Gaining access to healthy and affordable food can be a challenge for rural residents. Many rural areas lack food
retailers and are considered
food deserts: areas with limited supplies of fresh, affordable foods. Ironically, some of
these food deserts are in areas where farming is important to the local economy.
In rural areas, access to food may be limited by financial constraints or other factors, such as transportation
challenges. Rural shoppers may rely on more expensive and less nutritious food, such as the types available at
gas station convenience stores, or face a long drive to a town with a supermarket or grocery store that stocks
fresh produce, milk, eggs, and other staples.
Some rural residents and households are food insecure, meaning they cannot rely on access to
affordable and nutritious food at all times, increasing the risk of poor health outcomes. According to the 2017
United States Department of Agriculture
Economic Research Service (USDA-ERS) publication Food Insecurity, Chronic
Disease, and Health Among Working-Age Adults, food insecurity is strongly associated
disease and poor health, both of which disproportionately affect rural populations. Long-term food insecurity
can affect learning, development, productivity, physical and
mental health, and family life.
Food security can also be seen as a community-level issue. A 2002
USDA-ERS publication explains that community food security:
“…concerns the underlying social, economic, and institutional factors within a community that
and quality of available food and its affordability or price relative to the sufficiency of financial
available to acquire it.”
In 2021, 10.2% of U.S. households were food insecure at some time, down from 10.5% in 2020,
according to the USDA-ERS report, Household
Food Security in the United States in 2021. The same report notes that the rate of food insecurity in
rural areas declined, from 11.6% in 2020 to 10.8% in 2021.
During the COVID pandemic, what are some creative strategies that have been used by rural communities to
address hunger and food access issues?
The following rural communities and organizations have created innovations to help community members during the
initiative, developed and implemented by the rural Minnesota Lakewood Health System, distributed
fresh-frozen microwave meals to older adult patients who tested positive for COVID-19, thus enabling them to
quarantine immediately after receiving test results.
Vermont Everyone Eats! uses funds from the CARES Act to pay
restaurants in rural Vermont to provide free meals to people in need, and stipulates that 10% of the food
must come from local farms.
Charlevoix County Transit in northern
Michigan began home delivery of groceries, food pantry packages, and meals provided by senior centers, to
older adults and at-risk people who needed to remain at home during the pandemic.
How can we assess the level of food security and availability of healthy food in our rural community?
Security Assessment Toolkit was developed by the USDA-ERS to help local government officials, local
organizations, and community planners promote food security in all households. The toolkit examines 6
components of community food security:
Community socioeconomic and demographic characteristics
Community food resources
Household food security
Access to food
Food availability and affordability
Community food production resources
Feeding America conducts Map the Meal Gap, a research study
represented through an interactive map outlining overall and child hunger down to the county level. Food
insecurity data can be viewed by state, county, food bank service area, and congressional district.
The USDA-ERS Food
Atlas provides information on food access by census tract. This mapping tool uses
Distance to a store with healthy food or the number of stores in an area
Low vehicle access areas
Areas in which 67% or more of the population live in group quarters, such as correctional facilities or
skilled nursing facilities.
The USDA-ERS Food
Atlas provides county-level data on a wider set of statistics regarding food choices, health, and
community characteristics. The Food Environment Atlas has maps showing the following factors, all of which
influence the diet quality of individuals and communities:
Many rural areas lack a population base large enough to support a grocery store that stocks a variety of
affordable and healthy food, particularly if some residents bypass the local store to shop at distant
supermarkets offering lower prices or order groceries online. A 2009
article in the American Journal of Preventive Medicine discusses the economics of rural food
“…small town food stores, with limited floor space, economies of scale, and distance from
continue to provide limited food selection at higher prices and face the persistent challenge to remain
As a result, rural families with only convenience or small stores from which to choose experience higher
lower selection and quality of foods than those shopping in larger supermarkets.”
What strategies have rural communities used to improve access to healthy and affordable food?
Many different approaches have been used to address this issue. The Healthy
Food Access Portal can help communities find funding and resources related to retail projects and policy
efforts. Strategies include:
Special Financing for Food Retailers
Some rural communities offer subsidized financing for food retailers by participating in state programs.
Examples include the Michigan Good Food Fund and the California FreshWorks Fund, which offer financing to enterprises
that benefit underserved communities in those states.
Cooperative Grocery Stores
Some rural grocery stores are community-owned or use the cooperative model. Co-ops have long existed in rural
communities to provide key services such as electricity and phone service, where distance and low volumes make
providing that service unattractive and unsustainable for traditional businesses.
Cooperatives are composed of members who are
both customers and owners. The community-owned model closely resembles the cooperative model, although it is
typically organized as a corporation, in which community members can buy shares.
supported agriculture programs (CSAs), local residents commit to purchasing part of a local farmer’s
crop at the beginning of the year. Farmers receive a cash investment to operate their farm and residents receive
a supply of fresh produce. This program allows farmers and consumers to share the risks and benefits of local
Farm to School Initiatives
Farm to school initiatives help local farmers sell
fresh fruits and vegetables directly to public schools or incorporate school gardens in meal programs so that
nutritious meals and snacks can be served to students and teachers, as well as educating children about
nutrition and local farming. The Center
for Integrated Agricultural Systems offers toolkits and other resources related to farm to school
initiatives. RHIhub’s Rural Schools and Health topic guide has more
information about how schools can provide access to nutritious meals for students.
Food pantries and other forms of direct food assistance, such as backpack
food programs for children, can fill an important need for rural residents experiencing food insecurity.
Food pantries can distribute nutritious food to low-income families and work with the local social
services staff to give families information on nutrition, the Supplemental Nutrition Assistance Program (SNAP),
and other social services in the community. Mobile food pantry trucks may be an option in rural communities
without a suitable place to store and distribute food. For example, the Care
and Share Food Bank
provides mobile food pantry services to rural communities across Southern Colorado.
Community Education and Outreach
Community programs to improve access to food may also include education and outreach activities. Approaches to
assist low-income residents include education on food assistance programs, social services, and
training related to home economics, such as cooking from scratch and shopping wisely.
The SNAP Ed program and Expanded
Food and Nutrition Education Program (EFNEP) are federally-funded programs that provide
peer education. In addition, community organizations can plant community gardens and teach
people how to grow their own food.
How can rural healthcare organizations address food and nutrition issues in their community?
Rural healthcare organizations can work with human services providers to ensure that low-income patients are
able to access healthy food options. Human services organizations may be able to offer training and tools to
primary care providers so that they can screen patients for food insecurity. Addressing
Food Insecurity in
Health Care Settings provides tips for screening patients for food insecurity and providing
interventions, such as referrals. Healthcare providers can refer
Local food pantries
Human services agencies for food assistance programs
Women, Infants, and Children (WIC) offices
Meal programs for seniors
In addition, rural healthcare providers can provide counseling and nutrition education for patients, to promote
wellness and help manage chronic disease. Facilities may partner with other community organizations and
businesses to provide or refer patients to cooking classes, meal programs, and other nutrition-related services
Healthcare providers can also prescribe healthy foods. Providing Patients with
Access to Nutritious Food describes programs in which medical facilities actively promote consumption
of healthy foods among patients and local residents. The Lakewood Health System,
in rural Minnesota, created Lakewood
Engage, a program designed to improve access to safe, nutritious, and affordable food for positive
health impact. See the Models and Innovations section of
this topic guide for other examples of projects conducted in rural communities.
How widely used are federal nutrition programs among rural families?
The USDA Food and Nutrition Service’s Special Supplemental
Nutrition Program for Women, Infants, and Children (WIC) serves low-income women, infants, and children
up to age five who are at nutritional risk. WIC provides nutritious food, information on healthy eating,
education on breastfeeding, and referrals to healthcare. According to the Food Research & Action Center’s 2018
Rural Hunger in America, the
percentage of income-eligible families with young children participating in the WIC program is higher in rural
areas (46%) than in metropolitan areas (42%).
What nutrition programs are available for children in rural schools, daycare centers, and other settings?
In addition to SNAP, nutrition programs available for rural children include:
and Adult Care Food
Program (CACFP) provides financial assistance to childcare centers for nutritious meals and snacks.
The program helps in-home daycare providers, daycare centers, afterschool programs, and emergency shelters
improve access to healthy food. Their website also provides nutrition education, healthy recipes, and
One barrier for eligible rural families to participate in the Child and Adult Care Food Program is that
rural children are more likely to receive care in a relative's home than in a daycare center or afterschool
program which qualifies for the Child and Adult Care Food Program. Other challenges to increasing enrollment
in child nutrition programs for eligible rural families include a lack of awareness about existing programs
as well as a stigma related to receiving government assistance. Rural families may also have a more difficult
time utilizing the Summer Food Service Program because of the distance needed to travel to a participating site.
What food assistance programs are available for seniors in rural communities?
programs funded through the Administration on Aging provide access to nutritious meals, education, and
nutrition counseling for adults age 60 and above, particularly those who have social and economic need.
Programs vary depending on the needs and the resources available in each community.
Congregate meal programs offer meals in a central setting, such as a senior center. Home-delivered meal
programs, such as Meals on Wheels, bring meals to the homes
of frail, homebound, or isolated older adults. Providing hot home-delivered meals to older adults living in
remote rural communities can be a challenge due to travel distance and time required for delivery. In some
locations, frozen meals or sack lunches can be delivered on a less frequent basis or picked up from a designated
location. Often there is a suggested donation or sliding fee schedule to defray the cost of meals.
The Child and Adult Care
Food Program (CACFP) is a federal program that provides healthy meals and snacks to adults receiving
day care. Adult day care centers receive payments for serving healthy meals to adults who are 60 or older,
or who are physically or mentally impaired to a degree that limits their independence.
The Senior Farmers’ Market
Nutrition Program (SFMNP) is offered through the USDA Food and Nutrition Service to provide low-income
seniors with coupons that can be used at farmers markets, roadside food stands, and community-supported
agriculture programs to promote the consumption of fresh fruits and vegetables among seniors.
The Commodity Supplemental Food
Program works to improve the health of low-income people at least 60 years of age by distributing
shelf-stable food and administrative funds to participating states and tribal organizations.
USAging has more information about home and community-based services
available to seniors.
How does rural food insecurity affect health outcomes?
Research shows that access to nutritious and affordable food for rural residents is important for improving
health behaviors and status. Chapter 8 of the National Research Council’s Research
Opportunities Concerning the Causes and Consequences of Child Food Insecurity and Hunger: Workshop
Summary discusses the literature related to the health of children and pregnant women.
It shows that food insecurity and hunger adversely affect child development and academic performance, and
may contribute to behavioral health disorders, compromised immune systems, and other health issues.
Consuming fewer than five servings per day of fruits and vegetables
What are some funding opportunities for rural community food pantries?
To set up a food pantry in a rural community, it is helpful to start by contacting your local Feeding America
food bank. Food banks provide a range of supports and expertise for launching and maintaining an
effective food pantry, and collectively, the Feeding America network serves every county in the United States
allowing for a culture of learning and sharing best practices for rural, urban, and suburban communities alike.
Rural food pantries may receive donations from many sources. The Rural Monitor article, Food Pantries
Serving More and More of the Rural Poor, highlights rural food pantries that receive funding and
donations from federal programs, their state government, foundations, corporations, churches, and individuals.
The Emergency Food Assistance
Program (TEFAP) is a federal program that makes food available to State Distributing Agencies such as
food banks, which then provide food to local pantries and other organizations.