US counties with food deserts or food swamps tend to have higher rates of death from obesity-related cancers, according to a study published in JAMA Oncology.

Having a high rate of obesity-related cancer deaths was 59% more likely in counties with high food desert scores and 77% more likely in counties with high food swamp scores, researchers found. 

They calculated food desert scores as the proportion of each county’s population living more than 1 mile from a grocery store and living at least 200% below the federal poverty threshold. Food swamp scores were calculated as the ratio of fast food restaurants and convenience stores to grocery stores and farmers markets. The researchers categorized scores into low, moderate, and high based on the distribution of the total scores per county. Counties with higher scores (20.0 to ≥58.0) had fewer healthy food resources.

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Of the 3038 counties or county equivalents in this study, 758 had a high obesity-related cancer death rate, which was defined as 71.8 per 100,000 population or higher. Death rates for all 13 obesity-related cancers were included: meningioma, multiple myeloma, and cancers of the uterus, ovaries, breast, thyroid, kidneys, liver, gallbladder, upper stomach, pancreas, esophagus, and colon/rectum.

The age-adjusted odds of having high obesity-related cancer death rates were greater in counties with high food desert scores (adjusted odds ratio [aOR], 1.59; 95% CI, 1.29-1.94) and those with high food swamp scores (aOR, 1.77; 95% CI, 1.43-2.19). 

The researchers also observed a positive dose-response relationship between tertiles of food swamp or desert scores and obesity-related cancer death. In this analysis, high obesity-related cancer death rates ranged from 83.0 to 185.7 per 100,000 population.

The analysis showed that counties with the highest food swamp scores had greater odds of obesity-related cancer death than counties with the lowest food swamp scores (aOR, 2.10; 95% CI, 1.67-2.63). The same was true for food desert scores (aOR, 1.59; 95% CI, 1.28-1.96).

“The findings of this cross-sectional ecologic study suggest that policy makers, funding agencies, and community stakeholders should implement sustainable approaches to combating obesity and cancer and establishing access to healthier food, such as creating more walkable neighborhoods and community gardens,” the researchers wrote.


Bevel MS, Tsai M-H, Parham A, et al. Association of food deserts and food swamps with obesity-related cancer mortality in the US. JAMA Oncol. Published online May 4, 2023. doi:10.1001/jamaoncol.2023.0634

This article originally appeared on Cancer Therapy Advisor