Access to foods that support healthy eating patterns contributes to an individual’s health throughout his or her life.

Healthy eating habits include controlling calories; eating a variety of foods and beverages from all the food groups; and limiting intake of saturated and trans fats, added sugars, and sodium. Healthy eating can help lower the risk for chronic disease.

Evidence also shows that poor nutrition and an unhealthy diet are risk factors for high blood pressure, diabetes, and cancer. According to the 2015—2020 Dietary Guidelines for Americans, healthy eating patterns include: a variety of vegetables; fruits, especially whole fruits; grains, at least half of which are whole grains; fat-free or low-fat dairy; protein foods, including seafood, lean meats and poultry, eggs, legumes (beans and peas), unsalted nuts and seeds, and soy products; and oils.

Some research has shown that increased access to healthy foods corresponds with healthier dietary practices. 2022 NC SHIP, pg. 56

• There are barriers to, and disparities in, the accessibility and availability of foods that support healthy eating patterns. Data from 2012—2013 show that the average distance from U.S. households to the nearest supermarket was 2.19 miles. Individuals without a vehicle or access to convenient public transportation or who do not have food venues with healthy choices within walking distance have limited access to foods that support healthy eating patterns. 
• Transportation and distance to sources of healthy foods impact low–income and rural communities, especially older adults living in rural communities. Overall, for those who do not have access to a car or public transportation, the cost of travel time to find healthier options, in addition to out–of–pocket expenses, may be too high.
• Another barrier to the accessibility of healthy food choices is living in a food desert. In food deserts, food sources are lacking or limited, particularly in low-income areas that are more also likely to have a higher share of convenience stores and small food markets. These options tend to carry foods of lower nutritional quality compared to large chain supermarkets, which may have a wider variety of healthy options. 
• Improving access to foods that support healthy eating patterns is one method for addressing health disparities and population health. Several strategies that aim to “improve diet by altering food environments” are being considered and implemented.
• For example, a study has shown that a small financial incentive increased the use of Supplemental Nutrition Assistance Program (SNAP) benefits in participating farmer markets – resulting in increased access to healthy foods. 
• Several strategies have also been proposed to encourage more equitable access to healthy food choices, such as “attracting and opening supermarkets in underserved neighborhoods, selling healthy foods at reduced prices, and limiting the total number of per capita fast-food restaurants in a community.” 2022 NC SHIP, pg. 58

• Expand transit options in rural and lowincome communities
• Increase access to healthy foods in childcare, schools, churches, workplaces and other community-based settings
• Increase technological support for eWIC payments
• Increase technological support for SNAP EBT payments at food retailers
• Support nonprofit grocery stores working to meet the needs of residents of food deserts
• Support school-based meal programs
• Support tax-incentive programs designed to encourage grocery stores and farmers markets to move into food deserts

County Health Rankings and Roadmaps - United States Department of Agriculture (USDA) *Should not compare ranked data from year to year

DHHS, in partnership with a diverse set of stakeholders, developed a standardized set of SDOH screening questions to address and acquire data on the following:

• Food insecurity
• Housing instability
• Lack of transportation
• Interpersonal violence

https://www.ncdhhs.gov/about/department-initiatives/healthy-opportunities/screening-questions