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
sufficient, 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 with chronic
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 affect the
quantity and quality of available food and its affordability or price relative to the sufficiency of financial
resources available to acquire it.”
In 2022, 12.8% of U.S. households were food insecure at some time, up from 10.2% in 2021, according to the
USDA-ERS report, Household
Food Security in the United States in 2022. The same report notes that the rate of food insecurity in
rural areas increased, from 10.8% in 2021 to 14.7% in 2022.
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.
How can we assess the level of food security and availability of healthy food in our rural community?
The Community Food
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 hunger at the county level by age groups and race/ethnicity.
Food insecurity data can be viewed by state, county, food bank service area, and congressional district.
No Kid Hungry provides a Focus Area Map that shows
students in poverty, child food insecurity, and social vulnerability at the county level. The map also includes
the percentage of students who are eligible for free or reduced meals in schools.
The USDA-ERS Food Access
Research Atlas provides information on food access by census tract. This mapping tool uses the following
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
Environment 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 access:
“…small town food stores, with limited floor space, economies of scale, and distance from distribution centers,
continue to provide limited food selection at higher prices and face the persistent challenge to remain
profitable… As a result, rural families with only convenience or small stores from which to choose experience
higher prices and 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. Our 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 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 patients to:
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 document
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:
The Child 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 wellness resources.
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. One example of
a community addressing this issue comes from Blaine County, Idaho, where The
Hunger Coalition's Bloom Truck and Bloom Markets provide healthy sack lunches to children in the summer.
For more strategies related to addressing childhood hunger, see No Kid Hungry's Center for Best Practices repository of tools and resources.
What food assistance programs are available for seniors in rural communities?
Food insecurity has a significant impact on rural seniors. According to The
State of Senior Hunger in America in 2020: An Annual Report, 7.3% of seniors in nonmetro areas are food
insecure, compared to 6.7% in metro areas. Nutrition Services 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 daycare 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.
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, including federal programs, 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.