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Food System Approaches to Address Food Insecurity

This model focuses on making changes to the food system to address food insecurity, a social determinant of health (SDOH). Food insecurity, the lack of or limited access to food, is an important SDOH in rural communities. Many rural areas have limited access to healthy, affordable foods. An estimated 2.3 million rural families face hunger and are considered food insecure — the most vulnerable are children living in rural communities.

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.

Food systems approaches to address food insecurity may include strategies to improve access and promote increased availability and affordability of nutritious foods. Several promising approaches have been identified to help rural communities address food insecurity. These include:

The Rural Food Access Toolkit provides additional resources and program examples to support rural organizations implementing food access programs.

Examples of Food System Approaches to Improve Food Insecurity

  • 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 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 business 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.

For additional considerations, see Implementation Strategies for Healthy Food Access in Rural Communities in the Rural Food Access Toolkit.

Program Clearinghouse Examples

Resources to Learn More

Food Insecurity and the Role of Hospitals
Provides guidance on how hospitals can improve food insecurity as a social determinant of health. Includes case studies of U.S. hospitals implementing strategies to address food insecurity. Part of a series focused on how hospitals can help address social determinants of health.
Organization(s): American Hospital Association, Health Research & Educational Trust
Date: 6/2017

Good Laws, Good Food: Putting Food Policy to Work in the Navajo Nation
Policy toolkit that presents the food laws and policies that contribute to challenges with food security and access to healthy foods in the Navajo Nation.
Author(s): Downer, S., Balkus, O., Leib, E.B., & Blazek, K.
Organization(s): Harvard Food Law and Policy Clinic, Community Outreach & Patient Empowerment, Navajo Nation
Date: 5/2015

Rural Hunger
Provides resources and additional information about rural hunger, including an interactive mapping tool showing participation in the Supplemental Nutrition Assistance Program (SNAP).
Organization: Food Research & Action Center