Cardiovascular Disease and the Built Environment
August 4, 2021
Cardiovascular disease (CVD), is a leading cause of mortality in the United States. Recent prevention efforts have focused on the association of the built environment and modifiable risk factors for cardiovascular health. Policies that shape the built environment, including the physical surroundings where people live, work and access food, has the potential to impact health-related behaviors. Exploring the impact of the built environment by examining healthy food store availability and socioeconomic status can better inform health policies that target increasing or preserving access to healthy food stores.
In health policy-relevant research led by Gina Lovasi, PhD, MPH, Urban Health Collaborative (UHC) Co-Director and Dornsife Associate Professor of Urban Health, the team investigated the association of the presence of healthy food retail (supermarkets and produce markets in geographic areas) and cardiovascular mortality and all-cause mortality across the continental US. Although food deserts have been associated with CVD outcomes, prior research has not distinguished adequately between the built environment features of food deserts and the socioeconomic conditions present in food deserts. This research linked data from 2,753, 000 individuals from a nationally representative health survey with food retail data from across the continental US.
The hypothesized protective effects of access to healthy food retail on cardiovascular death was not supported in analyses. Presence of unhealthy food retail (e.g. fast food restaurants) was associated with increased all-cause mortality, but had no association with cardiovascular death. This research provides support for the notion that the impact of food deserts on CVD reflect the socioeconomic conditions in the geographic area, rather than the lack of accessibility to healthy food retail. This suggests that policy efforts to combat CVD that solely focus on increasing or preserving healthy food store access are likely missing the foundational cause. More research and efforts are needed to address the economic and racial factors that impact disparities in preventable diseases such as CVD.