Areas with less access to healthy foods have higher obesity-related cancer mortality rates
Click Here to Manage Email Alerts
Key takeaways:
- Counties with high obesity-related cancer mortality rates also had higher rates of poverty and adult diabetes.
- Researchers recommended leaders work to implement sustainable approaches to healthy food access.
Obesity-related cancer mortality rates tended to be higher in counties with limited access to grocery stores or greater access to fast food, according to data published in JAMA Oncology.
“Our results indicate that food swamps may be a more comprehensive and novel indicator of the typical U.S. food environment compared with food deserts because the counties with the fewest healthy food resources had the highest odds of obesity-related cancer mortality,” Malcolm Seth Bevel, PhD, MSPH, assistant professor of medicine at Augusta University, and researchers wrote.
Background and methodology
Approximately 40% of cancers within the United States are considered obesity-related.
Studies have shown consumption of healthy food can reduce obesity-related cancer mortality; however, these foods may be less accessible to individuals residing in areas with limited access to grocery stores (food deserts) or higher access to fast food (food swamps).
Researchers conducted a cross-sectional ecologic study utilizing 5 years of U.S. Department of Agriculture Food Environment Atlas data and CDC mortality data from 2010 to 2020 to analyze the potential association of food deserts and food swamps with obesity-related cancer mortality.
The study included 3,038 counties or county equivalents with complete food environment scores and obesity-related cancer mortality data. An age-adjusted regression model evaluated the association of food desert and food swamp scores with obesity-related cancer mortality rates.
Researchers calculated food swamp scores as ratio of fast-food and convenience stores to grocery stores and farmers markets. Food deserts consisted of counties with both low income and low grocery-store access. Higher food swamp and food desert scores (20 to greater than 58) determined if a county had limited healthy food resources.
High obesity-related cancer rates included scores equal to or greater than 71.8 per 100,000 persons per county, whereas low obesity-related cancer rates included scores lower than 71.8 per 100,000 persons per county.
Researchers analyzed data from Sept. 9 to Sept. 30.
Results, next steps
Counties or county equivalents with high vs. low obesity-related cancer mortality rates had higher percentages of non-Hispanic Black residents (3.26% vs. 1.77%) and residents aged older than 65 years (15.71% vs. 15.4%), as well as higher rates of poverty (19% vs. 14.4%), adult obesity (33% vs. 32.1%) and adult diabetes (12.5% vs. 10.7%).
In addition, counties or county equivalents with high food swamp scores had 77% higher odds of having high obesity-related cancer mortality rates (adjusted OR = 1.77; 95% CI, 1.43-2.19).
Policy makers, funding agencies and community stakeholders should look to address the growth of fast-food restaurants and their effect on public health, according to researchers, who noted that additional studies are needed to further evaluate connections between such foods and cancer-related health.
“Food swamps appear to be a growing epidemic across the U.S., likely because of systemic issues, and should draw concern and conversation from local and state officials,” researchers wrote. “Future studies should analyze the potential mediating association of obesity and specific social determinants of health with unhealthy food environments and cancer outcomes via group-level (census tract or neighborhood-level areas) and individual-level data to provide a thorough illustration regarding specific social determinants of health and cancer.”
In a commentary accompanying the study, Karriem S. Watson, DHSc, MS, MPH, chief engagement officer of NIH’s All of Us research program, and Angela Odoms-Young, PhD, associate professor of maternal and child nutrition in the division of nutritional sciences at Cornell University’s College of Human Ecology, wrote that such research shows the importance of taking into account a patient’s geographic surroundings when diagnosing and/or treating a potentially obesity-related cancer.
“We are at the cutting edge in cancer research where there is growing acknowledgment that one’s ZIP code and neighborhood may have just as much of an association with health outcomes as one’s DNA,” they wrote.
Additional studies may provide even further insight into the effect of food inequity on obesity-related cancer mortality, Watson and Odoms-Young wrote.
“Whether dealing with the lack of access to healthy foods or an overabundance of unhealthy food, there is a critical need to develop additional research that explores the associations between obesity-related cancer mortality and food inequities,” they added.
References:
- Bevel MS, et al. JAMA Oncol. 2023;doi:10.1001/jamaoncol.2023.0634.
- Watson KS, et al. JAMA Oncol. 2023;doi:10.1001/jamaoncol.2023.0593.
Collapse
Bevel MS, et al. JAMA Oncol. 2023;doi:10.1001/jamaoncol.2023.0634.
Read more about
Click Here to Manage Email Alerts