PROJECT SUMMARY/ABSTRACT The goal of this project is to test whether a multi-level, community-engaged intervention to build a sustainable food economy with food-is-medicine programs in the Mississippi Delta can improve minority health and reduce health disparities. Our central hypothesis is that an intervention developed with active community engagement to increase local production and distribution of fruits and vegetables (FV), will increase FV consumption and decrease body mass index (BMI), hemoglobin A1c (HbA1c) and health disparities among participating adults compared to control participants over a 12-month study period. Aim 1: To design a novel intervention that bolsters the local food economy and delivers food-is-medicine programming to a minority population within communities with persistent disadvantage. Using the principles and processes of community-engaged research, we will unite community partners and members of Bolivar, Washington, and Sunflower Counties in a local multi-sector Delta Food Policy Council (FPC). The FPC will design and implement a multi-level intervention to provide appropriate nutrition, focusing on locally grown FV, to build a sustainable food economy and improve health outcomes. Aim 2: To test whether the novel intervention reduces health disparities by improving outcomes related to obesity and diabetes among a rural minority population. We will work collaboratively with the FPC to implement and evaluate a multi-level, community-engaged, randomized controlled intervention targeting 300 adults (>25 y) with food insecurity, BMI >25, and HbA1c)>5.7-8.5%. Outcome measures are (*primary): Individual-level: increase F+V consumption*; decrease obesity (BMI)*, diabetes risk (HbA1c)*, and systolic blood pressure Community-level: increase production and distribution of FV; institute access to produce and decrease food insecurity; and decrease health care utilization Aim 3: Generate a replicable and scalable food economy model to reduce obesity and improve diabetes. The model will focus on adults living in areas with disadvantage and make sustainable food-is-medicine policy recommendations related to SNAP, Medicare/Medicaid and the Farm Bill to state and federal legislatures. Expected impact: Community-centered efforts that build vital local food economies to support food-is-medicine programming represent a major innovation that integrates nutrition into the healthcare system and social safety net to ameliorate disease, mitigate disparities, and save billions of dollars in health care expenditures annually.