Food insecurity among Americans with cardiovascular disease has skyrocketed over the past 20 years

According to a national study, the number of food-insecure Americans with cardiovascular disease — with limited or uncertain access to adequate food — has exploded over the past 20 years.

A Michigan medicine team analyzed National Health and Nutrition Examination Survey data representing 312 million American adults between 1999 and 2018, finding that 38% of people with cardiovascular disease were food insecure in 2017-2018. This number has more than doubled compared to two decades earlier, when the food insecurity rate was 16.3%. The findings are published in JAMA Cardiology.

Food insecurity is a common problem for people with cardiovascular disease, and we find that this problem has become even more prevalent in recent years. »

Eric J. Brandt, MD, MHS, FACC, lead study author and cardiologist, University of Michigan Health Frankel Cardiovascular Center

“We think there’s a two-way relationship here. People who are food insecure may have an increased risk of cardiovascular disease, and vice versa. When someone gets heart disease, it impacts their risk of developing socio-economic problems that could reduce access to adequate services and Food insecurity can often occur together with other social determinants of health, such as access to transportation or access to care of health, which further aggravates this relationship.

In the overall population, black and Hispanic adults were more likely to report food insecurity. As of 2011, 24% of Hispanic adults and 18% of black adults were food insecure, compared to 8% of Asian adults and 13% of white adults.

The researchers conclude that cardiovascular disease is associated with a higher risk of food insecurity. These adults were more than twice as likely to be food insecure as those without cardiovascular disease.

“Food insecurity has the potential to exacerbate existing racial and ethnic health disparities,” Brandt said. “But there is also a public awareness here that differences in cardiovascular outcomes between races and ethnicities are not related to an individual’s racial or ethnic origin, but rather to the social experience of an individual. In this broader perspective, having had a cardiovascular event could have a major impact on a person’s social status that places them at risk for food insecurity and other socioeconomic hardship.”

Cardiovascular disease remains the leading cause of death in the United States, and diet is the leading cause of death from these diseases – accounting for more than 400,000 deaths in 2016, according to The US Burden of Disease Collaborators.

People with food insecurity are more likely to bear a greater burden of diet-related cardiovascular disease. They are also more likely to be stressed and not take prescription medications to treat cardiometabolic risk factors, such as diabetes and high blood pressure.

As food insecurity remains a strong social determinant of health, the researchers say it is important for clinicians and health systems to use validated screening techniques to detect food insecurity in patients.

“Healthcare providers can impact the overall health and well-being of their patients by addressing food insecurity,” said co-author Tammy Chang, MD, MPH, MS, MD family at UM Health and co-director of the National Clinician Scholars Program at UM. Institute for Health Care Policy and Innovation.

“More patients than you might think are affected by food insecurity. A team approach including social workers, case managers, and social services can help patients connect with local resources. If we really want to promote health, health care providers need to make sure people have access to healthy food and don’t go hungry.”


Michigan Medicine – University of Michigan

Journal reference:

Brandt, E.J. et al. (2022) Food insecurity among people with cardiovascular disease and cardiometabolic risk factors by race/ethnicity from 1999 to 2018. JAMA Cardiology.

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