A healthier food environment is associated with lower HF mortality, according to a study published in Circulation: Heart Failure. Keerthi T. Gondi, MD, and colleagues examined the contribution of food environment to HF mortality. HF mortality rates and two county food environment indices (food insecurity percentage [FI%] and food environment index [FEI], which incorporates FI% and access to healthy food) were obtained. In 2,956 counties, the mean county FI% was 13% and the FEI was 7.8. The HF mortality rate was significantly higher for counties with FI% above versus below the national median (30.7 vs 26.7 per 100,000). Higher FI%, lower FEI, lower grocery store density, poorer access to stores among older adults, and lower Supplemental Nutrition Assistance Program participation rates were seen for counties with HF mortality rates above the national median. After adjustment, lower county FI% and higher county FEI were significantly associated with lower HF mortality. This association was stronger for HF mortality than for non-HF cardiovascular disease and all-cause mortality rates. Counties with the highest income inequity and poverty rates had a stronger relationship between food environment and HF mortality rate.
