The relationship between food deserts, farmers' markets, Nutrition Benefits, and health in Delaware census tracts; 2017.

Food desert residents struggle to maintain a well-balanced, nutritious diet, increasing their risk of obesity and diabetes. Farmers' markets are a community-level intervention, bringing healthy food to food deserts. This study explores the relationship between food deserts, farmers' market location, the prevalence of obesity and diabetes, and the availability of Nutrition Benefit Programs (NBPs) in Delaware. Data are from the 2017 USDA Food Access Research Atlas and the Farmers' Market Directory. Descriptive statistics and spatial visualization were used to explore census tract-level relationships. Twenty percent of Delaware census tracts are food deserts. Of these, 7.2% have a farmers' market within their boundary, compared to 5.7% of non-food desert tracts. Of these markets, 3.2% accept Farmers' Market Nutrition Program coupons, 9.6% accept WIC Fruit and Vegetable Checks, and 21.6% accept Supplemental Nutrition Assistance Program. Sussex County has the highest obesity and diabetes rates, and the least number of markets that accept NBPs. Fresh food remains inaccessible to low-income residents, which is associated with diet-related chronic diseases. To reduce food insecurity, farmers' markets could expand acceptance of NBPs. Additional farmers' markets could be established in food deserts to increase the availability of healthy food, reducing the risk of developing obesity and diabetes.