Developing an index to estimate the association between the food environment and CVD mortality rates.

The food environment has been shown to influence dietary patterns, which ultimately affects nutrition-related diseases such as diabetes, obesity, and cardiovascular disease (CVD). Measures of food accessibility and socioeconomics were combined to develop the Food Environment Index (FEI), characterizing all U.S. counties between 2008 and 2016. Multi-level regression models showed that this index is significantly negatively associated with CVD death rates across the two time periods studied (2008-2010 and 2013-2016). The FEI may be a useful proxy for identifying differences in the food environment to inform future interventions.