This paper examines associations between the composition of local food environments around FCCHs and the healthfulness of food selections served to preschool-aged children. The composition of local food environments is defined in terms of density (counts within a set distance) and proximity (distance to nearest) of healthful food stores, with higher density and closer proximity indicating greater access. that FCCHs will have generally low access to healthful food outlets (eg, supermarkets) but that FCCHs with greater access will serve healthier selections of foods to children. We also hypothesize that compared with urban FCCHs, rural FCCHs will have lower access to healthful food outlets and thus offer less-healthful food selections to children in their care. (author abstract)