Document Type

Presentation

Publication Date

Fall 10-5-2026

Abstract

Food insecurity and limited access to nutritious foods are linked to gestational diabetes, low birth weight, and maternal stress.1,3 Rural residents often have fewer full-service grocery stores and rely on convenience stores with little fresh food.4 Rural communities may also face broader gaps in health resources and care,2 which may widen maternal and infant health disparities. This matters in Tennessee, where rural counties make up a substantial proportion of the state’s area and population. Few studies have examined food insecurity and birth outcomes across Tennessee, especially by rurality. We evaluated these associations across all 95 counties, emphasizing rural–urban differences, to help identify opportunities for policy interventions and guide the allocation of nutritional, healthcare, and obstetric resources. Objectives • Compare food insecurity, limited food access, and exercise opportunity access between rural and urban Tennessee counties. • Compare birth outcomes (low birth weight, infant mortality) between the two groups. • Analyze associations between nutrition access and birth outcomes, with and without adjusting for rurality. • Test whether the food insecurity–birth outcome relationship differs by rurality.

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