(P12-51-26) Neighborhood Food Access and Tract-Level Cardiometabolic Disease Prevalence in the United States: A Cross-Sectional Analysis Using CDC PLACES Data

Saturday, July 25, 2026

11:30 AM - 12:30 PM ET

Location: Poster Board C-100

Presenting Author(s)

HZ

Hanyuan Zheng, MSPH (she/her/hers)

Graduate Research Assistant
Center for Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health
Baltimore, Maryland, United States
HZ

Hanyuan Zheng, MSPH (she/her/hers)

Graduate Research Assistant
Center for Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health
Baltimore, Maryland, United States

Co-Author(s)

RR

Rajesh K. Rai

Institute of Nutrition, Mahidol University, United States
RR

Rajesh K. Rai

Institute of Nutrition, Mahidol University, United States
JG

Joel Gittelsohn, PhD, MS

Professor
Johns Hopkins Bloomberg School of Public Health
Baltimore, Maryland, United States
JG

Joel Gittelsohn, PhD, MS

Professor
Johns Hopkins Bloomberg School of Public Health
Baltimore, Maryland, United States
Sabri Bromage, ScD

Researcher
Institute of Nutrition, Mahidol University
Bangkok, Krung Thep, Thailand
Sabri Bromage, ScD

Researcher
Institute of Nutrition, Mahidol University
Bangkok, Krung Thep, Thailand
MM

Mika Matsuzaki, PhD

Johns Hopkins Bloomberg School of Public Health
Baltimore, Maryland, United States
MM

Mika Matsuzaki, PhD

Johns Hopkins Bloomberg School of Public Health
Baltimore, Maryland, United States

Disclosure(s):

Hanyuan Zheng, MSPH: No relevant financial relationship(s) with ineligible companies to disclose.

Sabri Bromage, ScD: No relevant financial relationship(s) with ineligible companies to disclose.

Objectives: To examine the geographic distribution of neighborhood food access and its association with prevalence of multiple cardiometabolic conditions across U.S. census tracts, and to assess whether associations differ by urbanicity.

Methods: This cross-sectional study used census tract-level data from two national sources. Prevalences of cardiometabolic conditions including coronary heart disease, high blood pressure, diabetes, high cholesterol, and obesity were obtained from the CDC PLACES 2020 release. Neighborhood food access and sociodemographic data were obtained from the USDA Food Access Research Atlas 2019 release. Neighborhood food access was quantified using a Food Access Index (FAI), a tract-level indicator derived from the proportion of residents with low supermarket access. Higher FAI values indicate better neighborhood food access. Multivariable linear regression models estimated the associations between FAI quartiles and prevalence of each outcome, adjusting for demographic and socioeconomic characteristics. Stratified analyses were conducted to assess effect modification by urbanicity.

Results: The analytic sample included 52,042 US census tracts. The median FAI was 45.0 (IQR: 6.2, 82.1), and 66.9% of tracts were urban. Higher neighborhood food access was inversely associated with all outcomes. Compared with the lowest access quartile (Q1), tracts in the highest access quartile (Q4) had lower adjusted prevalence of coronary heart disease (β = -0.30; 95% CI: -0.33, -0.26), high blood pressure (β = -1.37; 95% CI: -1.49, -1.26), diabetes (β = -0.72; 95% CI: -0.78, -0.66), high cholesterol (β = -0.87; 95% CI: -0.96, -0.78), and obesity (β = -1.13; 95% CI: -1.24, -1.01). All associations were statistically significant (p < 0.001). Sensitivity analyses using an alternative food access definition yielded consistent results. Stratified analyses indicated stronger inverse associations in non-urban tracts; for coronary heart disease, the association comparing Q4 with Q1 was significantly greater in non-urban tracts (β = -0.47; 95% CI: -0.59, -0.35) than in urban tracts (β = -0.15; 95% CI: -0.19, -0.11).

Conclusions: Higher food access was inversely associated with cardiometabolic prevalence, particularly in non-urban areas.

Funding Sources: No external funding