Abstract Body (Do not enter title and authors here): Background: Food deserts - areas with limited access to affordable, nutritious foods - are increasingly recognized as contributors to adverse cardiovascular outcomes. Prior individual studies suggest that residing in a food desert is associated with elevated cardiovascular risk, but results have been inconsistent.
Objective: To quantify the association between residing in a food desert and cardiovascular mortality among U.S. adults by conducting a random-effects meta-analysis.
Methods: We systematically searched PubMed, Scopus, and Google Scholar for observational studies published between January 2018 and December 2022 that reported hazard ratios (HRs) for cardiovascular mortality or major adverse cardiovascular events (MACE) among individuals residing in food deserts or experiencing food insecurity compared to those in non–food desert or food-secure settings. Five peer-reviewed studies met inclusion criteria, encompassing diverse populations including adults with existing cardiovascular disease, peripheral artery disease, and community-based cohorts of young and middle-aged adults. Log-transformed HRs and corresponding standard errors were calculated from reported 95% confidence intervals (CIs). A DerSimonian-Laird random-effects model was used to pool logHRs, accounting for between-study heterogeneity. Heterogeneity was assessed using the I² statistic.
Results: The five studies included were Zenk et al. (2019), Leung et al. (2018), Walker et al. (2021), El-Zein et al. (2022), and Brandt et al. (2022). Individual study HRs for adverse cardiovascular outcomes ranged from 1.11 to 1.21. The pooled hazard ratio for cardiovascular mortality or MACE among food desert residents was 1.16 (95% CI: 1.12–1.20; p < 0.001), indicating a 16% higher risk than non-food desert residents. Moderate heterogeneity was observed (I² = 42%).
Conclusions: Residence in a food desert is associated with a statistically significant increase in cardiovascular mortality risk. Public health interventions should prioritize improving access to healthy foods in high-risk communities. Future research should explore mechanisms linking food accessibility to cardiovascular outcomes and evaluate interventions to mitigate risk.