Food insecurity—defined as inconsistent or insufficient access to nutritious food—has emerged as a critical risk factor for cardiovascular disease (CVD) and mortality. Recent research highlights a troubling bidirectional relationship: while food insecurity increases the likelihood of developing CVD, having CVD can also raise the risk of food insecurity due to medical costs, reduced work capacity, and other socioeconomic burdens. This cycle disproportionately affects vulnerable populations, particularly women and racially or ethnically minoritized groups, exacerbating existing health disparities. Given these findings, experts emphasize the urgent need for healthcare systems to integrate food insecurity screening and policy interventions into routine care.
The Link Between Food Insecurity and Cardiovascular Mortality
A study published in the Journal of the American Heart Association found that individuals experiencing very low food security had a 1.32 times higher risk of all-cause mortality and a 1.53 times higher risk of cardiovascular mortality compared to food-secure individuals. These associations remained significant even after adjusting for socioeconomic and lifestyle factors.
Similarly, data from JAMA Cardiology show that the prevalence of food insecurity among patients with CVD has more than doubled over two decades, rising from 16.3% in 1999 to 38% in 2018. Poor diet quality, heightened stress levels, and reduced adherence to prescribed medications—common challenges among food-insecure individuals—compound their cardiovascular risk.
Notably, this relationship is bidirectional. Individuals with CVD are more than twice as likely to experience food insecurity compared to those without the condition. The financial burden of managing chronic heart disease, coupled with social determinants such as limited transportation and healthcare access, can further restrict access to healthy food, creating a cycle that worsens health outcomes.
Disparities in Cardiovascular Health: A Gendered and Racial Lens
The impact of food insecurity on cardiovascular health is not distributed equally. Women—particularly those from racially and ethnically minoritized communities—are at higher risk of both food insecurity and poor cardiovascular outcomes. Research in Frontiers in Global Women’s Health highlights how structural inequities, including food deserts and systemic racism, contribute to these disparities.
Pregnant women face unique risks, as food insecurity during pregnancy is linked to worse cardiometabolic health, lower birth weights, and higher rates of preterm birth. One study found that Black and Hispanic pregnant women were more likely to experience food insecurity compared to their white counterparts, potentially worsening maternal and fetal health outcomes.
Addressing Food Insecurity in Clinical and Policy Settings
With growing evidence linking food insecurity to CVD, healthcare professionals are urged to take an active role in addressing this issue. Screening for food insecurity during patient visits—especially for those with existing cardiovascular risk factors—could allow for earlier intervention. Team-based approaches that include social workers, case managers, and community resource specialists can help connect patients to food assistance programs.
On a broader scale, policy-level solutions are needed. Programs such as the Supplemental Nutrition Assistance Program (SNAP), the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), and community-based food interventions have the potential to mitigate food insecurity’s impact on cardiovascular health. Experts emphasize that expanding these programs and integrating nutrition support into healthcare systems could be key to reducing disparities and improving long-term outcomes.