Food Deserts and Risk for Rehospitalization in Heart Failure Patients

Introduction Rehospitalization represents a financial burden on the healthcare system, estimated to be 17.4 billion dollars amongst Medicare recipients in 2004. The leading diagnosis for thirty day readmissions is for patients with congestive heart failure. Living in a socioeconomically disadvantaged neighborhood has been independently linked to increased rates of rehospitalization, with equivalent risk to having a diagnosis of chronic obstructive pulmonary disease. Lack of access to fresh fruits and vegetables in low-income areas, so called food deserts, has been linked to higher obesity rates, a risk factor for the development of congestive heart failure. While sodium restriction remains a recommendation in the ACC/AHA guidelines for the management of heart failure, data is inconsistent regarding the role of diet in symptomatic control. We hypothesized that distance to fresh produce and proximity to fast food may increase rate of admission for heart failure. Methods We created a dataset of all patients with an admission or discharge diagnosis of systolic heart failure from December 1st, 2010 to December 1st, 2015 at the University of Illinois Hospital. These patients were confirmed by chart review to have a left ventricular ejection fraction Results and Conclusions Patients were stratified by number of admissions, either having one or more than one admission. Patients with multiple admissions were found to have a grocery store closer to their home address (p=0.023) as well as more stores in a 5 mile radius (p=0.012) than patients with only one admission. Patients with multiple admissions were also found to have a significantly higher number of fast food restaurants in a 5 mile radius when compared to patients with only one admission (p=0.014). Availability of low sodium foods may be only a small factor in heart failure patient's dietary choices as patients with multiple admissions had more grocery stores within 5 miles and were closer to a grocery store. Patients with multiple admissions had significantly more fast food restaurants closer to their home, suggesting that taste preference, price and convenience play a significant factor in patient's dietary choices. It should also be mentioned that patients in all groups had more than twice the number of fast food restaurants near their home than grocery stores.