Food for Thought Series:

Promoting Health Through the Food System

Food systems can impact physical and mental health outcomes in many ways.

How Does the Food System Impact Health?

Many factors can affect individual and community health, including some that are part of the food system.

Figure 2 illustrates in a simplified way how the food system can impact health outcomes in a positive or negative way.

In this resource, we will focus on two sectors that are closely linked to health impact within the food system: Food Consumption and Food Markets and Retail.

Food Consumption and Health Impact

Indicators related to food consumption likely have the most direct connection to health outcomes, as consuming nutritious foods is essential to overall health.

Access to and cost of nutritious foods fluctuates over time and varies by geography. Food expenditures as a percentage of household budget have increased sharply since 2020.² Although high-income households spend more on food, low-income households devote a higher percentage of their income to food, leaving less to cover all other living expenses and leading neighbors to make economic trade-offs.³ These trade-offs often translate into frequent consumption of cheaper, less nutritious foods to stretch budgets.

Additionally, low-income households often live in areas where access to healthy food is more difficult than in high-income areas. Communities experiencing high rates of food insecurity tend to have higher prevalence of chronic disease.⁴

Food Markets and Retail and Health Impact

The food environment shapes neighbors’ access to and choices around food. One’s zip code is a strong indicator of one’s access to nutritious food and overall health. Areas where most households have high income generally have greater access to grocery stores than areas where most households have low income.

Federal programs, such as SNAP and WIC,ⁱⁱ also shape the food options available at retailers that accept them due to USDA stocking requirements. These retailers tend to offer a greater amount and variety of nutritious foods. In fact, SNAP participation is associated with higher food security after six months of participation, as well as better health outcomes and lower health care expenditures.⁵˒⁶ WIC is also associated with higher food security.⁷ These stores are not always located in areas where SNAP/WIC participation or eligibility is high, however, making it difficult for participating households to access those foods.

ⁱⁱ Supplemental Nutrition Assistance Program (SNAP) and Special Supplemental Nutrition Program for Women, Infants, and Children (WIC).

Figure 2. Examples of food system factors that may positively or negatively affect health over time

Annual Household Food Expenditures as a Percentage of Incomeⁱ

Increases in spending on produce may indicate higher produce consumption, which can lead to improved health.

Food for Thought

What do household food expenditures look like in your county?

What might be some ways to make nutritious foods more affordable for neighbors in your community?

Key Messages for Central Texas

On average, Central Texans spend 10.1% of their income on food. This is on par with the state average (10%), and slightly below the national average (11.2%).²⁸

Two-thirds of Central Texas food dollars are spent on dining out and “Other Food” (e.g., bakery items, snacks).

Only 13% of food dollars are spent on produce.

Community Voices

Neighbors participating in CNAs reported that, while they strongly prefer nutritious options, these options are often too expensive for their households, leading many to supplement with cheaper, calorie-dense alternatives.

“Fruits and vegetables are so high [in price], that’s why people run through McDonald’s, even though that’s not good for them...But guess what, I can feed my family of four for $20...We have it all upside down; the fruits and vegetables should be cheap and easy to consume.”
— Waco neighbor

ⁱ Data Source: 2017-2022 American Community Survey and 2023 Esri Consumer Spending Data. Central Texas average income: $91,182; and average food expenditures: $9,199 (Dining Out: $3,176; Other Food: $2,979; Meat, Poultry, Fish, Eggs: $1,301; Produce: $1,155; Dairy: $589).

Key Food System Metrics for Health Impact

Below is a snapshot of data on the Central Texas Food System Dashboard related to health impacts.

Food Retail Locations in Low-Income/Low-Access (LILA) Areasⁱⁱ

Increasing the number of food stores in LILA areas could facilitate access to a variety of food options more easily that can support neighbors’ health.

Food for Thought

What other food stores are available in your county?

Which strategies can be employed to increase the concentration of food retailers selling nutritious foods in underserved areas?

Key Messages for Central Texas

There are 6.2 times as many convenience stores and fast-food restaurants as grocery stores in Central Texas. This means that the region exceeds the threshold for being considered a “food swamp”: an area with ≥3.5 times more convenience stores and fast food restaurants compared to grocery stores.²⁹ Most Central Texas counties have LILA areas, and most LILA areas have convenience stores and fast food restaurants but few grocery stores. These trends indicate higher availability of ultra-processed foods and limited availability of fresh, nutritious foods.

Community Voices

Many neighbors participating in CNAs rate location as the most important factor determining where they shop but find that what is available are convenience or dollar stores with fewer food choices. Transportation budgets are often reserved for needs like commuting. Stakeholder interviews echoed these issues and noted that there are areas of limited food access beyond what LILA data currently show.

“We don’t have enough money to get enough food that will last–especially healthy food for our family. It’s a lot of time and money to get to the nearest grocery store.”
— Del Valle neighbor

ⁱⁱ Data Sources: Grocery and Restaurant Locations purchased from Data Axle Jan. 2024. LILA Areas: USDA Economic Research Service, Food Access Research Atlas, 2019-2021. Count of location types: Limited-Service: 2,367; Convenience: 619; Supermarkets: 478.

SNAP-Authorized Retailers by Census Tractⁱⁱⁱ

Increasing the number of SNAP-authorized retailers in areas with high SNAP participation and expanding online SNAP purchasing options could facilitate access to outlets that tend to stock more nutritious foods, which can, in turn, support neighbors’ health.

Food for Thought

Does your region seem to have enough SNAP retailers in areas with higher SNAP enrollment?

What barriers exist to increasing the number of SNAP-authorized retailers in your region?

Key Messages for Central Texas

While 9.6% of Central Texas households receive SNAP, many census tracts with relatively high SNAP enrollment have few authorized retailers. This means that neighbors must travel further to use their benefits.

Community Voices

Many neighbors participating in CNAs who access forms of federal assistance like SNAP report that benefits do not stretch far enough to meet their needs. Part of the reason for high prices may be due to fewer retail options. Stakeholder interviews shed light on barriers associated with becoming SNAP-authorized that small businesses like farmers markets may face: technology fees, increased labor costs, and a lack of farmers producing food that can be purchased using SNAP benefits.

“My $265 [in SNAP] is one grocery trip and not even a fully packed cart…By the end of the month, I’m trying to figure out, ‘Ok, we doing grilled cheese? We doing ramen?... What can I make some magical meal out of?’…[SNAP] hasn’t changed, even though costs do.”
— Hays County neighbor

ⁱⁱⁱ Data Source: USDA Food and Nutrition Service, Dec. 2022. Count of SNAP-authorized retailers: 2,059.

Key Health Indicatorsⁱᵛ

Actions addressing food consumption and access may contribute to decreased rates and improved management of diet-related diseases.

Food for Thought

What are the rates of chronic health conditions in your region? How do they compare to Texas?

How can increasing accessibility and affordability of nutritious foods through strengthening the food supply chain contribute to improved health outcomes?

Key Messages for Central Texas

Rates of obesity, diabetes, heart disease, and depression vary greatly across Central Texas and within each county. Half of counties have higher rates for all four conditions than the state average. Texas falls in the middle of all states in terms of obesity and is on par with national diabetes, heart disease, and depression rates.³⁰⁻³³

Community Voices

In areas where Central Texas Food Bank has conducted CNAs, many neighbors experience chronic health conditions that require more nutritious food options yet feel that they do not have the financial resources or nutrition knowledge to adequately address their needs. Stakeholder interviews echo the need for education.

“It’s really hard to put together or buy stuff that is healthy for you...I read labels... but I don’t always know everything I need to know and how to cook it... even though I’ve been dealing with [chronic illness] for a while. It gets frustrating... and I know there are a lot of other people out there, like me, that need to know how to eat.”
— Waco neighbor

ⁱᵛ Data Source: CDC PLACES: Local Data for Better Health, County Data 2023 release. Counties with higher rates of all four conditions than state average (10): Bastrop, Falls, Freestone, Lampasas, Lee, Limestone, McLennan, Milam, Mills, and San Saba.

Sample Strategies from Food Plans to Promote Health

Below are a few sample strategies mentioned in food plans across the U.S. that address the issues outlined above and can be implemented at the local or regional levels. Strategies listed here do not represent an exhaustive list and are not intended to serve as recommendations—they can serve as a starting point to explore further.

Strategies to impact the location of different types of food retail—especially those accepting SNAP and WIC benefits—include increasing the number and variety of retailers, both new and existing, that sell nutritious foods in LILA areas through incentives and/or assistance with site selection.⁸⁻¹⁹

Strategies to affect the ability to purchase nutritious foods include expanding efforts to connect neighbors in need with existing nutrition assistance programs like SNAP, WIC, and Double Up Food Bucks.⁹˒¹¹˒¹²˒¹³˒²⁰˒²¹˒²²

Strategies to affect the ability to prepare nutritious foods include delivering culturally relevant nutrition education on how to select and prepare nutritious foods affordably.¹⁰˒¹¹˒¹²˒¹⁴˒¹⁵˒¹⁶˒¹⁸˒¹⁹˒²⁰˒²¹˒²³⁻²⁶

Learn More

Explore the Central Texas Food System Dashboard for more food system data, including county-level data, insights, and questions.

For a curated list of food system resources, visit our Resources page.

Questions or feedback? Contact research@centraltexasfoodbank.org.

Click here to download a printable PDF of “Food for Thought: Promoting Health Through the Food System” (coming soon!).

References

Last updated January 2025