Featured Application (1) The methodological approach based on multiscale geographically weighted regression provides a nuanced understanding of how urban factors influence health disparities. (2) The findings highlight the importance of food accessibility as a determinant of health, reinforcing the need for interdisciplinary approaches that combine public health, urban planning, and nutrition science. (3) Policymakers can use this data to identify priority areas for improving food access, particularly in economically disadvantaged neighborhoods. This could involve incentivizing grocery stores and markets to establish themselves in underserved areas or enhancing public transportation links to existing food resources. (4) The call for sustainable food systems to support public health highlights the importance of long-term strategies that ensure consistent access to healthy, affordable food. This can influence agricultural policies, support for local food producers, and the promotion of urban agriculture initiatives.Abstract This study examines the link between food deserts and cardiovascular health in older adults in Santiago's Metropolitan Region, Chile. As the population ages and chronic diseases rise, understanding the impact of food accessibility on health is essential. Using multiscale geographically weighted regression, we analyzed data from the Cardiovascular Health Program, socioeconomic indicators, and food desert maps, sourced from the Chilean Ministry of Health and other databases. Spatial analysis, including Voronoi diagrams, assessed the influence of food deserts on health outcomes. Findings show a significant correlation between limited access to healthy foods and higher cardiovascular disease rates, especially in economically disadvantaged areas. The regression model is significant to contribute to the explanation of disease prevalence, emphasizing the impact of food availability on health. This study highlights the importance of considering spatial factors in urban planning and public health policies. By showcasing the role of food environments in health disparities, it advocates for integrated health interventions. Targeted urban planning to address food deserts can enhance access to healthy foods, improving cardiovascular health and well-being among Santiago's elderly. The findings provide insights for policymakers to create healthier urban environments and stress the need for sustainable food systems to support public health.