Food insecurity is estimated to affect about 10% of the United States population. Rural areas experience even higher rates and intensity of food security problems related to poverty, food access, and higher food costs. Reports of the relationship between household food security and health status, however, are limited. This report examines the relationship between household food security and measures of functional health status in a rural Appalachian sample. A comprehensive health status survey was completed by 1,006 individuals seen either in a clinical (n = 605) or nonclinical (n = 401) community setting. The survey included the USDA Food Security Core Module, the SF-36, and demographic and health care access questions. Household food insecurity was reported by 23% of respondents. Food insecure respondents reported significantly poorerfunctional status on all SF-36 scales compared tofood secure respondents (all p < 0.05). After adjusting for demographic and access variables in a multiple regression analysis, food insecurity remained a significant independent predictor of responses for each SF-36 scale. Generalizability of results are limited by the convenience sampling methods and geographic region in which the study was conducted. In this preliminary study, even minimal levels of food insecurity are related to self-reported levels of health status as measured by the SF-36 spectrum. Health professionals must be able to identify individuals at risk for food insufficiency; policy makers must develop more effective programs for alleviating the basic causes of food insecurity.