Introduction: Nearly 26.5% of the United States population is located in rural census tracts. Of this population, over 93% lived within 10 miles of a supermarket. Texas has an estimated population of 30,029,572 people, of which 3,035,014 (10.11%) are living in rural communities. Under normal circumstances for many rural areas, seemingly simple activities, such as shopping for healthy and affordable food, can be dif- ficult. In times of crisis, such as the COVID-19 pandemic, an already strained system of access to healthy and affordable food can be significantly exacerbated in rural communities. Methods: The study utilized both Geographic Information Systems (GIS) and quantitative methods to investigate the relationship between metro and rural classification, access to full-service grocery stores, and COVID-19. Results: Of the full-service grocery stores reported in Texas, 1,770 (79%) reside in Metro communities, leaving 369 (21%) full-service grocery stores to serve rural Texans. There was a significant (p=0.039) yet very weak (R2=0.021) inverse relationship between the number of normalized COVID-19 fatalities and full-service grocery stores in rural counties. In addition, simple linear regression indicates that there was a significant (p<0.0001) and strong (R2=0.879) positive relationship between the normalized confirmed COVID-19 cases and full-service grocery stores in metro counties. There was also a significant (p<0.0001) and weak (R2=0.348) positive relationship between the normalized confirmed cases of COVID- 19 and full-service grocery stores in rural counties. Conclusion: Our findings can help rural community health systems in understanding the effects COVID-19 had on rural communities. Additionally, and particularly importantly, these findings can assist rural communities in preparing for future pandemics. [ABSTRACT FROM AUTHOR]