Access to healthy food depends on a web of interconnected factors, from how close you live to a grocery store to how much money you have to spend there. In 2024, 13.7 percent of U.S. households (18.3 million) experienced food insecurity at some point during the year. The forces behind that number are geographic, economic, racial, educational, and political, and they often compound one another.
Distance to a Grocery Store
The most straightforward barrier is physical proximity. The USDA classifies neighborhoods as having low food access when residents live more than 1 mile from a supermarket in an urban area or more than 10 miles in a rural area. A stricter measure drops the urban threshold to half a mile, while a broader rural measure extends it to 20 miles. If the nearest store selling fresh produce is far away and you don’t have reliable transportation, your daily diet defaults to whatever is nearby.
These “food deserts” get the most attention, but a related concept may matter even more. Food swamps are areas flooded with fast food outlets and convenience stores relative to healthier options. A national study published in the International Journal of Environmental Research and Public Health found that food swamps are a stronger predictor of county-level obesity rates than food deserts. Even after controlling for the absence of full-service grocery stores, the density of high-calorie food outlets had a larger, statistically significant effect on obesity. In other words, it’s not just that healthy food is missing. It’s that unhealthy food is everywhere.
The Cost of Eating Well
Healthy food costs nearly twice as much as unhealthy food per serving. Data from the Multi-Ethnic Study of Atherosclerosis found an average price of $0.60 per serving for healthy items compared to $0.31 for unhealthy ones, a ratio of roughly 2 to 1. That gap adds up fast for a family buying three meals a day, seven days a week. When your budget is tight, calorie-dense processed food stretches further than fresh fruits, vegetables, and lean proteins.
This price difference helps explain why food insecurity doesn’t always mean hunger in the traditional sense. Of the 18.3 million food-insecure households in 2024, about 11.1 million fell into the “low food security” category, meaning they got enough calories but relied on less varied diets, federal food assistance, or community food pantries to do it. They were eating, but not eating well.
Whether You Own a Car
Car ownership quietly shapes diet quality in ways most people don’t think about. A study of 760 residents in New Orleans found that the amount of fruits and vegetables available near someone’s home only mattered for people who didn’t own a car. Among car owners, local availability had no measurable effect on intake, likely because they could simply drive to a store with better selection. For people without a car, the amount of fresh produce shelf space within about 1.2 miles of home significantly predicted how many fruits and vegetables they ate. An additional 100 meters of shelf space within that radius corresponded to roughly half a serving more per day.
This finding reframes the food desert conversation. Geographic distance isn’t inherently the problem. It becomes a problem when people lack the mobility to overcome it. In cities with limited public transit or in rural areas where the nearest grocery store is a 20-mile drive, not having a car can turn a manageable distance into an impassable one.
Historical Racism and Neighborhood Investment
The geography of food access in the United States didn’t happen by accident. A study of 102 urban areas found that neighborhoods redlined by the federal government in the 1930s, marked as “hazardous” or “declining” on maps used to deny mortgage loans, still have less healthy food environments today. This holds true even in census tracts that are now economically or racially different from what they were decades ago.
The mechanism is straightforward. Discriminatory housing policies drove down property values in minority neighborhoods. Lower property values meant fewer paying customers and less commercial investment, which kept grocery chains out. Over generations, this created a self-reinforcing cycle: disinvestment led to fewer stores, which made neighborhoods less attractive to retailers, which deepened the disinvestment. The result is that predominantly Black and Latino neighborhoods are more likely to rely on corner stores and fast food restaurants for daily meals while full-service supermarkets cluster in wealthier, whiter areas. The food environment and housing are deeply intertwined, and the patterns set nearly a century ago continue to shape who eats well and who doesn’t.
Food Literacy and Cooking Skills
Even when healthy food is available and affordable, people don’t always choose it. Nutrition knowledge helps, but research consistently shows that knowledge alone rarely changes eating behavior. The broader concept of food literacy, which includes knowing where food comes from, how to select it, how to prepare it, and how to make decisions that align with nutritional guidelines, appears to be the missing link.
A systematic review of adolescent dietary habits found that interventions focused purely on teaching nutrition facts had minimal impact on what young people actually ate. But programs that included hands-on cooking skills produced measurable changes. In one school-based cooking program led by a professional chef, participants reported increased confidence in the kitchen and higher vegetable consumption afterward. Adolescents who regularly cooked were more likely to have healthier overall diets. The takeaway is practical: access to healthy food matters little if someone doesn’t know what to do with a head of broccoli or a bag of dried lentils once they get it home.
Health Consequences of Poor Access
The effects of limited healthy food access show up in the body over time. In the general population, food insecurity is associated with insulin resistance and diabetes, along with the modifiable risk factors that drive those conditions: inflammatory diets heavy in processed foods, inadequate sleep, and physical inactivity. Central adiposity, the accumulation of fat around the midsection, is both a consequence of poor diet and a driver of metabolic disease. These connections mean that food access isn’t just a grocery shopping problem. It’s a chronic disease problem, and it falls disproportionately on communities that already face other health disadvantages.
Policy Interventions That Work
Financial incentive programs have shown some of the most concrete results in closing the gap. The USDA’s Healthy Incentives Pilot gave SNAP participants a 30-cent rebate for every dollar spent on targeted fruits and vegetables. Participants in the program consumed 26 percent more of those foods and spent 11 percent more of their benefits on them. A broader set of projects under the Food Insecurity Nutrition Incentives program, which used dollar-for-dollar matches in some cases, showed 12 to 16 percent increases in fruit and vegetable purchases.
These programs work because they address the cost barrier directly without requiring people to change neighborhoods, buy cars, or learn to cook. They meet people where they already are, in stores they already shop at, and make the healthier option more financially competitive with the cheaper, less nutritious alternative. The gains are modest in percentage terms, but across millions of households, they translate into meaningful shifts in diet quality.