ABSTRACT:
Many rural communities across the United States face significant barriers to accessing affordable, nutritious foods, with disproportionate impacts on minority populations who experience higher rates of diet-related chronic diseases. The Gullah Geechee community—an African-descendant population residing in the rural Lowcountry, South Carolina—is one of the most historically marginalized and understudied groups in public health research. This study aimed to (1) identify the obstacles that limit healthy food access and consumption; (2) explore strategies to improve dietary behaviors among this underserved community. A mixed-methods cross-sectional design was used to assess the lived experiences of the Gullah Geechee community. Quantitative data were collected through structured surveys administered to 125 individuals to examine food access barriers, purchasing behavior, and nutritional behavior patterns. To complement the survey findings, semi-structured interviews were conducted with 28 participants. Interviews explored contextual challenges, perceived supports, and culturally relevant ideas for strengthening the local food environment. Quantitative data were analyzed descriptively and using ANOVA tests. Qualitative data were analyzed using an inductive, grounded theory–informed thematic approach, involving open coding, constant comparison, and iterative refinement of categories to allow themes to emerge directly from participants’ accounts. Almost 58.2% of the participants reported food insecurity. The mean daily intake of fruit and vegetables was 2.21 servings, well below national recommendations. Only 27.5% of participants reported receiving supplemental nutrition benefits. Food access obstacles included geographic isolation, transportation barriers, limited availability of full-service grocery stores, and financial hardship. Promising strategies were identified as mobile markets, improved stocking of more nutritious foods in local stores, and expanded state-based nutrition assistance programs. This study generates culturally grounded evidence to inform the development of tailored policies, systems, and environmental interventions that account for rurality and minority populations, making healthy choices more accessible as a sustainable solution.