The State of Food Security and Nutrition in the World 2023

Urbanization contributes to the transformation of agrifood systems by reshaping spatial patterns of food demand and affecting consumer preferences, changing how, where and what food is produced, supplied and consumed. These changes are affecting agrifood systems in ways that are creating both challenges and opportunities to ensure everyone has access to affordable healthy diets.

With urbanization and rising incomes, households often eat greater and more diverse quantities of food, including dairy, fish, meat, legumes, fresh fruits and vegetables, as well as more processed foods.^{52, 53, 54, 55} This, together with population growth, implies substantial increases in the production and supply of some types of foods (i.e. meat, dairy, fresh fruits and vegetables, wheat and wheat products, as well as highly processed foods) to satisfy increased demand. This, in turn, as urban populations grow, translates into vast increases in the total amount of food that agrifood systems have to produce, process and distribute over time. There may also be slower growth or even declines in demand for other food products sold such as traditional grains, maize, roots and tubers.

Adjustments in the quantity and quality of food demand and supply bring about changes in markets and retail trade; midstream food supply chains (changes in post-harvest systems for logistics, processing, wholesale and distribution); rural input markets; agricultural technology; and the size distribution of farms.^{14, 56} Thus, agrifood systems are transformed, from traditional and mostly rural systems based on local market linkages and farming employment, to systems with greater connectivity between rural areas, and between rural, peri-urban and urban areas. This entails more complex rural–urban market linkages across a spatial and functional rural–urban continuum, and more diverse employment opportunities along the food value chain, including processing, marketing and trade. It also entails more dependence on income and food pricing (affordability) for dietary choices, as there is a greater dependence on purchased foods.

Of specific concern against this backdrop are the changes in the supply and demand of nutritious foods that constitute a healthy diet; their cost relative to foods of high energy density and minimal nutritional value, which are often high in fats, sugars and/or salt; and their cost relative to people’s income (i.e. their affordability).

Figure 20 presents a conceptual framework for understanding the different pathways through which urbanization is driving changes in agrifood systems across the rural–urban continuum, and is, in turn, affecting access to affordable healthy diets. The orange text throughout this section refers to specific elements in Figure 20 for emphasis and to ease cross-referencing with the figure. The framework was developed based on a systematic review and meta-analysis of evidence from scientific studies^o and informed by new analysis presented in Chapter 4 on changes in food demand and supply across the rural–urban continuum. Figure 20 recognizes that urbanization is not an agrifood systems driver in isolation but that it changes agrifood systems in interaction with other drivers including income growth, employment, lifestyles, economic inequality, policies and investments.

FIGURE 20 The pathways through which urbanization affects agrifood systems and access to affordable healthy diets

SOURCE: de Bruin, S. & Holleman, C. 2023. Urbanization is transforming agrifood systems across the rural–urban continuum creating challenges and opportunities to access affordable healthy diets. Background paper for The State of Food Security and Nutrition in the World 2023. FAO Agricultural Development Economics Working Paper 23-08. Rome, FAO.

This conceptual framework stipulates that in addition to rural areas, food can also be produced in urban and peri-urban areas. In many countries, the components of agrifood systems are more interconnected. There are also both short and long food supply chains, and there can be a dislocation of midstream processing away from urban areas as part of very long supply chains. For these reasons, the conceptual framework does not visualize the rural–urban continuum alongside the agrifood systems continuum; it is a broader continuum in which agrifood systems can be placed.

Figure 20 depicts the ways in which urbanization is affecting three major components of agrifood systems: i) consumer behaviour and diets; ii) midstream (e.g. logistics, processing and wholesale) and downstream (e.g. markets, retail and trade) food supply chains; and iii) food production. The figure presents these three components in the standard order for conceptualizing agrifood systems and food supply chains. However, the following sections start at the other end with consumer behaviour and diets, as this is one of the most important pathways through which urbanization is driving changes in agrifood systems. Changes across agrifood systems also impact food environments which here refer to physical, economic, sociocultural and policy conditions that shape access, affordability, safety and food preferences.^{57, 58, 59, 60}

Moreover, as illustrated in Figure 20 and expanded on below, food environments reflect a complex interplay among supply-side drivers including food pricing, product placement and promotion, and demand-side drivers including consumer preferences and purchasing power. Together this complex interplay of supply and demand considerations is key to understand how urbanization is driving changes in agrifood systems across the rural–urban continuum, affecting access to affordable healthy diets.

Consumer behaviour and diets

One of the most important pathways through which urbanization is driving changes in agrifood systems is through a shift in consumer behaviour and diets (Figure 20). Higher average incomes, combined with changing lifestyles and employment, are driving a dietary transition. While this is occurring in countries and regions at different speeds and with variations, it is happening around the world. This transition is characterized by changes in the types and quantities of food consumed, with diets shifting beyond traditional grains into dairy, fish, meat, vegetables and fruits, but also into consumption of more processed foods^p and convenience foods or food away from home. These changing preferences are reinforced by the greater diversity of both food products and places to buy food in urban food environments, ranging from supermarkets to informal markets, food street vendors and restaurants.⁶¹ The increased availability of these options often results in increased food consumption and dietary diversity. Dietary preferences are also shaped by marketing and other supply factors, with a reinforcing compounding effect on the food produced, supplied and consumed.

However, urbanization has also contributed to the spread and consumption of processed and highly processed foods, which are increasingly cheap, readily available and marketed, with private sector small and medium enterprises (SMEs) and larger companies often setting the nutrition landscape. Cost comparisons of individual food items and/or food groups from existing studies indicate that the cost of nutritious foods – such as fruits, vegetables and animal source foods – is typically higher than the cost of energy-dense foods high in fats, sugars and/or salt, and of staple foods, oils and sugars.^{62, 63, 64, 65} The relative prices of nutritious foods and foods of high energy density and minimal nutritional value have also been shown to differ systematically across income levels and regions.^{62, 66, 67}

With urbanization, purchases from supermarkets, fastfood takeaway outlets, home deliveries and e-suppliers and other convenience retailers are increasing.^{68, 69, 70} In Latin America and the Caribbean, for example, there has been a profound shift in the last 20 years towards foods of high energy density and minimal nutritional value, including sugar-sweetened beverages. While this phenomenon occurs predominately in urban and peri-urban areas, it is spreading to rural areas and Indigenous Peoples’ lands. There has also been a shift towards increased consumption of food away from home and snacking, which corresponds to high levels of overweight and obesity among all ages, along with high burdens of stunting in some countries.⁶⁹ Such challenges are not unique to the Latin America and the Caribbean region, and many settings now face multiple, simultaneous burdens of different forms of malnutrition.^{71, 72}

Another reason for the spread of processed foods is convenience. Urbanization is associated with changes in the lifestyles and employment profiles of both women and men, as well as increasing commuting times, resulting in greater demand for convenience, pre-prepared and fast foods. Women, who often bear responsibility for food preparation, are increasingly working outside the home, and thus may have less time to shop, process and prepare food. At the same time, men are increasingly working far from home in other cities. These trends are driving the purchase of pre-prepared or ready-to-eat cereals such as rice and wheat,^{73, 74} along with more processed foods and food away from home prepared by restaurants, canteens, retailers, etc.¹⁸ The food processing sector and fastfood segment have grown quickly as a result. For example, eating patterns of Tanzanian migrants change when they move from rural to urban areas, away from traditional staple foods such as cassava and maize, and towards convenience, ready-to-eat or pre-prepared foods such as rice, bread and food away from home.⁷⁵ Increasingly, this trend is also occurring in rural areas as a time-saving measure for off-farm labourers and women working outside the home, facilitated by increased rural incomes, increased supply of these foods from urban and other rural areas, and reduced transportation costs because of better roads.

The diet transition is also occurring in rural areas, though lagged and to a lesser extent compared to urban and peri-urban areas. New studies in the last two years,^{52, 53, 76} including the new analysis presented in Chapter 4, underscore the extent of the diet transition across the rural–urban continuum and the absence of stark differences between urban and rural areas within countries analysed.

There is also a diffusion of food purchases in rural areas, more so than is commonly understood. The diet in these areas has shifted from mainly home-produced foods to increasingly market-purchased products. The rural poor are heavily engaged in purchasing food from markets and are, in general, net food buyers. In Eastern and Southern Africa, research shows rural households buy 44 percent (in value terms) of the food they consume.⁷⁷ A study of Bangladesh, Indonesia, Nepal and Viet Nam shows rural households buy an even higher proportion of their food – 73 percent (in value terms).⁷⁸ Moreover, new research presented in Chapter 4 also shows that food purchases form the majority (average 56 percent) of the foods consumed (in value terms) by rural households in 11 countries in sub-Saharan Africa. This is true even for those households living 1 to 2 hours from a small city or town (average 56 percent), and those living more than 2 hours from a city or town (average 52 percent).

Studies show that while consumption of processed foods (of all types) is higher in urban areas, in terms of the proportion of expenditure on food, rural consumption of processed foods is not much lower.^{54, 79} In Eastern and Southern Africa, for example, 29 percent of total food outlays are spent on such food, and of these 17 percent are spent on purchased milled grains classified as minimally processed items, 48 percent on non-grain minimally processed foods and 35 percent on highly processed foods.^{77, 80} Recent evidence from three African countries shows that the shares of processed foods of all types are surprisingly high among the poor and even the ultra-poor, in both rural and urban areas.^{52, 53, 54} However, there are different patterns of consumption of various types of processed foods across the rural–urban continuum, with highly processed food and food away from home shares showing a strong correlation with total food-budget shares and urban areas in the 11 sub-Saharan Africa countries analysed (see Chapter 4).^{54, 79}

Midstream and downstream food supply chains

Another pathway through which urbanization is affecting agrifood systems is changes in midstream and downstream food supply chains (Figure 20). These changes are often the result of increased investments in infrastructure such as roads, warehouses and cold storage facilities. The midstream consists of the post-farm gate activities related to the logistics, processing and wholesale of food. This includes cleaning, sorting, packaging, transportation, storage and wholesaling of agricultural and food products. Downstream food supply chains involve those segments more directly related to consumer purchases, that is retail markets and sales, and trade.

Food supply chains

Urbanization can contribute to longer, more formal and more complex food supply chains, following rising consumer demand and increased regulation of agrifood systems.^{81, 82} As cities grow and diets of urban dwellers change, urban populations increasingly must look beyond local production for their food supply. Only around 30 percent of urban residents worldwide are estimated to fulfil their demand for specific crops locally (approximately 100 km radius).^{83, 84} The majority of urban food demand, about 80 percent, is supplied regionally (within a 500 km radius).⁸⁵

Although some of the foods consumed in urban areas must travel far to reach their destination, most are produced within national borders and traded domestically (for example, this share is 90–95 percent in Asia).⁸⁰ Exceptions are the entire Near East and North Africa region, some countries in sub-Saharan Africa, as well as the Small Island Developing States. According to the latest World Trade Organization report, there are 32 net food-importing developing countries.⁸⁶ For these countries, food imports can be substantial. For example, according to the OECD–FAO Agricultural Outlook, roughly 70 percent of all food commodities consumed in the Near East and North Africa are imported.⁸⁷ For most other countries, imports are a low share of food supply, and mainly consist of a few products, such that domestic supply chains really drive food supply.⁵⁵ This is consistent across regions and most food groups (except oils and fats), and is particularly the case for fruits, vegetables and animal source foods, which are important food groups for healthy diets.

Domestic food supply chains are usually long and criss-cross a country from supply zones to cities and rural areas.⁸⁸ Short rural local supply chains, or traditional food supply chains based around subsistence agriculture, only account for approximately 10 percent of the food economy in Africa and Southern Asia, and 5 percent in South-eastern Asia and Latin America.^{76, 88, 89} On the other hand, long supply chains connecting rural producers to urban consumers through a web of labour-intensive agrifood SMEs are more prevalent, accounting for approximately 70 percent of the food economy in Africa and Southern Asia, and 50 percent in South-eastern Asia and Latin America.^{88, 89} Modern food supply chains based around supermarkets and large processors tend to be long as well, stretching from rural areas to urban areas, but they also include international elements. Such long supply chains account for approximately 20 percent of agrifood systems in Africa and Southern Asia, and 45 percent in South-eastern Asia and Latin America.

Midstream food supply chains

Midstream food supply chains have become major supply chain growth engines as a result of the overall rise in urban food demand and more specifically the higher demand for high-value and processed products.⁹⁰ These supply chains have grown quickly over several decades and now constitute a significant share of the total value added and costs in food value chains. In low- and lower-middle-income countries, midstream food supply chains form 30 to 40 percent of the value added in food value chains.⁸⁰ Additionally, due to the embeddedness in local economies, the midstream segments can provide locally adapted services and market linkages to farmers contributing to enhancing food supply and rural economies.⁹¹

The past several decades have witnessed a rapid proliferation of SMEs, which now play an important role in the transformation of agrifood value chains in Africa, Asia and Latin America.^{91, 92} The spread of SMEs is most rapid during the transitional stage of this transformation, when agrifood value chains develop and grow longer as urbanization progresses, but remains fragmented (see Table 7 for more detail on the transformation of agrifood value chains). The absence of appropriate policies has been a factor hindering the proliferation of “formal” SMEs, particularly in the processing sector.⁹¹

TABLE 7The three stages of transformation of agrifood value chains

SOURCE: Adapted from Barrett, C.B., Reardon, T., Swinnen, J. & Zilberman, D. 2022. Agri-food Value Chain Revolutions in Low- and Middle-Income Countries. Journal of Economic Literature, 60 (4): 1316–1377. https://doi.org/10.1257/jel.20201539

In sub-Saharan Africa, SMEs operating in the midstream food value chains procure 95 percent of the total supply for small farms and have become the largest investors in agricultural produce markets in the region.⁹³ The productivity of this midstream is, therefore, as important as farm yields for food security in poor countries. The post-farm gate segments of the supply chain – the midstream (processing and wholesale/transport) and downstream (retail and food stalls) segments – together comprise 40 to 70 percent of food costs for urban Africans.⁹⁴ Rural areas nearer to cities tend to experience a more rapid transformation of food value chains, including the development of the midstream.⁸⁰ However, in some low-income and urbanizing countries, the midstream segments of agrifood systems are still at an early stage of transformation. For example, in many countries in sub-Saharan Africa, most cities still have only a narrow range of packaged and processed foods, with the greatest diversity of products available in the capital or large cities.^{95, 96, 97}

Importantly, growing midstream and downstream activities provide important off-farm employment opportunities, which can provide steady and liveable incomes, increasing the affordability of healthy diets. For example, in sub-Saharan Africa, employment in off-farm agrifood systems is currently growing more rapidly than employment in farming itself⁴⁵ – a clear manifestation of agrifood systems transformation. Employment in off-farm activities, most often in SMEs, includes post-farm gate jobs in food processing, wholesale, logistics, retail, and food service, as well as non-agrifood systems jobs. Studies show that SME employment in agrifood systems in processing, wholesale, transport and retail can be especially important to the employment of women and youth.^{36, 98} While estimates of the number of employed people in food supply chains are scarce, a number of studies have estimated employment in agrifood systems as a whole for specific regions and subpopulations. For example, one study estimates that in Africa, Asia and Latin America, youth employment rates in agrifood systems are 61 percent, 39 percent and 48 percent, respectively.⁹⁹ Another study in Western Africa estimates that agrifood systems account for 66 percent of total employment and that processing and food vending/services are disproportionately female, with women comprising over 80 percent of workers in those sectors.⁴⁵ In the fisheries and aquaculture sector, women represent 50 percent of those employed in the entire aquatic value chain (including pre- and post-harvest).¹⁰⁰

Furthermore, several studies highlight that especially in low- and middle-income countries, where agrifood systems employ the largest number of workers, agrifood systems transformation offers the promise of new jobs both downstream and midstream, particularly for large, young populations.^{101, 102, 103} A new study estimates that total employment in agrifood systems was 1.23 billion people worldwide in 2019.^{104, 105} Total agrifood systems employment in Africa is estimated at 62 percent, compared with 40 percent in Asia and 23 percent in the Americas. While the study does not disaggregate employment by the different components of agrifood systems, it does separate out employment related to food supply trade and transportation. Of the 1.23 billion people employed in agrifood systems, 375 million are in jobs related to food supply, trade and transportation. The inclusion of trade and transportation jobs has the biggest impact in Africa, where the share of non-agricultural jobs in agrifood systems is between 5 percent and 14 percent. Across all other regions, the share ranges from 8 percent in Europe to 14 percent in Africa.^{104, 105}

Changing urban food markets: the rise of supermarkets and highly processed foods

Urbanization results in an increase in the number and size of urban food markets. Both formal and informal food market outlets have been expanding with city growth, owing to the demand and purchasing power of urban residents as well as to public and private investments in these markets. A study in Eastern and Southern Africa estimates the growth of urban markets in the two regions at between 600 percent and 800 percent over the last four decades.⁹⁰ A study of South-eastern Asia places growth at roughly 1 000 percent in the same period.¹⁰⁶ Urbanization and changing agrifood systems have also given rise to both food deserts and swamps, which are characterized by markets that provide poor access to or limited availability of diverse and nutritious foods (Box 4).

The formal food sector is characterized by more formalized supermarkets and chains; they are regulated and taxed by governments at various scales, and – unlike informal markets – are able to afford financial and technical services. In contrast, the informal food sector can be broadly defined as all food-related economic activities that take place in independent, small and/or unregistered enterprises. Mostly, there is limited coverage by formal authorities for monetary, regulatory and institutional arrangements such as taxation.

Supply-side factors, coupled with an increase in demand for readily available foods, have contributed to a substantial expansion of supermarkets and hypermarkets.^{107, 108, 109} These supply factors include policy liberalization and privatization in the 1980s and 1990s leading to competitive domestic investments, public infrastructure investments that reduced transaction costs for supply chain development (e.g. procurement systems), and globalized distribution of modern technology related to food production, transportation and marketing, mass media, and the flow of capital and services. Supermarkets have been able to attain economies of scale in procurement, and economies of scale and scope in marketing, which has allowed them to increase over time their share of retail compared to small shops and wet markets (marketplaces selling fresh foods such as meat, fish, produce and other consumption-oriented perishable goods in a non-supermarket setting), especially in Asia and Latin America.^{108, 109}

Increasingly, supermarkets and hypermarkets represent the major force contributing to the diet transition in any country or region. Their establishment has been facilitated by the increase in large urban food markets, which both bring together potential consumers and attract foreign investments.¹¹⁴ These markets are often part of multinational chains or, in countries such as South Africa and China, domestic chains that function like global chains.

The relationship between urbanization and the growth of supermarkets differs widely by region and city size. In Latin America and the Caribbean, urbanization occurred in the 1980s, before the rise of supermarkets, and the process was actually more profoundly linked to privatization and liberalization of agrifood systems.⁶⁹ In Asia on the other hand, supermarket development was closely correlated with urbanization. Ultimately, the shift towards more supermarkets has been driven by a range of factors including rising incomes, changing lifestyles, marketing and increasing awareness of food safety and quality.^{115, 116, 117}

While supermarkets can be linked to increased access to nutritious foods,¹¹⁸ and modern food technology has provided benefits in terms of reducing waste, enhancing sanitation and reducing adverse effects of seasonality,¹⁰⁹ they have also been associated with increased supply of energy-dense and highly processed foods.^{81, 119, 120, 121, 122, 123} The substantial expansion in the types, varieties and quantities of highly processed foods sold worldwide can be associated with the expansion of supermarkets and hypermarkets, the industrialization of agrifood systems, technological change, and globalization including market growth and the political activities of transnational food corporations. While there are wide variations between regions and countries, sales of highly processed foods are highest in Oceania and the Pacific, Northern America, Europe and Latin America, but are also growing rapidly in Asia, the Near East and Africa.¹¹⁹

Despite the greater penetration of formal markets such as supermarkets and hypermarkets, open and wet markets, as well as informal kiosks and street vendors, are still important for local urban food cultures in many countries around the world, particularly in Asia and Africa.¹¹⁷ Here, the low average annual income per person is seen as an important limitation for supermarkets to expand.¹²⁴

Poor urban dwellers especially buy most of their food at informal markets or street shops. For example, supermarkets account for only 3 percent and 0.4 percent of all food expenditure of slum dwellers in Nairobi and Kampala, respectively.¹²⁵ In Zambia, the share of supermarkets is lower in small cities than in larger cities.¹²⁶ Despite a greater penetration of formal markets, informal food retailers – such as street and market traders and small-scale shops – remain abundant across the African continent as well as in many Asian countries.¹¹⁷ In Latin America and the Caribbean, street markets and wholesale markets are also still relevant, especially for fresh foods.^{127, 128, 129} In places where supermarkets are expanding, this process affects prices, quality and safety standards, often restricting access to sales channels for small producers.^{130, 131}

Food production

Urbanization, in particular, by increasing the connectivity of rural and urban areas, also affects agrifood systems through changes in agricultural production (Figure 20). As consumer behaviour and diets change, this influences agricultural production and diversification, with shifts in intensity and type of production factors (i.e. labour, land and other natural resources). Furthermore, as already highlighted, this has a reinforcing compounding effect – as food supply changes in turn influence consumer behaviour and choices, which further affect food production.

Food production, production factors and agricultural services

Urbanization is often associated with a diversification of diets, including dairy, fish, meat, vegetables, fruits and legumes – foods that help constitute a healthy diet, as already highlighted above. However, the availability of vegetables and fruits, in particular,^q is insufficient to meet the daily dietary requirements in almost every region of the world (Table 8). Particularly concerning is the insufficient availability of all food groups apart from staple foods in Africa. There are, however, notable differences across countries and within regions. For example, the supply of vegetables is more than adequate in Asia.⁵⁵

TABLE 8The availability of food groups to meet a Healthy Diet Basket, by region (per capita per day), 2020

NOTES: Yellow highlights emphasize where amounts of food available are insufficient to meet a Healthy Diet Basket (HDB). Food availability is based on FAO Food Balance Sheets data and healthy diet requirements by food group are those of the HDB used in the cost and affordability of a healthy diet in Chapter 2.
SOURCE: Dolislager, M.J., Holleman, C., Liverpool-Tasie, L.S.O. & Reardon, T. 2023. Analysis of food demand and supply across the rural–urban continuum for selected countries in Africa. Background paper for The State of Food Security and Nutrition in the World 2023. FAO Agricultural Development Economics Working Paper 23-09. Rome, FAO.

Urbanization affects agricultural production in different ways across the rural–urban continuum. In rural and peri-urban regions that are well connected to expanding urban markets or storage and processing facilities, small- and large-scale farmers are increasingly commercial and relatively well served by agribusinesses providing inputs and farm output marketing services.¹³³ Farmers located close to urban markets often receive higher returns on their agricultural products and benefit most from growing markets for diversified high-value products.^{134, 135}

As urban areas become better connected to rural areas, rural producers may also have better access to agricultural inputs and services, allowing for improved productivity that typically increases income levels,¹³⁶ which is key to increase access to nutritious foods. For instance, in Meru, United Republic of Tanzania, urbanization has stimulated the demand for milk, providing a reliable source of income for smallholders in a region facing a scarcity of (fertile) land.¹³⁷ Improved access to inputs and the support of stable institutions were important conditions that facilitated this intensification, resulting in higher incomes.

The effects of urbanization can spread to agricultural zones quite far from towns and cities, depending on the connectivity between rural and urban areas, which is shaped by the proximity to cities and by existing transport routes.¹³⁸ This can be seen in the rural regions around Delhi, India. Vegetables and dairy products are becoming increasingly important components of consumption not only in high-income urban households, but also in low- and middle-income urban households. As a result of these changes in urban consumption, the rural areas around Delhi, which used to be cultivated with cereals, are now increasingly being diversified to vegetable production and livestock keeping, and productivity is rising.¹³⁹ The far-reaching influence of urbanization is also seen in fisheries, where it has impacted fishers' ability to meet the rising cost of living in fishing communities.¹⁴⁰

At the same time, millions of smallholders in less accessible or detached hinterlands remain cut off from the opportunities that growing urban food markets can bring.¹⁴¹ In more isolated rural areas, agricultural growth is limited due to low productivity and high transportation costs.¹³⁸ Farmers with limited access to urban markets have few opportunities to profit from urban development. For example, in sub-Saharan Africa, the adoption of high-input technology and crop productivity is found to be negatively correlated with travel time to urban centres.¹⁴²

Another important direct impact of urban expansion is land-use change. In some countries, farmers receive high compensation for selling their land,¹⁴³ whereas in others, dispossession of agricultural land is not compensated, resulting in a loss of livelihoods and issues around land rights. As farms in peri-urban areas make voluntary or involuntary room for urban expansion and associated infrastructure, they often move farther away from cities and convert more remote natural areas (mostly forests and scrublands) into new farmland, negatively affecting habitat quality and biodiversity, and causing environmental degradation and deforestation.^{144, 145, 146, 147} In some cases, farmers are driven to use less productive lands in more remote villages, or are restricted to unauthorized public spaces.^{148, 149} What is more, converted lands are less fertile than arable lands around cities, leading to a loss in agricultural productivity that is higher than the absolute loss of land.¹⁵⁰ Meeting food production and demand for an urbanizing population when land availability and quality are reduced requires agricultural intensification; this implies intensive use of energy, land and water, which if not managed to mitigate against climate change, can lead to an increase in greenhouse gas emissions.^{151, 152, 153, 154}

With urbanization continuing, the resultant loss of cropland is expected to be 3 percent in the whole of Asia and Africa by 2030. The production loss, however, is 6 and 9 percent (respectively), because (as stated above) agricultural land around cities is often more fertile – an important reason why cities historically developed where they did. Additionally, farmers close to cities are often more productive due to higher input use and knowledge levels.¹⁵⁰ Therefore, the productivity loss is higher than the absolute loss of land. In most countries, production is relocated, although this is not possible everywhere – in Egypt, for instance, the amount of arable and fertile land is limited.¹⁵⁵

Urbanization can also affect farm size in various ways. Impacts depend on land tenure security, non-farm opportunities, and the magnitude and impact of land purchases by urban buyers.^{133, 138} In low-income countries, farm sizes have decreased from an average of 2.1 hectares in 1960 to 1.3 hectares in 2010, due to rural population growth (and subsequent outmigration as part of urbanization).¹⁵⁶ In general, farm sizes decrease until off-farm opportunities, often in cities, expand sufficiently to absorb new workers. Asia has now passed this turning point so its average farm sizes can rise, while in Africa average farm sizes are expected to continue to fall in many countries¹³⁸ – although in some areas they are rising. In sub-Saharan Africa, the growing acquisition of farmland by urban buyers has increased average farm sizes compared to other African countries.¹⁵

How urbanization affects access to affordable healthy diets, food security and nutrition

Urbanization can have both positive and negative impacts on access to affordable healthy diets and on food security and nutrition across the rural–urban continuum. Linkages between urbanization and access to affordable healthy diets are not unequivocal: observations depend highly on local or national context-specific dynamics, including investments in agrifood systems as well as in rural and urban infrastructure, training and education, and economic policies. There are however some important overarching challenges and opportunities concerning urbanization across the rural–urban continuum. Figure 21 summarizes the most important of these, drawing from the previous sections on how urbanization is affecting agrifood systems, as well as further empirical evidence and studies. Although the challenges outnumber the opportunities, this is not per se the case for the magnitude of the impacts on access to affordable healthy diets.

FIGURE 21 Challenges and opportunities in accessing affordable healthy diets across the rural–urban continuum

SOURCE: de Bruin, S. & Holleman, C. 2023. Urbanization is transforming agrifood systems across the rural–urban continuum creating challenges and opportunities to access affordable healthy diets. Background paper for The State of Food Security and Nutrition in the World 2023. FAO Agricultural Development Economics Working Paper 23-08. Rome, FAO.

In recent years, many studies have focused on urbanization and agrifood systems transformation; nevertheless there is limited common understanding of how the nexus of these two processes affects both access to affordable healthy diets and food security and nutrition, and even fewer studies have applied a rural–urban continuum lens. Data to support such a disaggregated rural–urban continuum analysis are extremely limited; the analysis requires household survey data with geospatial locational data, and for most countries in the world such data are not readily available. Chapter 4 explores this question through a new analysis on variations in food demand, economic access to healthy diets, and food security and nutrition across the rural–urban continuum, using selected country case studies as far as data availability allowed.

What we do know is that empirical evidence reveals socioeconomic disparities in access to affordable healthy diets throughout the rural–urban continuum as a result of a number of structural challenges.^{62, 157} These include economic challenges related to the high cost of nutritious foods (Figure 21), which varies within countries and can be even higher in poor neighbourhoods. For urban populations living in poverty, the most easily available and affordable diets tend to be unhealthy.¹⁵⁸ Access to nutritious foods is often limited, as these types of foods are more expensive, or in some cases unavailable, in more urbanized areas. Poorer households are inclined to prioritize meeting dietary energy requirements over nutritional quality, spending their resources on more affordable foods, which tend to be of high energy density and minimal nutritional value.^{158, 159} Other structural barriers are found in agrifood supply systems and markets, impeding physical access to healthy diets (resulting in food deserts and swamps in urban areas, for example).

For other income groups of urban dwellers, an important challenge to access to affordable healthy diets is that urban centres have more supermarkets and especially fastfood chains, including multinational outlets, offering a ready and abundant supply of highly processed foods, as well as energy-dense snacks, sweets, and sugar-sweetened beverages (Figure 21). These developments have negatively affected obesity levels and health conditions of urban dwellers.^{160, 161} It is important to note that while supermarkets have an advantage in selling highly processed foods because of economies of scale, a growing number of small shops are also selling these products.^{54, 69} The rapidly increasing share of highly processed foods of high energy density and minimal nutritional value, especially in urban consumption patterns, is linked to the rise in obesity and non-communicable diseases.⁵⁴ In many countries, obesity levels have risen alongside urbanization. New evidence for Africa suggests that consumption of highly processed foods and high-calorie snacks and beverages is spreading across the full spectrum of the rural–urban continuum, even among the rural poor – a trend of great concern (see Section 4.1).

Recent empirical studies show that the risk of food insecurity can even be higher in urban areas than in rural areas, due to the intra-urban inequalities present in many rapidly urbanized countries.¹⁶² Indeed, new analysis from country cases studies in sub-Saharan Africa (see Section 4.2) shows that the prevalence of moderate or severe food insecurity based on the Food Insecurity Experience Scale in urban and peri-urban areas is similar to (e.g. Côte d’Ivoire, Senegal) or sometimes even higher than (e.g. Niger, Nigeria) that in rural areas. Access to food – nutritious foods in particular – across the rural–urban continuum is complex, with multiple determinants. It cannot be assumed that this access is always better for populations in urban areas. In fact, several studies show that the so-called “urban advantage” does not benefit the poorest, who – on the contrary – face disproportionate barriers to accessing and consuming a healthy diet and have an increased risk of food insecurity and malnutrition.¹⁵⁷

Furthermore, when migration decisions reflect the push factors in rural areas (e.g. conflict or lack of access to land) rather than the pull of better opportunities in urban areas, food security and nutrition outcomes can be compromised (Figure 21).¹⁰ Challenges around accessing food and the risk of food insecurity among rural–urban migrants are intensified during crises.^{163, 164, 165} Rural–urban migrants who often inhabit informal settlements lack social protection coverage and their neighbourhoods often fall outside the remit of urban planning. The COVID-19 pandemic is an example of a situation in which low-income and informal rural–urban migrants experienced food insecurity in cities.

Food insecurity in urban areas is strongly driven by income limitations; low-income households need to allocate a high proportion of their total expenditure to food and are extremely vulnerable to external shocks including unemployment, health problems and food price inflation.¹⁵⁷ Food insecurity can be further compounded by poor health, as low-income urban households tend to have poor sanitation and a low standard of other essential housing infrastructure and goods.^{166, 167, 168} Urban poverty poses diverse challenges that prevent access to healthy diets (e.g. unplanned built environments), and challenging social network structures often prevent low-income households from finding strategies to cope with food insecurity. Social protection and food assistance programmes designed to facilitate food access – such as monetary or in-kind transfer schemes, community kitchens and food banks – are often insufficient by themselves to fully resolve food insecurity problems, because they do not address barriers such as lack of cooking facilities or food storage, and competing health or housing expenses.

On the other hand, in rural areas, urbanization can provide opportunities for on- and off-farm employment (Figure 21), thus increasing purchasing power and options to access healthy diets. Especially in rural communities where agriculture completely dominates the economy, the growth of small cities and towns can play an important role in providing access to inputs, markets and non-farm activities, thus reducing poverty and improving food security.¹⁶⁹ However, there are also risks of losing or decreasing opportunities to sustain livelihoods due to formalization processes. For example, fees for stalls in formal markets are often relatively expensive, which decreases the accessibility of these markets for many small-scale farmers and traders. Nearly all smallholder farmers, most traders in food markets and many micro- and small-scale food processors and food retailers are not part of the formal food economy in sub-Saharan Africa,¹⁷⁰ and improvements in formal markets will not benefit these actors. Thus there is a risk that smallholders, small-scale food processors and food retailers be excluded from formalizing value chains. Understanding how to best sustain informal value chains is critical; however, this knowledge is often lacking.¹⁷¹

The rural-to-urban outmigration of young people, often men, also poses both challenges and opportunities in terms of improving access to affordable healthy diets (Figure 21). In some contexts, rural outmigration can result in substantial remittances that increase the accessibility of healthy diets and improve food security in rural areas.^{172, 173} Households that receive remittances can be better off in terms of total income, assets, calorie supply and micronutrient supply.¹⁷⁴ Rural-to-urban migration can also contribute to resilience in the communities of origin and further the transfer of knowledge and other resources besides financial remittances.¹⁷⁵ However, there are instances where remittances are too low (or even absent) to replace the lost workers with hired labour.¹⁷⁶ In such cases, the lost labour and associated reduction in income or agricultural produce can result in decreased access to healthy diets, or in longer working hours for the left-behind women in subsistence farming to maintain household food security.

In terms of malnutrition, studies generally show that rural populations face a higher burden of child undernutrition than urban populations,^{177, 178} not only but especially in sub-Saharan Africa, a subregion where many households still live in remote rural areas. Studies suggests there are no fundamental differences in the characteristics that determine child nutrition outcomes in urban and rural areas. Instead, differences are explained by the better urban environment, greater choices and increased opportunities related to socioeconomic characteristics, from maternal and spousal education, wealth, and employment, to social and family networks, as well as access to health care and other services.

Urbanization typically entails improved access to non-food markets and services that are important for nutrition, including schools, health clinics and non-farm labour markets that improve income stability.^{177, 178, 179} Furthermore, proximity to towns can also weaken the relationship between agricultural shocks and child nutrition.^{180, 181} More recently, studies find that “market access” can be an important determinant of dietary diversity and hence child nutrition outcomes.^{182, 183, 184} There is relatively little research, however, on the degree to which rural populations have access to urban markets and services and the associated differences in nutrition seen across rural and urban populations, or across gradients of rural remoteness.¹⁸⁵ One such study, which examined the linkages between child nutrition and urbanization and proximity to large urban centres in sub-Saharan Africa,¹⁸⁵ found that rural populations are characterized by worse nutrition outcomes than urban populations, but it also produced the somewhat unexpected result that the nutrition outcomes of more remote rural populations are not substantially worse than those of less remote rural populations. This finding is also aligned with new analysis (presented in Section 4.2) of child stunting and wasting, which looks at rural catchment areas of varying travel times to the nearest town or city in three sub-Saharan African countries. Furthermore, and broadly in keeping with previous analyses of rural–urban inequality in nutrition, it appears that the majority of this nutritional disadvantage is explained by differences in wealth, education, health and non-road infrastructure services across rural and urban areas.¹⁸⁵

In conclusion, access to affordable healthy diets is generally better and food security and nutrition levels are higher in cities than in rural areas because of the better availability of food, higher average purchasing power in urban areas, and better access to health care, education and other services that are essential for health and nutrition. However, this does not always hold true given the transformations underway in agrifood systems, the stark inequalities that exist within urban populations, and the increasingly spatial and functional connectivity between cities, towns and rural catchment areas.^{185, 186} New evidence from 11 countries in sub-Saharan Africa presented in Section 4.2 suggests that the “urban advantage” in accessing affordable healthy diets, food security and nutrition may not be as great as expected. Thus, it will be increasingly important to analyse these across the rural–urban continuum, and to understand the patterns of urbanization and connectivity across the rural–urban continuum in order to identify the challenges and opportunities for ensuring access to affordable healthy diets, to improve food security and nutrition for all.