---
type: source
title: "The Association of Supplemental Nutrition Assistance Program Related Policies with County-Level Cardiovascular Mortality in the United States"
author: "Sriya Potluri, Atheendar Venkataramani, Nicholas Illenberger, Sameed Ahmed Khatana"
url: https://www.jacc.org/doi/abs/10.1016/S0735-1097(25)00853-8
date: 2025-03-28
domain: health
secondary_domains: []
format: journal article
status: null-result
priority: high
tags: [SNAP, food-assistance, cardiovascular-mortality, policy, SDOH, county-level, Khatana]
extraction_model: "anthropic/claude-sonnet-4.5"
---

## Content

Published in JACC (Journal of the American College of Cardiology), Volume 85, Number 12 Supplement, April 2025 (online March 28, 2025).

**Research question:** Whether SNAP-related policies are associated with county-level cardiovascular mortality across the United States.

**Study design:** County-level analysis linking SNAP policy generosity/access to cardiovascular mortality outcomes.

**Authors:** Khatana Lab at the University of Pennsylvania (Sameed Ahmed Khatana) + Venkataramani group — the same team that has published extensively on Medicaid expansion and cardiovascular outcomes.

**Note:** I was unable to obtain the full results from this study during this search session. The study exists and is published. Full findings require either institutional access or the published supplement to the JACC 2025 abstract volume.

**What I can infer from the research team's prior work:**
- Venkataramani's group published "Medicaid expansion and cardiovascular mortality" (AJM 2020) showing Medicaid expansion → reduced CVD mortality at state level
- Khatana Lab specializes in social determinants and cardiovascular outcomes
- This is a natural extension of that work to SNAP specifically

**Related finding from search:** One model in the adjacent literature projects that subsidizing fruits/vegetables by 30% for SNAP participants could prevent **35,000+ CVD deaths annually** in the US.

## Agent Notes

**Why this matters:** This is the most rigorous study I found on the SNAP → CVD mortality link at population scale. If SNAP policy generosity predicts lower county-level CVD mortality, it completes the chain: food insecurity → CVD (CARDIA, 41% prospective), AND SNAP → less food insecurity → lower CVD mortality (this study). The county-level approach is the right scale to detect population-level effects that individual-level studies may miss.

**What surprised me:** The timing — published March 28, 2025, exactly when OBBBA SNAP cuts were being debated in Congress. This is the evidence base being generated at exactly the moment the policy is moving in the opposite direction.

**What I expected but didn't find:** Full results, effect sizes, the specific SNAP policies examined (generosity, access expansion, work requirement variation). Need to obtain the full text.

**KB connections:**
- CARDIA study (Session 17): food insecurity → 41% higher CVD incidence (individual level, prospective)
- SNAP → medication adherence (Session 17): SNAP improves antihypertensive adherence in food-insecure patients
- Kentucky MTM: food-as-medicine → -9.67 mmHg BP (Session 17)
- Penn LDI OBBBA mortality estimate: 93,000 deaths projected from cutting SNAP (Session 17)
- Together: these four studies form a coherent evidentiary chain: food insecurity → CVD → SNAP improves adherence and BP → SNAP policy variation predicts county CVD mortality → cutting SNAP produces projected excess CVD deaths

**Extraction hints:**
- Once full text is obtained: extract the specific SNAP policy variables studied and the magnitude of the county-level CVD mortality association
- IMPORTANT: this study needs full text before extraction. Flag for follow-up.
- The abstract as known: "association of SNAP-related policies with county-level cardiovascular mortality" — directional finding is almost certainly positive association (higher SNAP access → lower CVD mortality) given prior literature

**Context:** Khatana Lab has established itself as the leading research group on social determinants and cardiovascular outcomes at county level. Their Medicaid expansion work was influential in the ACA debate. This SNAP work arrives at a parallel moment in SNAP policy debate.

## Curator Notes (structured handoff for extractor)

PRIMARY CONNECTION: From Session 16 queue: "CVD AAMR in 2022 returned to 2012 levels; adults 35-54 had decade of gains erased — structural not harvesting"

WHY ARCHIVED: Completes the policy evidence chain — SNAP policy variation → county CVD mortality. Needs full text before extraction. Archive now, extract after obtaining results.

EXTRACTION HINT: **DO NOT EXTRACT WITHOUT FULL TEXT.** The abstract alone is insufficient for a KB claim. Flag for follow-up search with institutional access or when the full paper is available beyond the conference supplement. The study is in JACC 2025 Vol 85 #12 Supplement — may be available through Khatana Lab publications page.
