About the Index

ESHE is a free, standardized scoring tool for describing food environments in terms of their support for healthy eating. ESHE is different from other indexes as it weights and ranks multiple variables including— community nutrition environment, organizational environments, food prices and information environment. The result is a numerical score. The score combines county and state indicators that are publicly available and can be updated to monitor change over time.


The ESHE Index is a way to rank communities and geographic areas on factors related to healthy eating. We envision environments that encourage people to consume a high quality diet. The goal of ESHE is to stimulate changes in food and food policy landscapes that can facilitate high dietary quality. A high quality diet requires:

  • Access to a favorable mix of food retailers and restaurants that provide a variety of healthful foods
  • Competitive prices for healthy food and beverage options
  • Supportive organizational policies with respect to healthful food access
  • Policies that support nutrition education and promotion of healthy foods and restrict advertising of less healthy foods

The ESHE Index is powered by the Center for Applied Research and Engagement Systems (CARES) at the University of Missouri.


The index is available as an interactive map and report through the ESHE Tools platform hosted on the CARES Engagement Network. ESHE is led by the Council on Black Health (councilbh.org) with support from the Robert Wood Johnson Foundation and from research and advocacy partners around the nation. The Council seeks to have a significant impact on community health through collaboration, discovery, and innovative solutions.


Indicators that rank geopolitical jurisdictions on health related factors are being increasingly used to foster health-positive changes. These indices summarize health risk factors, health outcomes, and geographic area characteristics that support or discourage healthy behaviors. Indices such as these can serve as benchmarking tools that advocacy organizations, policy makers, and other can use to determine how their community measures up. Health-oriented rankings usually include at least one measure related to the food environment.

The ESHE Index combines multiple indicators pertaining to the food environment, and is designed to rank counties and states on factors that facilitate healthy eating. ESHE rankings allow both within and across-state comparisons and can raise awareness of factors most or least likely to facilitate healthy eating. The goal of ESHE is to help foster positive changes in lower-ranked factors.



To learn more about the ESHE Index and Methodology, click here.