Date Available


Year of Publication


Degree Name

Doctor of Education (EdD)

Document Type

Doctoral Dissertation




Kinesiology and Health Promotion

First Advisor

Dr. Melody Noland


Household food security status in rural areas is a significant issue facing caregivers as positive health outcomes depend on appropriate access to healthy foods necessary to lead an active life. Access and affordability of healthy foods are two mediating factors of household food security that may be improved to ultimately increase rates of food security and overall health status among rural, low income populations.

The purpose of the study was to examine the factors of access and affordability of nutritionally adequate food sources in one rural community in relation to food security status through the perspective of its caregivers. In general, populations suffering from low rates of food security report lower access to healthy foods and the inability to afford healthy foods.

The study utilized a primarily qualitative approach; however, thirty-one participants were initially categorized by levels of food security by the US Household Food Security Survey Core Module as a quantitative measure. Twelve participants who were classified as food insecure and were caregivers to children under the age of 18 responded to an in-depth interview focusing on the factors of access and affordability.

Twenty-six (84%) of the thirty-one food pantry clients who completed the initial survey were classified as food insecure. Open-ended interviews of participant perceptions of access and affordability to health foods in relation to food security revealed several major themes titled transportation and physical ability challenges, key issues in store choice, cost barriers in food shopping, strategies to maximize food dollars, and factors involved in food choice.

The results of this study, while they must be interpreted with caution, suggested there were multiple systems interacting that mediated the problem of food insecurity in this rural area through the perception of low income caregivers. The data can be used to improve health promotion programs and inform public health policies that can have a positive impact on overall health in rural areas.