Food environment and cardiovascular kidney metabolic diseases mortality.

Cardiovascular, kidney, and metabolic (CKM) diseases are leading causes of mortality in the United States (US), with geographic and socioeconomic disparities. The community food environment, including food accessibility and security, is a modifiable determinant of CKM health. We systematically examined associations between county-level multidimensional food environment indicators and CKM-related mortality across US counties. We conducted an ecological analysis integrating data from the County Health Rankings and CDC WONDER. Generalized linear models estimated rate ratios (RR) for age-adjusted CKM mortality across quartiles of the food environment index, limited access to healthy foods, and food insecurity. Adjusting for demographic and socioeconomic factors, the most favorable quartile of the food environment index was associated with reduced mortality from cardiovascular disease (RR 0.85, 95% CI 0.84-0.86), diabetes (RR 0.76, 0.73-0.79), renal failure (RR 0.73, 0.69-0.77), and overall CKM disease (RR 0.83, 0.82-0.84) compared with the least favorable quartile. Conversely, limited access to healthy foods (RR 1.11, 1.09-1.12) and food insecurity (RR 1.19, 1.18-1.21) correlated with higher overall CKM mortality. Counties with less favorable food environments are linked to higher CKM-related mortality. Improving structural food access and security may be essential for reducing disease burden and promoting health equity.