Cardiovascular health is intricately linked to the food security status of minoritized groups

In a recent study published in BMC Public Health, researchers investigated the relationship between food security and ideal cardiovascular health while addressing disparities across minoritized groups by studying a representative sample of the United States (U.S.) population balanced for race, ethnicity, and sex.

Study: Food security status and cardiometabolic health by sex/gender and race/ethnicity among adults in the United States. Image Credit: Chinnapong/Shutterstock.com

Background

Research indicates that food insecurity is unequal across the U.S. population, and various minority groups, such as specific racial or ethnic groups, as well as women, have disproportionate access to food, resulting in inequalities in cardiovascular health.

These discrepancies in nutritional substance access are generally due to resource or financial constraints. Statistics from 2020 indicate that Non-Hispanic Black households experienced 21.7% food insecurity when the overall population experienced 10.5% food insecurity.

Furthermore, households headed by single parents or women were also found to be more likely to experience food insecurity.

The increase in frequency and intensification of natural disasters due to climate change is adding to the strain on agricultural systems in meeting global food demands, and food insecurity is expected to worsen in the future.

Diets beneficial for health and the environment, such as plant-based diets, also have inequitable distributions.

Furthermore, social factors such as structural racism and policies at the state and local levels also contribute to the creation of ‘food deserts,’ which are areas without access to healthy foods.

About the study

In the present study, the researchers aimed to understand the relationship between food insecurity and achieving ideal cardiovascular health while considering the disparities in food security status based on race, ethnicity, and sex.

They hypothesized that individuals falling in the marginal, low, and very low food security categories would have the lowest prevalence of ideal cardiovascular health and that the association between food security status and ideal cardiovascular health would be the most apparent in minoritized groups as compared to Non-Hispanic White adults, who do not generally experience high food insecurity.

The researchers used data from the National Health Interview Survey from 2014 to 2018 and cross-sectional data from 2020.

The study population consisted of adults above 18 belonging to Non-Hispanic Black, Non-Hispanic White, Non-Hispanic Asian, and Hispanic groups.

Participants were included only if they had complete data on the exposure (food security status) and outcomes (ideal cardiovascular health metric), as well as confounders such as body mass index (BMI), smoking status, physical activity levels, hypertension, sleep duration, dyslipidemia, and prediabetes or type 2 diabetes status.

The Household Food Security Survey Module developed by the Department of Agriculture, a 10-item survey used to monitor the availability and consumption of various foods in a household over a month, was used to assess the food security status.

The ideal cardiovascular health metric was calculated based on three clinical factors (hypertension, dyslipidemia, and diabetes status) and four health behaviors: smoking, physical activity, sleep duration, and BMI.

The analyses also considered sociodemographic variables such as sex or gender, age groups, household income, education levels, marital status, geographic region of residence, and alcohol consumption.

Results

The results confirmed the hypothesis that food insecurity was linked to a lower prevalence of ideal cardiovascular health and that minoritized groups based on race, ethnicity, and sex did face a disproportionate burden of food insecurity.

However, the study also found that associations between food security and ideal cardiovascular health were stronger among Non-Hispanic White adults than in minoritized groups.

Additionally, when the prevalence of ideal cardiovascular health was compared across racial and ethnic groups with high food security, the minoritized groups had a lower prevalence as compared to Non-Hispanic White adults.

Women also showed associations between higher food insecurity and lower ideal cardiovascular health prevalence that were significantly stronger than those observed among men.

Among the racial and ethnic groups, adults having low or very low food security belonged more to the Non-Hispanic Black and Hispanic groups than the Non-Hispanic White and non-Hispanic Asian.

The researchers also believe that additional social determinants, such as structural racism, which goes beyond the phenotype and creates differential access to opportunities, resources, and power, are important drivers of disparities in health status across the U.S.

They also believe that while public health strategies have focused largely on individual behaviors while examining disparities in cardiovascular health status, equal attention needs to be given to factors at the community level, such as the food environment.

Public health policies that address the upstream factors that influence food availability can help reduce the inequalities in food insecurity and alleviate the health status disparities in the population,

Conclusions

Overall, the findings suggested that there is indeed a disproportionate burden of food insecurity on minoritized groups, while it is strongly linked to a lower prevalence of ideal cardiovascular health.

Public health policies and government measures need to address community-level factors that influence the social determinants of food insecurity, and not just individual behaviors, while addressing the cardiovascular health status of the population.