Farmers markets
A farmers market is a multiple vendor farm-to-consumer retail operation, where producers sell goods directly to consumers at a set outdoor or indoor location. Farmers markets usually sell fresh fruit and vegetables, though meat, dairy, grains, prepared foods, and other items may also be available. Markets are usually held once a week and vary in size from a few stalls to several city blocks. Most farmers markets are organized and operated by community organizations, public agencies, or public/private collaborations with volunteer support.
What could this strategy improve?
Expected Benefits
Our evidence rating is based on the likelihood of achieving these outcomes:
Increased access to fruits & vegetables
Potential Benefits
Our evidence rating is not based on these outcomes, but these benefits may also be possible:
Increased healthy foods in food deserts
Increased fruit & vegetable consumption
Strengthened local & regional food systems
Improved local economy
Reduced emissions
What does the research say about effectiveness? This strategy is rated some evidence.
There is some evidence that farmers markets increase access to healthy foods, especially fresh fruits and vegetables1, 2, 3, 4, 5, 6. Establishing farmers markets is a suggested strategy to increase fresh produce in food deserts7, 8. Additional evidence is needed to confirm effects.
Farmers markets can increase fruit and vegetable consumption in low income communities9, 10, 11, 12 and among low income diabetics1. An evaluation of the Fresh to You partnership program suggests markets can also increase consumption among low income children when discount produce is available13. Overall, farmers markets have been associated with increases in fresh produce purchases and self-reported increases in fruit and vegetable consumption14, 15, 16, 17, 18, 19, 20, 12, 21. Individuals who shop at farmers markets two or more times per week report higher levels of consumption than peers shopping less frequently22. Education, promotion, and financial incentives may need to accompany farmers markets to substantially affect consumption23, 24, 25.
Starting and sustaining farmers markets in low income areas may reduce disparities in access to healthy foods, especially fresh fruits and vegetables26, but will not fully eliminate disparities in healthy food purchases between families with low and high incomes23. Experts suggest that farmers markets in low income, minority communities may have difficulty balancing shoppers’ needs for low cost produce and vendors’ needs for profitability27. Farmers markets in low income neighborhoods also appear to be smaller and provide fewer fresh fruits and vegetables than typical markets in more affluent communities28.
Prices at farmers markets are often lower than supermarket prices29, 30, 31, although prices vary and may be higher in some counties than others17.
High quality produce, produce variety, and lower prices are the most commonly reported reasons for shopping at farmers markets32. Limited transportation options, lack of information about the location or hours of farmers markets, and markets not accepting Electronic Benefit Transfer (EBT) payment for Supplemental Nutrition Assistance Program (SNAP) benefits are frequently reported barriers to farmers market use3, 34, 35, 36, 15, 32, 33. Increasing transportation options, developing safe routes to healthy foods at farmers markets, expanding market hours and locations, promoting awareness, and offering community health education may support farmers market use15, 33, 37.
Zoning that supports farmers markets, street food vendors, and other public markets may strengthen local food systems, enhance local economies, and contribute to a livelier pedestrian environment38. Shopping at farmers markets that offer seasonal, locally grown foods may reduce emissions from fossil fuels used to produce, process, and transport food39, 40, and may reduce the energy intensity of an individual’s diet if more plant-based foods are consumed in place of animal products39.
How could this strategy impact health disparities? This strategy is rated no impact on disparities likely.
Implementation Examples
As of February 2018, the US Department of Agriculture (USDA) includes over 8,700 farmers markets in the National Farmers Market Directory41. As of 2013, at least 17 states and Washington DC enacted legislation to support local food production, marketing, and consumption, including farmers markets and local food distribution42. Various state and local policies can encourage farmers market establishment43. For example, in Fresno, CA local zoning ordinances establish zones where farmers markets are an approved land use, and in Minneapolis, MN streamlined permitting processes support small farmers markets44. The Produce Plus Program in Washington DC and Gorge Grown Food Network in Washington state are examples of collaborative efforts to support farmers markets in urban and rural areas45, 46.
The US Department of Agriculture’s Agricultural Marketing Service (AMS) operates the Farmers Market and Local Foods Promotion Program, which distributed about $15 million in 2014 to support farmers markets and other direct to consumer retail outlets42, 47. The Centers for Disease Control and Prevention (CDC)’s Division of Nutrition, Physical Activity, and Obesity (DNPAO) provides guidance and funding to state health departments to support interventions promoting access to fresh produce and encouraging healthy eating, including establishing or supporting farmers markets48.
Implementation Resources
ChangeLab-Land use and FMs - Wooten H, Ackerman A. From the ground up: Land use policies to protect and promote farmers’ markets. Oakland: ChangeLab Solutions; 2013.
PolicyLink-FMs 2008 - PolicyLink. Equitable development toolkit: Farmers markets. 2008.
USDA-Farmers markets - US Department of Agriculture (USDA), Agricultural Marketing Service (AMS). Farmers markets and direct-to-consumer marketing.
USDA-FMPP - US Department of Agriculture (USDA), Agricultural Marketing Service (AMS). Farmers market promotion program (FMPP).
US DHHS-Healthy food financing - US Department of Health and Human Services (US DHHS), Administration for Children & Families (ACF). Healthy food financing initiative.
CDC-Supporting FMs - Centers for Disease Control and Prevention (CDC), Division of Nutrition Physical Activity and Obesity (DNPAO). Current practices in developing and supporting farmers’ markets.
CDC-HFR 2014 - Centers for Disease Control and Prevention (CDC), Division of Nutrition, Physical Activity, and Obesity. Healthier food retail (HFR): An action guide for public health practitioners. 2014.
CDC DNPAO-Data - Centers for Disease Control and Prevention (CDC), Division of Nutrition Physical Activity and Obesity (DNPAO). Nutrition, physical activity and obesity: Data, trends and maps online tool.
PolicyLink-HFAP map - PolicyLink, The Reinvestment Fund (TRF), The Food Trust. Healthy food access portal (HFAP): Research your community interactive map for healthy food access.
LHC-Rockeymoore 2014 - Rockeymoore M, Moscetti C, Fountain A. Rural childhood obesity prevention toolkit. Leadership for Healthy Communities (LHC), Center for Global Policy Solutions, Robert Wood Johnson Foundation; 2014.
PAS-Zoning 2016 - Planning Advisory Service (PAS). Planning & zoning for health in the built environment. American Planning Association (APA); 2016.
SRTSNP-Safe routes to healthy foods‡ - Safe Routes to School National Partnership (SRTSNP). Healthy communities: Safe routes to healthy foods.
ISU-Food and sustainability resources - Iowa State University (ISU), Sustainable Food Processing Alliance. Online resources for food and sustainability.
Footnotes
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1 Freedman 2013 - Freedman DA, Choi SK, Hurley T, Anadu E, Hebert JR. A farmers’ market at a federally qualified health center improves fruit and vegetable intake among low-income diabetics. Preventive Medicine. 2013;56(5):288–92.
2 McCormack 2010 - McCormack LA, Laska MN, Larson NI, Story M. Review of the nutritional implications of farmers’ markets and community gardens: A call for evaluation and research efforts. Journal of the American Dietetic Association. 2010;110(3):399-408.
3 Young 2011 - Young C, Karpyn A, Uy N, Wich K, Glyn J. Farmers’ markets in low income communities: Impact of community environment, food programs and public policy. Community Development. 2011;42(2):208-20.
4 Sallis 2006 - Sallis JF, Glanz K. The role of built environments in physical activity, eating, and obesity in childhood. Future of Children. 2006;16(1):89-108.
5 Larsen 2009a - Larsen K, Gilliland J. A farmers’ market in a food desert: Evaluating impacts on the price and availability of healthy food. Health and Place. 2009;15(4):1158–1162.
6 Freedman 2011a - Freedman DA, Bell BA, Collins LV. The veggie project: A case study of a multi-component farmers' market intervention. Journal of Primary Prevention. 2011;32(3-4):213-24.
7 CDC-Food deserts - Centers for Disease Control and Prevention (CDC). A look inside food deserts.
8 UW IRP-McCracken 2012 - McCracken VA, Sage JL, Sage RA. Bridging the gap: Do farmers’ markets help alleviate impacts of food deserts? Madison: Institute for Research on Poverty (IRP), University of Wisconsin-Madison; 2012: Discussion Paper 1401-12.
9 Strome 2016 - Strome S, Johns T, Scicchitano MJ, Shelnutt K. Elements of access: The effects of food outlet proximity, transportation, and realized access on fresh fruit and vegetable consumption in food deserts. International Quarterly of Community Health Education. 2016;37(1):61-70.
10 Evans 2012 - Evans AE, Jennings R, Smiley AW, et al. Introduction of farm stands in low-income communities increases fruit and vegetable among community residents. Health & Place. 2012;18(5):1137-43.
11 Racine 2010 - Racine EF, Smith Vaughn A, Laditka SB. Farmers' market use among African-American women participating in the special supplemental nutrition program for women, infants, and children. Journal of the American Dietetic Association. 2010;110(3):441-6.
12 Ruelas 2012 - Ruelas V, Iverson E, Kiekel P, Peters A. The role of farmers' markets in two low income, urban communities. Journal of Community Health. 2012;37(3):554-62.
13 Gorham 2015 - Gorham G, Dulin-Keita A, Risica PM, et al. Effectiveness of Fresh to You, a discount fresh fruit and vegetable market in low-income neighborhoods, on children’s fruit and vegetable consumption, Rhode Island, 2010-2011. Preventing Chronic Disease. 2015;12:140583.
14 Singleton 2016 - Singleton CR, Baskin M, Levitan EB, et al. Farm-to-consumer retail outlet use, fruit and vegetable intake, and obesity status among WIC program participants in Alabama. American Journal of Health Behavior. 2016;40(4):446-454.
15 Jilcott Pitts 2015 - Jilcott Pitts SB, Wu Q, Demarest CL, et al. Farmers’ market shopping and dietary behaviours among Supplemental Nutrition Assistance Program participants. Public Health Nutrition. 2015;18(13):2407-2414.
16 Jilcott Pitts 2014 - Jilcott Pitts SB, Gustafson A, Wu Q, et al. Farmers’ market use is associated with fruit and vegetable consumption in diverse southern rural communities. Nutrition Journal. 2014;13(1).
17 Wheeler 2014 - Wheeler AL, Chapman-Novakofski K. Farmers’ markets: Costs compared with supermarkets, use among WIC clients, and relationship to fruit and vegetable intake and related psychosocial variables. Journal of Nutrition Education and Behavior. 2014;46(3 Suppl):S65-S70.
18 Grin 2013 - Grin BM, Gayle TL, Saravia DC, Sanders LM. Use of farmers markets by mothers of WIC recipients, Miami-Dade County, Florida, 2011. Preventing Chronic Disease. 2013;10(2):120178.
19 Cromp 2012 - Cromp D, Cheadle A, Solomon L, et al. Kaiser Permanente’s Farmers’ Market Program: description, impact, and lessons learned. Journal of Agriculture, Food Systems, and Community Development. 2012;2(2):29–36.
20 Blanck 2011 - Blanck HM, Thompson OM, Nebeling L, Yaroch AL. Improving fruit and vegetable consumption: Use of farm-to-consumer venues among US adults. Preventing Chronic Disease. 2011;8(2):A49.
21 USDA-Ragland 2011 - Ragland E, Lakins V, Coleman C. Results of DOT survey: USDA outdoor farmers market. Washington, DC: US Department of Agriculture (USDA), Agricultural Marketing Service (AMS); 2011.
22 Jilcott Pitts 2017 - Jilcott Pitts SB, Hinkley J, Wu Q, et al. A possible dose–response association between distance to farmers’ markets and roadside produce stands, frequency of shopping, fruit and vegetable consumption, and body mass index among customers in the Southern United States. BMC Public Health. 2017;17(1):65.
23 NBER-Handbury 2016 - Handbury J, Rahkovsky I, Schnell M. Is the focus on food deserts fruitless? Retail access and food purchases across the socioeconomic spectrum. National Bureau of Economic Research (NBER). 2016: Working Paper 21126.
24 Fitzgerald 2011 - Fitzgerald N, Hallman WK. Effectiveness of a farmers market intervention to improve the food access and intake in an urban setting. Journal of the Federation of American Societies for Experimental Biology. 2011;25(98.6).
25 Lieff 2017 - Lieff SA, Bangia D, Baronberg S, Burlett A, Chiasson MA. Evaluation of an educational initiative to promote shopping at farmers’ markets among the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) participants in New York City. Journal of Community Health. 2017;42(4):701-706.
26 PolicyLink-Flournoy 2005 - Flournoy R, Treuhaft S. Healthy food, healthy communities: Improving access and opportunities through food retailing. Oakland: PolicyLink; 2005.
27 PolicyLink-FMs 2008 - PolicyLink. Equitable development toolkit: Farmers markets. 2008.
28 Lowery 2016 - Lowery B, Sloane D, Payán D, Illum J, Lewis L. Do farmers’ markets increase access to healthy foods for all communities? Comparing markets in 24 neighborhoods in Los Angeles. Journal of the American Planning Association. 2016;82(3):252-266.
29 Valdez 2016 - Valdez Z, Ramírez AS, Estrada E, Grassi K, Nathan S. Community perspectives on access to and availability of healthy food in rural, low-resource, Latino communities. Preventing Chronic Disease. 2016;13(E170):160250.
30 Swenson 2012 - Swenson PJ. Paired price comparisons of farmer’s market and supermarket produce in San Luis Obispo County. San Luis Obispo: California Polytechnic State University (Cal Poly); 2012.
31 McGuirt 2011 - McGuirt JT, Jilcott SB, Liu H, Ammerman AS. Produce price savings for consumers at farmers’ markets compared to supermarkets in North Carolina. Journal of Hunger & Environmental Nutrition. 2011;6(1):86–98.
32 Singleton 2017 - Singleton CR, Baskin M, Levitan EB, et al. Perceived barriers and facilitators of farm-to-consumer retail outlet use among participants of the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) in Alabama. Journal of Hunger & Environmental Nutrition. 2017;12(2):237-250.
33 Di Noia 2017 - Di Noia J, Monica D, Cullen KW, Thompson D. Perceived influences on farmers’ market use among urban, WIC-enrolled women. American Journal of Health Behavior. 2017;41(5):618-629.
34 Jones 2011 - Jones P, Bhatia R. Supporting equitable food systems through food assistance at farmers’ markets. American Journal of Public Health. 2011;101(5):781-3.
35 Hood 2012 - Hood C, Martinez-Donate A, Meinen A. Promoting healthy food consumption: A review of state-level policies to improve access to fruits and vegetables. Wisconsin Medical Journal. 2012;111(6):283-8.
36 Leone 2012 - Leone LA, Beth D, Ickes SB, et al. Attitudes toward fruit and vegetable consumption and farmers' market usage among low-income North Carolinians. Journal of Hunger & Environmental Nutrition. 2012;7(1):64-76.
37 Farmer 2016 - Farmer J, Minard S, Edens C. Local foods and low-income communities: Location, transportation, and values. Journal of Agriculture, Food Systems, and Community Development. 2016;6(4):1-13.
38 Morales 2009 - Morales A, Kettles G. Zoning for public markets and street vendors. American Planning Association. 2009;25(2):1-8.
39 Ringling 2020 - Ringling KM, Marquart LF. Intersection of diet, health, and environment: Land grant universities’ role in creating platforms for sustainable food systems. Frontiers in Sustainable Food Systems. 2020;4(70).
40 CCAFS-Campbell 2012 - Campbell B. Is eating local good for the climate? Thinking beyond food miles. Research Program on Climate Change, Agriculture and Food Security (CCAFS), CGIAR Research Programs. 2012.
41 USDA-Farmers market directory - US Department of Agriculture (USDA), Agricultural Marketing Service (AMS). Local food directories: National farmers market directory.
42 NCSL Winterfeld 2014a - Winterfeld A. State actions to reduce and prevent childhood obesity in schools and communities: Summary and analysis of trends in legislation. National Conference of State Legislators (NCSL); 2014.
43 NCSL-Farmers market - National Conference of State Legislatures (NCSL). Farmers’ market.
44 ChangeLab-Land use and FMs - Wooten H, Ackerman A. From the ground up: Land use policies to protect and promote farmers’ markets. Oakland: ChangeLab Solutions; 2013.
45 Urban-Thompson 2016 - Thompson M. How DC’s farmers’ markets improve food access and the local food system. Washington, DC: Urban Institute; 2016.
46 GGFN-Mobile market - Gorge Grown Food Network (GGFN). Farmers’ market network uses mobile market trucks to support markets.
47 USDA-FMPP - US Department of Agriculture (USDA), Agricultural Marketing Service (AMS). Farmers market promotion program (FMPP).
48 Kahin 2017 - Kahin SA, Wright DS, Pejavara A, Kim SA. State-level farmers market activities: A review of CDC-funded state public health actions that support farmers markets. Journal of Public Health Management and Practice. 2017;23(2):96-103.
Related What Works for Health Strategies
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