Neighborhood food store and subsequent health and well-being of older adults in Japan: an outcome-wide study

• We conducted an outcome-wide assessment of perceived availability of neighborhood food across 40 outcomes in seven domains. • Low availability was associated with adverse outcomes in five domains: physical/cognitive health, health behaviors, mental health, psychological well-being, and cognitive social capital. • After Bonferroni correction (p = 0.0013), robust associations remained for low self-rated health and IADL, low frequency of going out, more depressive symptoms/hopeless, low happiness/life satisfaction, and low community attachment. Evidence on neighborhood food stores and public health is limited. This study examined the association of availability of neighborhood food stores and health and well-being. We used three-wave data (2013, 2016, and 2019) from a nationwide cohort study of physically and cognitively independent older adults ≥65 years old in Japan. Exposure was the perceived availability of neighborhood food stores in 2016. We assessed 40 health/well-being outcomes in 2019 across seven domains; physical/cognitive health, health behaviors, mental health, psychological well-being, social well-being, character and virtue, and cognitive social capital. We adjusted for pre-exposure covariates including prior outcome in 2013. We included 47,318 respondents for 4 outcomes (death, dementia, any level of functional disability, and level 2 or greater functional disability) and 34,181 respondents for 36 other outcomes. The primary analysis was performed using linear, logistic, and poisson regression analysis depending on the nature of the outcome, and Bonferroni correction was used to correct for multiple tests. Compared to older adults who reported having many availability of neighborhood food stores, those reporting fewer stores were associated with less favorable outcomes in 5 of 7 domains; physical/cognitive health (low self-rated health and Instrumental activities of daily living), health behaviors (low frequency of going out), mental health (more depressive symptoms and hopeless), psychological well-being (low happiness and life satisfaction), cognitive social capital (low community attachment). These associations remained statistically significant after Bonferroni correction (p < 0.0013). Improving the availability of neighborhood food stores may promote health and well-being.