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Rural Health Information Hub

Approaches to Increase Access to Foods that Support Healthy Eating Patterns

Many rural areas have limited access to healthy, affordable foods. Food deserts can be found in rural areas where supermarkets or grocery stores are scarce, which directly contributes to food insecurity. These areas may instead have more convenience stores which are more likely to sell processed, shelf-stable goods rather than fresh produce. As a result, residents may have to travel to find healthy food, which can be more challenging for those without reliable access to transportation.

Rural residents who lack reliable transportation are particularly isolated, given the distance to the grocery store in rural communities and lack of public transportation options. These findings suggest the complexity of food access and its relationship to poverty and transportation.

Several promising approaches have been identified to help rural communities improve access and promote increased availability and affordability of nutritious foods. These include:

See Approaches to Improving Food Insecurity in School Settings for additional information about food assistance programs for children.

Examples of Programs to Increase Access to Foods that Support Healthy Eating Patterns

  • GrowingChange is working to turn a decommissioned prison in rural North Carolina into a sustainable farm to educate and employ youth at risk of entering the criminal justice system and returning veterans. GrowingChange began as a program combining cognitive behavioral therapy for at-risk youth with a service learning component and a focus on professional development. In its early years, the program developed community gardens and put together boxes of produce grown in the gardens for families in need of fresh produce. Now GrowingChange is focusing on providing education and training, helping youth acquire skills to address food insecurity in the region. The program will teach participants sustainable agriculture skills and leadership skills. They are also aiming to sell crops grown on the farm to local restaurants and to develop community-supported agriculture to improve economic stability and create community wealth.
  • Community Outreach & Patient Empowerment (COPE) strives to improve health and equity by empowering Native communities through 3 main strategies: community-based outreach, local capacity building and system-level partnerships, and increasing access to healthy foods. To improve access to healthy foods in the Navajo Nation, COPE administers programs such as the Navajo Wholesome Rx: Fruit and Vegetable Prescription Program (FVRx), the Healthy Navajo Stores Initiative, and the Growers Initiative. FVRx engages local health clinics to provide free vouchers for fruits and vegetables to underserved people in an effort to improve consumption of healthy foods. Families can use these vouchers at local food retailers, which then send used vouchers to COPE to be processed for reimbursement. The Healthy Navajo Stores Initiative is improving access to healthy and traditional foods in Navajo Nation by helping small stores better stock and market these healthier products.
  • Appalachian Sustainable Development has been working since 1995 to connect communities with local, healthy produce and to improve the local economy. They help farmers in Appalachia build up their businesses and partner with other sectors in West Virginia, Kentucky, and Ohio to provide a variety of economic development opportunities. Some of their food access programs provide support and technical assistance for families to grow their own food. For example, Healthy Families-Healthy Farms, is a donor-funded program that purchases produce from farms for local food banks and pantries.
  • The Farm & Food Education Center provides educational opportunities for youth and families in rural Tennessee to teach sustainable agriculture techniques and how to build businesses around local foods. Their mission is to improve the community and to increase the consumption of healthy foods. They operate several programs including the Farm & Food Teen Training Program, Farmer and Rancher Mentoring, and Farm Day Camps. They also are helping residents develop community gardens to grow local produce to address food insecurity.

Implementation Considerations

In many rural areas, access to healthy foods may be limited because of transportation challenges or distances to get to healthy food options. In addition, in some communities, there may be stigma about programs that address food insecurity or a lack of awareness about their availability. Finding sustainable strategies is important when considering new programs or improvements to local food systems.

Although there are many factors that inform the success of food access initiatives, attention must be paid to how well-positioned a community is to implement a strategy. The health of the food environment is one method to determine readiness and it can be measured in several different ways, such as a community food assessment. This tool collects information from community members on what they identify as assets to the local food environment as well as opportunities for improvement.

Where to establish an initiative is a critical consideration. In some communities, bolstering an existing or building a new retail environment would yield the greatest results. In other communities, targeting specific demographics may be the best point of intervention, such as targeting:

Program Clearinghouse Examples

Resources to Learn More

Municipal Strategies to Increase Food Access
Presents multiple strategies that municipalities and food system advocates can use to increase access to healthy foods.
Organization(s): Massachusetts Department of Public Health, Pioneer Valley Planning Commission, Metropolitan Area Planning Council, Massachusetts Association of Health Boards, Massachusetts Municipal Association
Date: 2017

Food Access Strategies in Rural Communities
Webinar outlining a framework for addressing four types of issues that affect access to food: physical, economic, cultural, knowledge. Provides both community-level and policy-level suggestions to help develop, fund, and implement a rural food access strategy.
Author(s): Wooten, H., Fry, C., Redfern, T., & Holady, R.
Organization(s): ChangeLab Solutions
Date: 9/2014

Improving Access to Healthy Food in Rural Communities
Presentation Slides
Slides from a webinar highlighting three programs across the country (Rural Grocery Initiative in KS, The Conservation Fund in NC, Farm to Table in NM) that are using innovative approaches and methods to address food access.
Author(s): Laveta, T., Procter, D., Roy, P., & Sager, M.
Organization(s): Grantmakers in Health
Date: 7/2015