovascular medicine at the University of Pennsylvania, and a co-author of the study, tells Verywell. “It’s what’s happening in communities and in the broader economy. Interventions that are going to address those things are probably going to be as important as what we do in the clinic in terms of impacting patients’ health.”

Rising Cardiovascular Disease Rates

To conduct the study, researchers used publicly available data from the National Center for Health Statistics and the Map the Meal Gap project. Because of the unreliability of data for older adults, they limited the analysis to 20 to 64-year-olds. They divided the counties into four groups based on how great the change in food insecurity was in those places between 2011 and 2017.

They found that in the counties in the lowest quartile, where food insecurity changed only slightly or not at all, there was no significant change in cardiovascular-related deaths. For the counties in which food insecurity increased the most, the cardiovascular mortality rate increased from 82 to 87 per 100,000 people. For every 1% increase in food insecurity, there was a 0.83% in cardiovascular mortality.

Although Khatana says the researchers noticed significant differences in the demographics and economic factors of different sets of counties, their model held those factors constant in order to see the direct link between food insecurity and cardiovascular mortality.

He noted in the U.S., the rate of death from heart disease has declined over the last several decades. But in the past 10 to 15 years, that downward trend has started to flatten, and some places are seeing an increase in cardiovascular-related deaths. To better understand this trend, the researchers set out to see if there was a linkage between cardiovascular mortality and food insecurity.

How Food Insecurity Affects Cardiovascular Health

Khatana says more studies will need to be done to determine the reasons for which food insecurity affects cardiovascular health. Previous studies show that people’s level of food insecurity is associated with the development of long-term cardiovascular diseases like diabetes and high blood pressure. Socio-economic status is associated with health outcomes like inflammation and higher levels of stress.

Although poverty and food insecurity are not the same, the impact of socioeconomic pressures on one’s health may be similar to those of food insecurity. Additionally, if a person experiencing food insecurity has a cardiovascular disease, they may not prioritize their medication over fulfilling their food needs.

“You can imagine that if individuals or a household can’t afford the food they need on a regular basis, they might cut back on buying medications they are prescribed,” Khatana says.

With unemployment rates reaching record highs this year, there is an increased risk of food insecurity and the negative health outcomes that are associated with it. Feeding America, an organization that works to combat hunger in the U.S. says many people that experience food insecurity do not qualify for federal nutrition programs like SNAP. These people may need to rely on food banks to access necessary food supplies. 

While the primary objective should be immediately increasing access to healthy, reliable, and affordable food sources, Khatana says the long-term health effects of a life without food security need also be confronted.

“Likely the association between food insecurity and cardiovascular health in 2020 is going to be a long-term issue," he says. "I think what this highlights is yes, immediately policymakers and healthcare providers need to make sure that individuals who are food insecure get the resources they need. But it is useful to know that the impacts could be long-lasting and potentially there could be an impact on chronic diseases—like heart disease—for years to come.”