Health motivation is found to be a significant driver of local foods purchase (Maples et al., 2013; Onozaka, Nurse, and McFadden, 2010), yet it remains unclear what specific health aspects determine consumer purchase decisions. We study the specific health factors focusing on six particular diseases: cancer, heart disease, diabetes, obesity, back/joint pain and Alzheimer’s/dementia to find out whether a relationship exists between disease incidences and consumer decisions to buy local foods. We examine two separate decisions of whether and how frequently southeastern consumers buy local foods in a two-step decision framework known as Double Hurdle model. Results indicate that cancer, diabetes, obesity and back/joint pain are statistically significant to purchase foods at farm stands. Findings might help local food sellers and product marketers in the southeastern United States to gain a deeper understanding of how consumers’ health background and health concerns affect their choice of local food outlets.