Food Insecurity and Mortality From Digestive Tract Diseases in the United States

BACKGROUND AND AIMS: Food insecurity arising from insufficient access to food necessary for an active and healthy lifestyle is a prevalent yet underrecognized predictor of health that can increase the risk of chronic disorders. The impact of food insecurity on mortality rates from digestive tract diseases within the United States was analyzed. METHODS: County-level age-standardized mortality rates for digestive tract diseases, encompassing both gastrointestinal tract and liver diseases, were obtained for 2015-2020 and linked to corresponding county-level measures of food insecurity, access to stores, enrollment in food programs, and other local variables. Separate analyses were performed for cancer and for noncancer conditions. RESULTS: Mortality rates from digestive diseases were significantly higher in counties within the highest compared to those with the lowest quintile of food insecurity. These associations remained positive when assessed separately for gastrointestinal tract or liver diseases, or for cancers and noncancer diseases. Food insecurity was associated with mortality from some cancers such as primary liver and colorectal cancers, but not for others such as esophageal or gallbladder cancer. Within food-insecure regions, factors such as younger age, population size and health, health care access, and economic factors were related to higher rates. Composite measures of social vulnerability or deprivation could identify locations with higher mortality. CONCLUSION: Food insecurity has a significant and detrimental association with mortality rates from digestive tract diseases. These findings emphasize the need to address food access with targeted interventions and for research on disease-specific impacts as crucial determinants of disease-related outcomes.