Limited access to healthy foods*
Percentage of population who are low-income and do not live close to a grocery store.
The 2021 County Health Rankings used data from 2015 for this measure.
Reason for Including
There is strong evidence that residing in a food desert is correlated with a high prevalence of obesity and premature death.[1-3] Supermarkets traditionally provide healthier options than convenience stores or smaller grocery stores. Additionally, lack of access to fresh fruits and vegetables is related to premature mortality. This measure is no longer ranked, it was replaced by a composite measure of the food environment which includes food insecurity and access to healthy foods.
Key Measure Methods
Limited Access to Healthy Foods is a Percentage
Limited Access to Healthy Foods measures the percentage of the population that is low income and does not live close to a grocery store.
The numerator is the number of people who are low income and do not live close to a grocery store. Living close to a grocery store is defined differently in rural and nonrural areas; in rural areas, it means living less than 10 miles from a grocery store; in nonrural areas, less than one mile. Low income is defined as having an annual family income of less than or equal to 200 percent of the federal poverty threshold for the family size.
The denominator is the 2010 US Census population.
Can This Measure Be Used to Track Progress
This measure can be used to track progress with some caveats. The data for this measure are usually not updated annually, so pay close attention to the years of data as you try to measure progress.
Years of Data Used
USDA Food Environment Atlas
From the United States Department of Agriculture (USDA):
The Atlas assembles statistics on three broad categories of food environment factors:
Food Choices--Indicators of the community's access to and acquisition of healthy, affordable food, such as: access and proximity to a grocery store; number of foodstores and restaurants; expenditures on fast foods; food and nutrition assistance program participation; food prices; food taxes; and availability of local foods.
Health and Well-Being--Indicators of the community's success in maintaining healthy diets, such as: food insecurity; diabetes and obesity rates; and physical activity levels.
Community Characteristics--Indicators of community characteristics that might influence the food environment, such as: demographic composition; income and poverty; population loss; metro-nonmetro status; natural amenities; and recreation and fitness centers.
The USDA produces two excellent resources for communities looking to explore their access to healthy foods: the Food Access Research Atlas and the Food Environment Atlas. Both of these resources are regularly updated and can provide you with information on where there are healthy food options, and where people live with few easy options for finding healthy foods.
 Ahern M, Brown C, Dukas S. A national study of the association between food environments and county-level health outcomes. The Journal of Rural Health. 2011;27:367-379.
 Taggart K. Fast food joints bad for the neighbourhood. Medical Post. 2005;41.21:23.
 Schafft KA, Jensen EB, Hinrichs CC. Food deserts and overweight schoolchildren: Evidence from Pennsylvania. Rural Sociology. 2009;74:153-277.
 Vaughan CA, Cohen DA, Ghosh-Dastidar M, Hunter GP, Dubowitz T. Where do food desert residents buy most of their junk food? Supermarkets. Public Health Nutr. 2017 Oct;20(14):2608-2616.
 Brownson RC, Haire-Joshu D, Luke DA. Shaping the context of health: A review of environmental and policy approaches in the prevention of chronic diseases. Annu Rev Public Health 2006;27:341-70.