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The main difference between a rural and an urban food desert is the distance of residents from the nearest supermarket. Twenty percent of rural areas in the U.S. are classified as food deserts. There are small areas within each state in the U.S. that are classified as rural food deserts, but they occur most prominently in the Midwest Within these counties, approximately 2.4 million individuals have low access to a large supermarket. This difference in distance translates into pronounced economic and transportation differences between the rural and urban areas. Rural food deserts are mostly the result of large supermarket stores that move into areas and create competition that is impossible for small businesses to keep up with. The competition causes many small grocers to go out of business. This makes the task of getting nutritious, whole ingredients much more difficult for citizens who live far away from large supermarket stores.

In most cases, people who live in rural food deserts are more likely to lack a high school degree or GED, to experience increased poverty rates, and to have lower median family income. People who live within rural food deserts also tend to be older. This is due to an exodus of young people (ages 20-29) who were born in these areas and decided to leave once they are able. States with numerous rural food deserts have a lower overall level of income as a result. This creates a negative feedback loop. Areas caught in these loops often struggle to repair the damages done, and typically remain as isolated communities that consist of uneducated and poor citizens.

Based on the 2013 County Health Ratings data, residents who live in rural U.S. food deserts are more likely to have poorer health than those who live in urban food deserts. People who live in rural communities have significantly lower scores in the areas of health behavior, morbidity factors, clinical care, and the physical environment. Research attributes these discrepancies to a variety of factors including limitations in infrastructure, socioeconomic differences, insurance coverage deficiencies, and a higher rate of traffic fatalities and accidents.

In a 2009 study, it was discovered that of the people who were polled, 64% did not have access to adequate daily amounts of vegetables, and 44.8% did not have access to adequate daily amounts of fruits. Comparatively, only 29.8% of those polled lacked access to adequate protein. This lack of access to fruits and vegetables often results in vitamin deficiencies. This eventually causes health problems for those who live within the area. When tasked with finding a solution to this problem, research has shown that it will take individual and community actions, as well as public policy improvements, to maintain and increase the capacity of rural grocery stores to provide nutritious, high quality, affordable foods while being profitable enough to stay in business.

Although personal factors do impact eating behavior for rural people, it is the physical and social environments that place constraints on food access, even in civically engaged communities. Food access may be improved in communities where civic engagement is strong, and where local organizations join in providing solutions to help decrease barriers of food access. Some ways communities can do this is by increasing access to the normal and food safety net systems and by creating informal alternatives. Some informal, communal alternatives could be community food gardens and informal transportation networks. Further, existing federal programs could be boosted through greater volunteer involvement.

A 2009 study of rural food deserts found key differences in overall health, access to food, and social environment of rural residents compared to urban dwellers. Rural residents report overall poorer health and more physical limitations, with 12% rating their health as fair or poor compared to 9% of urban residents. They believed their current health conditions were shaped by their eating behaviors when the future chronic disease risk was affected by the history of dietary intake. Moreover, the 57 recruited rural residents from Minnesota and Iowa in one study perceived that food quality and variety in their area were poor at times. The researchers reached the conclusion that, for a community of people, while food choice which bound by family and household socioeconomic status remained as a personal challenge, social and physical environments played a significant role in stressing and shaping their dietary behaviors.