Food Security in Hickory and the Foothills: A Growing Public Health Crisis

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Understanding Food Deserts and Their Causes

Food deserts are areas where people have to travel long distances to find stores selling healthy food at affordable prices (northcarolinahealthnews.org). In practical terms, this means many residents of low-income neighborhoods or rural communities live miles away from the nearest supermarket. The 2008 U.S. Farm Bill formally defines a food desert as a low-income census tract where at least 500 people or 33% of residents live more than 1 mile from a supermarket (10 miles in rural areas)

(wsoctv.com). In such places, families without reliable transportation often end up relying on convenience stores or fast-food outlets for groceries. These small stores rarely stock fresh fruits or vegetables and tend to sell mostly packaged snacks and sodas – leading some experts to label them “food swamps” because unhealthy options swamp out any healthy ones (localfood.ces.ncsu.edu). 

Several factors cause food deserts to emerge. Poverty is a central driver – supermarkets avoid low-income areas if they fear low profits, high theft, or costly operations, leaving a void in healthy food retail (medicalnewstoday.com). Lack of transportation worsens the problem, especially in rural parts of the foothills; if you don’t own a car and there’s no bus, a grocery store 5 or 10 miles away might as well be on the moon. On top of that, decades of development patterns and zoning decisions often concentrated retail in certain districts and left other neighborhoods with none. The result is pockets of our community where the only nearby food outlets are gas stations or fast-food franchises. Map 1 below illustrates the challenge – large areas of North Carolina (including parts of our Foothills region) are shaded to indicate poor access to grocery stores, especially in rural and low-income tracts (localfood.csu.edu). These are the food deserts on the map, and they translate to real families struggling to find fresh, nutritious foods close to home.  

Map 1: USDA Food Environment Atlas map of North Carolina, showing areas with limited access to grocery stores (shaded). Rural counties and low-income communities have higher concentrations of “food deserts,” where residents live far from supermarkets (localfood.ces.ncsu.edu). 

The causes of food deserts are intertwined with economic and social trends. When household incomes fall or local industry declines, full-service grocers often close up or move to wealthier areas, leaving behind a “grocery gap.” High unemployment can also suppress demand for fresh food – people struggling to pay bills may opt for the cheapest calories (often processed foods) rather than pricier produce (medicalnewstoday.com). In our Hickory Metro and greater Catawba County region, the decline of manufacturing jobs and wages over past decades has contributed to this dynamic (file-tpbtfr5gizd1klftcpe1qy). Additionally, urban planners note that transportation is crucial: one North Carolina study found the biggest barrier keeping families from using farmers’ markets was simply getting there (northcarolinahealthnews.org). Without a car or reliable bus service, even a moderately distant supermarket is out of reach, forcing people to shop at the nearest corner store. All these factors – low incomes, store investment decisions, transportation gaps, and even historical segregation of neighborhoods – combine to create food deserts. The outcome is the same: thousands of residents in Hickory and surrounding communities have limited access to affordable, nutritious food in their daily lives (schs.dph.)ncdhhs.gov).

Access to Fresh Food in Hickory and Catawba County

How easy is it to get healthy food in Hickory or the broader Foothills? The answer varies dramatically by neighborhood. In affluent parts of town or busy commercial corridors, one can find chain supermarkets, big-box grocery retailers, and specialty food stores. But in West Hickory, Long View, Ridgeview, Southeast Hickory and several other communities identified by local health assessments, there are no full-service grocery stores nearby (schs.dph.ncdhhs.gov). Residents in these areas must travel outside their neighborhood – sometimes several miles – to reach a supermarket with fresh produce, dairy, and meat. Public health officials have pinpointed six to seven such food desert zones across Catawba County (including parts of Hickory and Newton), where roughly 1 in 10 people have limited food access due to where they live and their income level (schs.dph.ncdhhs.gov - catawbacountync.gov). Notably, these include historically underserved and lower-income neighborhoods like Long View, Ridgeview, the Southeast quadrant of Hickory, East Newton, Highland, and St. Stephens (schs.dph.ncdhhs.gov). In these communities, families often rely on distant supermarkets or make do with convenience marts that stock mostly canned goods and junk food. It’s a daily challenge that many outside these neighborhoods don’t see – but it shows up in our maps and statistics. 

Grocery stores remain the backbone of food access for most families, but their distribution is uneven. Hickory proper has a handful of large grocery outlets (including national chains and discount grocers), yet many are clustered along major highways or suburban-style shopping centers. For example, you’ll find several supermarkets strung along US-70 and around Valley Hills Mall, serving those who can drive, while inner-city neighborhoods like Ridgeview (a historically Black community) have no grocery store and instead have multiple convenience stores and fast-food shops. In Catawba County’s smaller towns and rural fringes, the situation is even starker – some rural residents live 8–10 miles from the nearest supermarket (wsoctv.com). If they cannot drive, they must depend on others, or on small dollar stores that have limited fresh food selection. This urban-rural divide is evident across North Carolina: overall our state has more than 170 food desert tracts in 57 counties, impacting nearly one-third of North Carolinians (wsoctv.com). Our Foothills corridor is part of that picture, with both urban food deserts in city centers and rural food deserts in outlying areas.

Aside from traditional groceries, the region’s farmers’ markets and produce stands play an important role in fresh food access – though they operate on a limited basis. Hickory hosts a downtown farmers’ market that runs twice weekly in season and features over 30 vendors at its peak (catawbacountync.gov). This market, along with smaller seasonal markets in Conover, Claremont, and at a church in the Bandys community, brings local fruits, vegetables, and handmade goods directly from farmers to consumers (catawbacountync.gov). These are vibrant community gatherings and offer an alternative to supermarket shopping, especially for those seeking organic or locally grown produce. However, farmers’ markets typically operate only one or two days a week and often during daytime hours, which can limit their reach. Recognizing this, Catawba County’s Public Health department established its own weekday farmers’ market at the health department parking lot – explicitly aiming to improve healthy food access. This market runs Thursdays mid-morning to early afternoon, timed for convenience of seniors and parents, and it accepts SNAP/EBT as well as WIC Farmers Market Nutrition vouchers, even offering up to $30 in matching funds for SNAP shoppers to double their produce buying power (catawbacountync.gov). Such efforts are crucial in bridging the gap for low-income families. One local survey found cost was the number one barrier to eating healthy, cited by residents; doubling programs help stretch limited food dollars (schs.dph.ncdhhs.govcatawbacountync.gov). 

Despite these positive efforts, major gaps in the food distribution system remain. While we have a strong network of charitable food pantries and soup kitchens (often operated by churches and nonprofits), these are meant as emergency stop-gaps, not everyday grocery sources. The Hickory area benefits from a regional food bank and mobile pantry visits, yet demand remains high. For instance, 14.9% of Catawba County’s population – about 24,000 people – receive SNAP (food stamp) benefits to help buy groceries (schs.dph.ncdhhs.gov - schs.dph.ncdhhs.gov). Many of these households still rely on food banks toward month’s end when benefits run low. The food distribution infrastructure for local produce is another missing piece: small farmers often struggle to get their crops into local stores or institutions. There have been discussions of creating a regional food hub or aggregation center (essentially a local produce distribution warehouse) to connect our small farms with schools, restaurants, and groceries. A few years ago, farmers and stakeholders expressed interest in a shared packing house or commercial kitchen facility (catawbacountync.gov). Ultimately, a feasibility study concluded that while an aggregation center could greatly help small farms and improve local food availability, it wasn’t yet economically viable due to insufficient scale and coordination (catawbacountync.gov). As a result, the region still lacks a dedicated food hub, meaning much of the produce grown by Foothills farmers gets sold either directly at farm stands or shipped out through wholesalers, rather than feeding our own community at scale. 

Meanwhile, independent grocery stores vs. chains present a contrasting picture of food access. In the past, Hickory and surrounding towns had many family-owned grocers and neighborhood markets. Today, large chain supermarkets and supercenters dominate the landscape (e.g. big-box retailers and national grocery chains). These chains can offer lower prices due to volume buying, which benefits consumers if they can get to the store. However, the big chains strategically locate along highways and high-traffic zones, rarely in the middle of low-income residential areas. Smaller independent grocers, which might be more willing to locate in town centers, have struggled to survive against the giants. The result is what some call a “grocery gap”: wealthy areas have plenty of options, while poor and rural areas have very few. Public policy has started to respond – North Carolina launched a Healthy Food Small Retailer program to assist corner stores in food deserts to stock fresh items (providing refrigerators and small grants)- (policylink.org - lrs.sog.unc.edu). Locally, there have been incentives offered for any grocery store willing to open in underserved parts of Hickory, though progress has been slow. One bright spot is that a major wholesale distributor based near Hickory (Merchants Distributors, Inc. in Caldwell County) has begun initiatives to source from local growers and potentially improve distribution of fresh produce in the region ) (catawbacountync.gov). If local farmers can more easily sell to local grocers through such channels, it could encourage more stores to carry truly fresh, regional produce rather than just trucked-in food. But for now, access to fresh, nutritious food in Hickory and the Foothills remains highly uneven – essentially abundant in some places and scarce in others, depending on where you live and whether you can drive.

The Local Food Ecosystem: Farms, Restaurants, and Zoning

Hickory’s regional food ecosystem is a mix of old agricultural traditions and modern commercial realities. Catawba County and its neighbors have deep farming roots – our county seal even features a cow, nodding to the dairy farms that once made this area famous (catawbacountync.gov). To this day, agriculture is a significant (if diminished) part of the local economy, generating an estimated $52 million in farm cash receipts as of 2011 and much more when you include food processing and related businesses (catawbacountync.gov). Farms here produce poultry, beef, corn, soybeans, and vegetables, among other goods. However, the number of local farmers and acres under cultivation have steadily declined over the past few decades. As the region urbanized and population grew since the 1970s, thousands of acres of farmland have been lost to housing developments, shopping centers, and industrial parks. In one five-year span (2002–2007), Catawba County saw 6,600 acres of farmland converted to other uses (catawbacountync.gov). This loss of local farms means less locally grown food available and longer supply lines for what we eat. The farmland that remains is often held by aging farmers: the average age of a Catawba County farm operator is about 58 years (catawbacountync.gov), slightly older than the state average. Young people are less inclined to take up the family farm, especially as small-scale farming struggles to turn profit. Generational loss of farmers, combined with development pressure, poses a challenge to maintaining a robust local food supply. Fewer farmers in the Foothills means more dependence on imported food trucked in from elsewhere.

Local restaurants play a dual role in the food system: they shape food habits and also could be buyers of local produce. The Hickory area boasts a lively mix of chain restaurants, fast-food outlets, and a handful of farm-to-table style eateries. On the whole, though, the majority of restaurants here – especially the ubiquitous fast-food and fast-casual chains – rely on mass-produced, hyper-processed ingredients shipped from national distributors. A typical chain restaurant or drive-thru in our area sources little to nothing from local farms; their menus are standardized and supplied by corporate systems. This keeps costs down for diners but also reinforces a food culture heavy in salt, sugar, and unhealthy fats (think burgers, fried chicken, pizza, and sugary sodas). Locally owned restaurants, including some barbecue joints and diners, sometimes buy from local farms or farmers’ markets when possible, but they are relatively few. We do have a couple of newer farm-to-fork restaurants in the region that pride themselves on sourcing meat and produce from nearby farms – these are promising models, yet remain niche and often priced out of reach for lower-income residents. For the most part, restaurant economics favor cheap ingredients and volume sales, which means fresh and local foods struggle to compete with processed bulk foods. It’s a tough balance: independent restaurants would love to use more local organic greens or pasture-raised beef, but those inputs cost more than the bulk equivalents from a national supplier. Without broader consumer demand and willingness to pay, many eateries stick to the status quo. This affects food security indirectly by influencing what people eat daily – if dining out means mostly unhealthy options, it’s harder for the community to maintain healthy diets.

Zoning and land use policies also influence our regional food ecosystem in subtle but important ways. Historically, zoning laws in cities like Hickory separated residential areas from commercial areas, which meant that neighborhood grocery stores or markets were not always permitted near homes. This has begun to change – planners and city officials are recognizing that mixed-use development (where shops and homes coexist) can improve access. Hickory’s recent comprehensive plan updates and the county’s strategic plan explicitly mention integrating health and food access considerations into future development (catawbacountync.gov). For example, ensuring that new subdivisions have space nearby for a grocery store, or that community gardens are allowed in neighborhoods. Agricultural zoning in the rural parts of Catawba and surrounding counties has been another tool: it can protect farmland from dense development, but only if elected officials and landowners support it. Our county’s voluntary agricultural district program encourages landowners to keep farmland in production by offering some benefits and recognition (catawbacountync.gov). Still, when a farmer retires, the economic pressure to sell land for development is strong. Local ordinances on urban agriculture (like keeping chickens or front-yard gardens in town) have generally been permissive in this region – we haven’t seen the kinds of restrictive bans on gardens that some big cities have flirted with. In fact, community and school gardens are increasingly promoted here as a way to improve food literacy and provide fresh produce in food desert areas. One limiting factor, though, is infrastructure: if an old grocery building closes in a low-access area, zoning alone can’t revive it without a willing grocer. Some advocates have proposed using vacant city-owned land or closed school buildings as sites for community grocery co-ops or food hubs. Identifying potential sites like schools, churches, or disused groceries for food access projects is an active discussion in local food policy circles (catawbacountync.gov). Overall, while zoning and planning won’t solve food insecurity by themselves, they are being leveraged more now to support a healthier food environment – from allowing farmers’ markets and community gardens in more places to incentivizing supermarkets to open in underserved zones. 

At the intersection of local agriculture and the broader food industry, there are some hopeful developments. We mentioned the big distributor (MDI) working with local farms; additionally, cooperative extension agents and nonprofits have been linking farmers to institutions through Farm-to-School and Farm-to-Church programs. Schools in our region, for instance, have started to source local apples, sweet potatoes, or strawberries when in season for cafeteria meals. There is recognition that keeping food local can be a win-win: farmers get a stable market and residents get fresher food. However, scaling that up remains difficult without the infrastructure (like the earlier-mentioned food hub or processing center). The Farm & Food Sustainability Plan for Catawba County, developed a decade ago, laid out dozens of action items to bolster the local food economy – from preserving prime farmland to expanding farmers’ markets and exploring value-added processing (such as a shared commercial kitchen) (catawbacountync.gov). Many of those ideas are still on the table, slowly being implemented. One conclusion of that plan was that an aggregation/marketing center could greatly improve viability for small farms, but it required more coordination and evidence of supply and demand than was available at the time (catawbacountync.gov). In short, our local food ecosystem is in transition: trying to hang onto its agricultural heritage and boost local production, while grappling with the realities of a modern food economy that often favors consolidation and imports. How we navigate land use, support farmers, and integrate local food into mainstream outlets will determine if the Hickory area can build a more resilient, healthy food system for the future.

Nutrition and Health Outcomes in the Foothills

The consequences of our food environment show up starkly in regional nutrition and health outcomes. In communities with abundant fresh food access, people’s diets tend to include more fruits, vegetables, and whole foods. But in our identified food deserts and generally across lower-income segments of the population, diets skew heavily toward processed and ultra-processed foods – the packaged snacks, instant meals, sugary drinks, and fast foods that are cheap and convenient. Public health data paints a worrying picture. Catawba County, like much of North Carolina, is in the throes of an obesity and metabolic health crisis. Over the period 2016–2021, there were 4,146 deaths in Catawba County from diet-related chronic illnesses – including heart disease, stroke, diabetes, and certain cancers – accounting for 43.5% of all deaths in that time (schs.dph.ncdhhs.gov). In other words, nearly half of local deaths are tied to conditions strongly influenced by diet and nutrition. This is a glaring indicator that what we eat is literally a life-and-death matter. Our county health rankings consistently show high rates of obesity, hypertension, and diabetes, especially concentrated in the same neighborhoods that lack healthy food access. For example, in the Ridgeview area of Hickory (a lower-income, predominantly Black neighborhood), almost 48.5% of adults are classified as obese, 45.5% have high blood pressure, and 19.6% have diabetes, the highest such rates in the county (schs.dph.ncdhhs.gov). In Southeast Hickory (around census tract 110), about 9.5% of adults have been diagnosed with heart disease – again the county’s highest rate (schs.dph.ncdhhs.gov ). These prevalence figures are dramatically above the county averages, indicating a cluster of diet-related illness where healthy food is hardest to obtain. 

Even county-wide averages are sobering. Roughly 30-35% of Catawba County adults have obesity (BMI ≥30) according to recent estimates, which is on par with North Carolina’s overall adult obesity rate (the state was ~33-35% obese in 2021) (communityclinicalconnections.com. Childhood obesity is a growing concern as well: among young children (ages 2–4) from low-income families in Catawba, around 30% are obese – nearly double the statewide rate for that age group (communityclinicalconnections.com). Such early obesity puts kids on a trajectory for lifelong health struggles. Diets high in sugar, salt, and unhealthy fats are contributing to these outcomes. Survey data and health interviews in our region indicate that many residents consume diets heavy in fast food, sugary beverages, and processed snacks, and low in fresh produce and fiber. Soft drinks and sweet tea are extremely popular here – part of the Southern food culture – and that adds a huge sugar load to daily intake. Statewide data shows about 30% of North Carolina adults drink at least one sugar-sweetened beverage every day, as do nearly one in three high school students (schs.dph.ncdhhs.gov (schs.dph.ncdhhs.gov). Catawba County likely mirrors this pattern. Over time, all that sugar contributes to weight gain, insulin resistance, and tooth decay. Similarly, cheap processed foods often contain high levels of sodium (salt) and industrial oils. The typical convenience diet of ramen noodles, frozen pizzas, canned ravioli, and drive-thru burgers can easily exceed recommended salt and fat intake, fueling high blood pressure and cholesterol issues. 

One distinctive feature of food insecurity is that it paradoxically coexists with obesity – sometimes called the “hunger-obesity paradox.” When money is tight, families often must maximize calories per dollar, which leads them to the least healthy caloric dense foods (like chips, sweets, and starches) over more expensive lean meats or vegetables (medicalnewstoday.com). This can result in people being overweight and undernourished in terms of vitamins and minerals. Health officials note that nutrient deficiencies (such as low iron, potassium, or vitamin intake) can occur even in those consuming plenty of calories, because heavily processed diets lack the micronutrients of fresh whole foods (medicalnoday.com). We see evidence of this in rising diabetes rates, persistent anemia in some populations, and anecdotal reports from doctors about young patients with ailments like hypertension and pre-diabetes that used to only be seen in older adults. Indeed, the burden of metabolic syndrome (a cluster of high blood pressure, high blood sugar, abnormal cholesterol, and belly fat) is high in our region. The local health assessment data showed significant racial disparities too: Black residents in Catawba County suffer higher rates of diet-related chronic conditions and food insecurity, compounding an already dire situation (schs.dph).ncdhhs.gov). 

It’s not just obesity and diabetes – dental health is affected by diet (high sugar intake drives cavities, and many lower-income folks drink soda in lieu of water). Liver disease can emerge from diets full of high-fructose corn syrup (non-alcoholic fatty liver disease is on the rise). And of course, poor nutrition in childhood impairs growth, learning, and immune function. We should also mention mental health and productivity: there’s a growing recognition that diets heavy in ultra-processed foods may be linked to higher rates of depression and lower cognitive function, not to mention how hunger and erratic eating harm school and work performance. 

Statistically, our region’s overall health outcomes rank in the bottom half of North Carolina counties on many measures. The life expectancy gap within the county is telling – residents of one food desert community (Long View) have a life expectancy of only 64.6 years, whereas in a more affluent part of Hickory it’s 82.6 years (schs.dph.ncdhhs.gov). That 18-year difference correlates strongly with differences in diet, obesity, and chronic disease prevalence, alongside other factors. Another startling metric: if we consider healthcare costs, North Carolina has among the highest proportions of medical expenses attributable to obesity – about 14% of all healthcare spending in the state was linked to obesity-related issues in 2015 (pmc.ncbi - .nlm.nih.gov). That suggests our local hospitals and clinics are pouring resources into treating preventable diseases that stem from poor diet and nutrition. Taken together, these outcomes form a portrait of a public health crisis. 

To summarize: processed and hyper-processed foods dominate many residents’ diets in the Hickory-Foothills region, leading to excessive consumption of added sugars, high sodium levels, and unhealthy fats. This dietary pattern has produced high rates of obesity (one-third or more of adults), widespread hypertension and elevated blood sugar, and consequently high incidences of heart disease and diabetes. The places with the worst food access have the worst health outcomes – a clear geographic and socioeconomic pattern. It is crucial to note that while food access is not the sole determinant of health (exercise, genetics, etc. play roles), research shows better access to affordable healthy food enables better dietary choices. The mixed results in studies about food deserts and health often highlight that simply having a grocery nearby isn’t a silver bullet if people’s habits or transport don’t change (localfood.ces.ncsu.edu - northcarolinahealthnews.org). Nonetheless, improving the food environment is a necessary foundation for improving nutrition. In public health circles here, you’ll often hear the phrase “food as medicine” – meaning that improving diet quality (more vegetables, fruits, whole grains, lean proteins) could substantially reduce our burden of chronic illness (file-tpbtfr5gizd1klftcpe1qy).  The data we have strongly supports that: better diet could potentially save many of those 4,000+ lives lost in five years to diet-related disease and lighten the heavy load of disease management that so many families carry.

Public Assistance, Nonprofits, and Private Efforts

Addressing food insecurity and poor nutrition requires a multi-sector effort. Public assistance programs like SNAP (Supplemental Nutrition Assistance Program, formerly food stamps), WIC (Women, Infants, and Children nutrition program), and school meal programs are critical lifelines in our community. In Catawba County, as noted earlier, roughly 15% of residents rely on SNAP to buy groceries, and nearly 67% of public school students qualify for free or reduced-price meals due to low household income (schs.dph.ncdhhs.gov). That means two-thirds of the children in our area depend on school for at least one nutritious meal a day – a staggering figure that underscores the economic challenges families face. The good news is our local school districts have robust nutrition programs: all three public school systems (Hickory, Newton-Conover, and Catawba County Schools) participate in summer feeding programs and send food home on weekends (through backpack programs) for kids who might otherwise go hungry (embed.clearimpact.com - embed.clearimpact.com). These initiatives ensure continuity of nutrition beyond just the lunch bell. During the COVID-19 pandemic, schools here even delivered meals along bus routes to reach kids when campuses were closed, an effort that likely prevented a spike in child hunger. 

SNAP, administered by county social services, puts purchasing power directly in the hands of low-income households. However, simply having SNAP benefits doesn’t guarantee access to healthy food if there are no stores nearby or if healthy foods are unaffordable. One promising strategy has been expanding SNAP acceptance at farmers’ markets and creating “Double Bucks” programs. As mentioned, the Hickory Farmers Market and the Public Health Farmers Market both accept EBT and have matching dollar programs up to $30 (catawbacountync.gov). This effectively doubles the amount of fresh produce SNAP shoppers can take home and supports local farmers at the same time. The WIC program specifically targets pregnant women, infants, and young children with nutritional support (providing vouchers for specific healthy foods like milk, whole grains, baby food, etc.). Local WIC participation has been strong – on average about 3,500 individuals (including 950 infants and 1,770 children) were on WIC each month recently (schs.dph.ncdhhs.gov). Yet there’s room to grow: one analysis found that only 56% of eligible mothers on Medicaid were using WIC, suggesting some families aren’t accessing the help available (schs.dph.ncdhhs.gov). Reasons often include transportation to WIC clinics or stigma of being on assistance. 

Stigma is indeed a real barrier. Community feedback sessions revealed that pride and stigma around food assistance prevent some people from seeking help (schs.dph.ncdhhs.gov). In certain cultures or among older generations, there’s a reluctance to accept “handouts,” even if the family is struggling. Also, misinformation about what benefits entail (for example, some think food stamps can only buy junk food or that using them is overly difficult) can reduce uptake. Local agencies and nonprofits are working to combat these stigmas by reframing assistance as nutrition support rather than charity. For instance, the North Carolina Alliance for Health has campaigned to rebrand SNAP as a nutritional program and dispel myths (fulfillnj.org - poynter.or). In our area, outreach workers from public health and cooperative extension attend community events to sign people up for SNAP or WIC on the spot, often emphasizing how these programs are already paid for by taxpayer dollars and meant to be used to keep families healthy. Churches have also played a key role – many churches run discreet food pantries or “blessing box” free food kiosks that people can use anonymously, which helps those who feel embarrassed about lining up for food. 

On the nonprofit front, Catawba County is home to several notable hunger relief organizations. The Hickory-based Greater Hickory Cooperative Christian Ministry and the Salvation Army provide food pantry services. Catawba County Health Partners, a local nonprofit collaborative, has made improving food access one of its top priorities. They’ve used data to identify the six highest-need food desert tracts and have convened coalitions to find solutions (salud-america.org) . We have soup kitchens in Newton and Hickory that serve hot meals daily to anyone in need (many working poor and homeless individuals depend on these). During the pandemic, these nonprofits saw demand skyrocket and learned to adapt with drive-through food pickups and home deliveries to seniors. While charities are indispensable, many leaders acknowledge that charity alone cannot solve food insecurity – they prefer to talk about “food security” in terms of a sustainable system, not just emergency feeding. This has led to some innovative partnerships: for example, hospitals and clinics have started “food prescription” programs where doctors can actually prescribe fresh fruits and vegetables to patients with diet-related illness, redeemable at local markets or pantries. Catawba County’s Access to Healthy Foods workgroup is exploring a produce prescription program now (embed.clearimpact.com), which would tightly link healthcare and nutrition assistance (imagine a diabetic patient getting a “prescription” for weekly CSA produce). 

Private industry efforts beyond grocery stores are also emerging. One interesting development is the role of local farmers co-ops and online marketplaces. There’s a new initiative by Carolina Farm Trust aiming to launch a community grocery in the Hickory area that sources from local farms – effectively a nonprofit/community-owned grocery store in a current food desert (instagram.com). If successful, this could be a model of a private, mission-driven entity tackling the gap left by for-profit grocers. Additionally, some employers in the region have begun wellness programs that address nutrition. For instance, larger factories and employers have hosted mobile farmers’ markets at workplaces or have farm produce subscription drop-offs for employees. They recognize that healthier employees are more productive and have lower healthcare costs. 

At the policy level, North Carolina’s legislature took notice of food deserts a few years ago. A House Study Committee on Food Desert Zones (co-chaired by a local legislator from Hickory) looked at policy measures (wsoctv.com). This resulted in small grants and the aforementioned Healthy Food Small Retailer Act to get refrigeration units into corner stores in food deserts. While relatively modest (funding was limited and inconsistent year to year (dph.ncdhhs.gov - ncleg.net), it signaled an understanding that public-private partnerships are needed. For example, a local convenience store in one of Hickory’s underserved areas might get a grant to add fresh produce and a banner saying “Healthy Food Sold Here.” Mecklenburg County (Charlotte) did something similar by certifying “Healthy Corner Stores” that carry fruits and vegetables and promoting them in the community (health.mecknc.gov - bmcpublichealth.biomedcentral.com). We could see such models expanded in our Foothills corridor with the right support. 

Another intersection of public and private is transportation – local transit authorities and rideshare companies have considered programs for “grocery shuttles.” Greenway Public Transportation, which serves Hickory and surrounding towns, has a bus route that stops at major grocery centers and even at the Public Health Farmers Market(catawbacountync.gov).

Ensuring those routes are maintained or exp    anded is an ongoing advocacy point. If private transit or Uber-type services could offer discounted rides for grocery trips (perhaps subsidized by a health foundation), that might alleviate the transport barrier for some households. Indeed, a pilot project in another part of NC gave low-income mothers $24 annual farmers’ market vouchers but found many went unused because of transportation issues (northcarolinahealthnews.org - northcarolinahealthnews.org). When transit was provided or markets went mobile into neighborhoods, usage jumped. Learning from these experiences, our community is interested in mobile markets – essentially a farmers market on wheels that can visit food deserts weekly. Some churches have even converted old buses into mobile grocery stores that carry staples into rural trailer parks or housing projects. These kinds of creative solutions blur the line between nonprofit and private entrepreneurship, all aimed at filling the access gaps. 

In summary, a lattice of support systems is at work: public assistance (SNAP, WIC, school meals) provides essential financial and food support; nonprofits and churches catch those who fall through the cracks with pantries and meal programs; and private sector and policy initiatives attempt to improve the overall retail landscape (through incentives for healthy food retail, mobile markets, and corporate wellness). Each has had successes, but challenges remain. Notably, despite tens of thousands of residents benefiting from SNAP and WIC, there are still many more who are eligible but not enrolled – often due to administrative hurdles or stigma (schs.dph.ncdhhs.gov). Efforts like simplifying enrollment and reducing stigma (for instance, making EBT usage as normal as using a debit card, which it effectively is) continue. The intersection of all these efforts is crucial: when a family uses SNAP at a farmers market with a double bucks incentive, supported by a nonprofit-run market stand, and perhaps was referred there by their doctor, we see public, private, and nonprofit sectors working in concert. That kind of ecosystem approach is what many advocates say is needed to truly move the needle on food security.

Culture, Behavior, and Food Literacy

Food security isn’t just about programs and proximity; it’s also deeply tied to cultural and behavioral factors. In the Hickory and Foothills region, as in much of the South, food culture has undergone significant shifts over the past couple of generations. Cultural dietary norms here have traditionally included home-cooked meals of comfort foods – think pinto beans, cornbread, fried chicken, collard greens, etc. Many older residents reminisce about how their parents or grandparents kept vegetable gardens and cooked virtually every meal at home. Canning summer produce for winter, cooking big family dinners on Sundays, and passing recipes through generations were common practices. However, these traditions have been steadily eroded by the fast-paced modern lifestyle and the proliferation of convenience foods. Younger generations are less likely to know how to can vegetables or even cook from scratch regularly. One recent survey found that Americans are cooking at home less than ever before, averaging only about 8 home-cooked meals per week in 2022 (down from 9+ a week a couple decades ago)- (deseret.com). We in the U.S. (and particularly the Southeast) have become heavily reliant on pre-packaged meals, takeout, and restaurant food. Hickory’s busy working families often find it easier to swing through a drive-thru or pop a frozen pizza in the oven than to prepare a meal from raw ingredients – especially if they have dual-income parents with little time to spare. 

This reliance on fast food is vividly visible in our community. Along every commercial strip, fast-food restaurants dot the landscape, and they are frequently busy at all hours. It’s estimated that on any given day, roughly 37% of American adults consume fast food, and the figure is even higher among younger adults (abcactionnews.com). Locally, one can see this in the lunchtime rush at burger and fried chicken chains, or the steady stream of cars at biscuit and donut shops each morning. Fast food is popular not just for convenience but also because it’s relatively affordable and heavily marketed. Combo meals, dollar menus, and constant advertising make it a default choice for many. Unfortunately, the nutritional profile of most fast food is poor – typically high in calories, saturated fats, sugar (in soda and dessert items), and sodium (abcactionnews.com). Overconsumption of these meals contributes significantly to obesity and related health issues. Some residents humorously call Hickory “Fast Food Alley” because of the density of such outlets. It reflects a behavioral norm that eating out or grabbing takeout is a daily occurrence, not an occasional treat. 

Cooking habits have changed accordingly. Fewer people have robust cooking skills or confidence in the kitchen, particularly among those who didn’t grow up in households that cooked. Food literacy – meaning understanding nutrition, knowing how to read a food label, or how to prepare healthy meals on a budget – is uneven in the population (tandfonline.com).

There are ongoing efforts to improve this: Cooperative Extension runs classes on cooking and nutrition (like the EFNEP program for nutrition education or local “Cooking Matters” workshops). Some churches and community centers have started offering basic cooking classes, often aimed at young parents, to teach how to make simple, healthy dishes and stretch ingredients. The demand is there: when such classes are offered, they often fill up, indicating people want to learn. But reaching everyone is a challenge. Many folks rely on what’s quick and what they know – for example, heating up processed foods or sticking to a very limited repertoire of meals. A not uncommon scenario is a working parent who might stop at a convenience store to buy cheap hot dogs and boxed mac-and-cheese for dinner because it’s fast, filling, and what the kids will eat. Part of improving food security is expanding people’s sense of what they can cook or eat easily. Something as simple as a crockpot stew with vegetables can be economical and healthy, but one has to have the idea and the know-how to do it, and possibly the fresh ingredients on hand. 

Generational differences in diet are striking. Older generations (say those born in the 1940s–50s) often grew up on homegrown vegetables, fresh milk, etc., albeit sometimes in the context of poverty or subsistence farming. They might have eaten simpler foods with fewer calories (lots of beans, seasonal produce, small portions of meat). Younger generations (1980s–90s born) came of age in the era of fast food, microwave dinners, and ubiquitous soft drinks. It’s no surprise that rates of childhood obesity began climbing in the 1990s and 2000s. We now have parents in their 20s and 30s who themselves never learned to cook from scratch because their parents were the first fast-food generation. This generational cycle is hard to break. Grandparents in some local families have voiced concern that their grandkids “won’t eat anything that’s not chicken nuggets or pizza.” That reflects both taste preferences shaped by the food industry and perhaps a loss of family meal culture. Family structure plays a role too: with more single-parent households and busy schedules, the sit-down family dinner has become less common. People grazing on ultra-processed snacks or eating separately in front of screens is more the norm now, which can reduce the transmission of cooking knowledge and also often means less healthy choices. 

Additionally, stigma around food assistance and even around certain foods affects behavior. For instance, some people feel embarrassment using an EBT card at the grocery checkout, which can discourage them from buying the full allotment of healthy foods they could. There’s also a social stigma in some circles about drinking tap water versus soda – bizarre as it may sound, in certain communities drinking water might be seen as something you only do if you can’t afford sweet tea or soft drinks. Conversely, there can be stigma in more affluent circles about obesity or buying “unhealthy” foods, which can breed shame and hidden eating behaviors. Addressing these attitudes requires community conversations about health and acceptance. Encouraging everyone that it’s okay to seek help (like SNAP or WIC) when you need it is part of that. The local REACH grant mentioned in the county strategy aims in part to reduce stigma around using programs like SNAP, WIC, and school meals by better messaging (embed.clearimpact.com). For example, letting families know that most kids at school are getting free lunch (so no one is being singled out) or promoting farmers’ markets as welcoming to EBT users helps normalize these positive behaviors. 

Finally, we must consider food-related knowledge gaps. Many residents simply aren’t aware of how serious the health impacts of diet are, or they might lack information on how to manage diet-related conditions. For example, a person with hypertension might not realize how much salt is in canned soup or fast-food burgers. A teenager may not connect daily sugary drinks with future diabetes risk. Food literacy education is needed at all ages – from school curricula that teach nutrition and cooking, to adult education at workplaces or clinics. Some encouraging moves: local hospitals are starting to provide nutritional counseling referrals for patients with obesity or diabetes. The Cooperative Extension’s Master Food Volunteer program in our area sends trained volunteers to community events to demonstrate healthy recipes. All of this tries to shift the culture toward one where healthy eating is valued and feasible. 

Culture change is slow, but we have seen some positive momentum. Farmers’ markets have become social gathering spots, not just for the elite or “health nuts” but increasingly for everyday folks; this helps create a culture of valuing local, fresh food. The popularity of community events like farm-to-table dinners, or the inclusion of local produce in some restaurant menus, also signals a cultural appreciation for healthier foods. And importantly, there’s a growing narrative in our region that being food insecure or needing help is nothing to be ashamed of, rather it’s a community problem to solve together. Breaking the stigma and building food skills are as critical as addressing the logistical access issues. In the long run, a community that knows about nutrition, enjoys cooking, and values healthy food will support the policies and markets needed to keep everyone fed and healthy.

Food Security as a Public Health and Economic Crisis

The evidence is overwhelming that food insecurity and poor nutrition constitute a public health crisis in our community, not merely a symptom of poverty. When nearly half of our county’s deaths in recent years are tied to diet-related diseases (schs.dph.ncdhhs.gov), and when thousands of residents are living with chronic illnesses that sap their quality of life, it is clear that we are paying a steep price – in lives lost, medical costs, and human potential wasted. The economic costs alone are staggering: obesity-related health problems were estimated to account for about 14% of North Carolina’s total medical expenditures in the mid-2010s (pmc.ncbi.nlm.nih.gov). For Catawba County, with its population of around 160,000, that translates to tens of millions of dollars every year in healthcare spending attributable to poor diets and their consequences. This includes hospital visits for heart attacks and strokes, dialysis for kidney failure due to diabetes, medications for hypertension and cholesterol, and so on. These are costs borne by all of us – through higher insurance premiums, strain on public health programs, and lost productivity at work. A Duke University study found that each obese child incurs about $19,000 more in lifetime medical costs compared to a normal-weight child (ncmedicaljournal.com corporate.dukehealth.org). Multiply that by the many hundreds of obese children in our region and you glimpse a future economic burden that is completely preventable if we act now. 

The societal costs go beyond dollars. Food insecurity undermines children’s ability to learn in school – a child who comes to class hungry or undernourished cannot concentrate, may have more behavioral issues, and will likely perform worse academically. Over time, this contributes to lower educational attainment and perpetuates the cycle of poverty. Health-wise, communities burdened by high rates of chronic disease see impacts like reduced workforce participation (people missing work or dropping out of the labor force due to disability) and increased dependency on social services. There’s also a cost to military readiness – a perhaps undermentioned fact is that a significant percentage of young adults are ineligible for military service primarily due to obesity. When a large swath of our youth is not healthy enough to qualify for service or certain jobs, that is a national security and economic competitiveness issue. Closer to home, think of the personal toll: families losing loved ones too soon, parents unable to keep up with energetic children because of health issues, or grandparents who cannot enjoy their golden years due to diet-related illnesses. These human stories accumulate into a community narrative of suffering that we have the power to change. 

Framing this issue as a public health crisis rather than just a matter of individual lifestyle or isolated poverty shifts how we respond. It underscores that ensuring access to healthy food is as vital as other public health measures like clean water or infectious disease control. Indeed, food insecurity and unhealthy diets act as a slow, grinding pandemic – one that cuts across urban and rural lines and is deeply intersectional with economic and racial equity. In Hickory and the broader Foothills, we see that the highest-risk populations (low-income families, Black and Latino communities, rural residents) suffer the worst outcomes (schs.dph.ncdhhs.gov). This means any solution must also address those equity issues. It’s not enough to tell individuals to “eat better and exercise” – we must create conditions that make healthy choices truly accessible and affordable for everyone. 

From an industry perspective, focusing on institutions rather than individual companies is key to systemic change. That means engaging sectors: the healthcare sector (hospitals and clinics investing in prevention and nutrition programs), the education sector (schools doubling as nutrition hubs for children), the retail sector (grocery and food outlets finding viable models in underserved areas), and the agricultural sector (boosting local food production and distribution). Other cities have pioneered reforms that we can take cues from. For example, Minneapolis passed zoning laws to require corner stores to carry staple produce – showing that local policy can influence the retail mix. New York City incentivized supermarkets to open in food deserts by offering tax breaks. Philadelphia implemented a soda tax that, while controversial, raised revenue for nutrition programs and possibly curbed some sugary drink consumption. We should examine these case studies not to copy them wholesale, but to glean what might work in our context. Our challenges have unique contours – for instance, our rural areas might benefit more from mobile markets or improved transportation than a dense city would. 

The path forward will likely involve a combination of immediate relief and long-term system reforms. Immediate relief means continuing to support and expand things like food pantries, backpack programs for kids, and emergency benefits (like pandemic-era EBT which proved extremely helpful to families). Long-term reforms mean pursuing goals like attracting a grocery store to every food desert neighborhood – or exploring non-traditional models such as co-op groceries or municipally-supported markets where private chains won’t go. It means integrating “food is medicine” into healthcare: imagine if doctors could routinely prescribe healthy meal kits or produce boxes and insurance would cover it – some pilot programs are testing this and seeing improved health outcomes. It also means ongoing education and cultural change efforts: rebuilding a culture of healthy home cooking, gardening, and shared meals. Community gardens, culinary classes, and public awareness campaigns all have a role. 

In closing, tackling food insecurity in Hickory, Catawba County, and the Foothills Corridor is not about casting blame on individuals for their diet choices. It’s about recognizing that we as a community have allowed an unhealthy food system to take root, and now we collectively bear the costs. But we also collectively have the power to reform that system – by ensuring that every family has a grocery store or farmers market within reach, that every child learns about nutrition and gets healthy meals at school, and that every person who falls on hard times can access assistance without shame. The issue goes far beyond poverty; it strikes at the heart of our public health and economic vitality. If we fail to act, we will continue to pay for it in hospital bills, lost productivity, and shortened lives. If we succeed, however, we will reap dividends in the form of a healthier, more productive population, lower healthcare costs, and a stronger, more vibrant community where no one has to choose between an empty stomach and a junk food meal. In a region known for its resilience and innovation – from furniture manufacturing to community spirit – there is no reason we cannot come together to ensure food security for all, making it a cornerstone of our public health strategy and a point of pride for the Hickory and Foothills region in the years to come.

This article was written with assistance from ChatGPT.