Faculty, Staff and Student Publications
Language
English
Publication Date
4-21-2026
Journal
Journal of the American Heart Association
DOI
10.1161/JAHA.125.045302
PMID
41960759
PMCID
PMC13279066
PubMedCentral® Posted Date
4-10-2026
PubMedCentral® Full Text Version
Post-print
Abstract
Background: 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.
Methods: 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.
Results: 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).
Conclusions: 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.
Keywords
Humans, Male, Female, Aged, Prospective Studies, Middle Aged, United States, Cardiovascular Diseases, Neighborhood Characteristics, Aged, 80 and over, Incidence, Atherosclerosis, Food Supply, Risk Factors, Residence Characteristics, Socioeconomic Disparities in Health, Risk Assessment, Diet, Healthy, Heart Disease Risk Factors, Social Determinants of Health, cardiovascular disease, food access, health disparities, neighborhood food environment, social determinants of health
Published Open-Access
yes
Recommended Citation
Haidar, Amier; Ghanem, Ghadi; Rikhi, Rishi; et al., "Perceived Inadequate Neighborhood Food Shopping and Cardiovascular Disease Risk: The Multi-Ethnic Study of Atherosclerosis" (2026). Faculty, Staff and Student Publications. 1546.
https://digitalcommons.library.tmc.edu/uthsph_docs/1546