Food Deserts and Swamps Linked to Higher MASLD Mortality, Study Finds
A new national analysis has found that food environment disparities—specifically food deserts and food swamps—are significantly associated with higher mortality from metabolic dysfunction–associated steatotic liver disease (MASLD) in the United States.
Researchers analyzed MASLD-related deaths from 2016 to 2020 using data from the National Vital Statistics System and correlated those figures with food environment metrics from the Food Environment Atlas. Food deserts refer to areas with limited access to affordable, nutritious food, while food swamps describe areas dominated by unhealthy food options.
Counties in the highest quartile of MASLD-related mortality were predominantly located in the South (78.7%) and in rural regions (76.1%), and exhibited higher rates of poverty (30.2% vs 18.5%), unemployment (6.4% vs 4.7%), lack of high school education (16.1% vs 9.0%), and household crowding compared to counties in the lowest mortality quartile.
After adjusting for sociodemographic and clinical variables, the researchers found that counties with the highest food desert exposure had a 3.66 per 100,000 higher MASLD-related mortality rate than those with the lowest exposure (95% CI, 2.66–4.72). Similarly, counties with the highest food swamp exposure had a 3.57 per 100,000 higher mortality rate (95% CI, 2.44–4.71).
“In the United States, addressing sociodemographic and food environment disparities is paramount to reduce MASLD-related mortality,” the authors concluded.
For gastroenterologists, this study highlights the need to consider social determinants of health and local food environments in MASLD risk assessment and management. Interventions aimed at improving food access may play a key role in mitigating liver disease burden in vulnerable communities.
Reference
Paik A, Henry L, de Avila L, et al. Food swamps and food deserts impact on metabolic dysfunction-associated steatotic liver disease mortality in us counties. Clin Gastroenterol Hepatol. 2025;23(6):997-1007.e5. doi:10.1016/j.cgh.2024.08.053
