Perceived Inadequate Neighborhood Food Shopping and Cardiovascular Disease Risk: The Multi-Ethnic Study of...

Individuals with access to healthy food have healthier diets, improved cardiometabolic risk profiles, and decreased cardiovascular disease (CVD). However, previous studies have focused on the neighborhood food environment as distance to and density of food retailers. Our study examines the association between an individual's perceived adequacy of neighborhood food shopping and incident CVD.

We analyzed data from 6814 participants in the MESA (Multi-Ethnic Study of Atherosclerosis), a prospective cohort study of individuals aged 45 to 84 who were enrolled in the study between 2000 and 2002 and followed longitudinally. Cox proportional hazards models estimated hazard ratios (HRs) for incident CVD, adjusting for sociodemographic, behavioral, and cardiovascular risk factor covariates.

Approximately 20% of participants reported inadequate neighborhood food shopping, with higher prevalence among Black and Hispanic participants, lower income, or educational level of high school or less. In fully adjusted models, perceived inadequate neighborhood food shopping was associated with a 21% increased risk of incident CVD (HR, 1.21 [95% CI, 1.04-1.41]; P=0.013). The CVD incidence rate per 100 person-years was higher in the inadequate neighborhood food shopping group (1.39 versus 1.19).

In this large, diverse, prospective cohort study, the perceived inadequacy of neighborhood food shopping was associated with a significantly higher risk of incident CVD. These findings add to growing evidence that the neighborhood food environment plays a critical role in shaping cardiovascular health. Future research should evaluate the impact of neighborhood-level interventions and policies on cardiovascular outcomes.