Research has shown health concerns may motivate consumers to purchase foods sold at direct market outlets, yet connections between management of specific diseases and food purchase decisions remain unclear. We utilize a two-step decision framework to evaluate whether family incidences of six illnesses (cancer, heart disease, diabetes, obesity, back/joint pain, and Alzheimer’s disease/dementia) affect decisions to buy food at farmers’ markets and farm stands.We find that cancer, diabetes, obesity, and back/joint pain influence the decision to purchase from farm stands. Disease incidences have varying directional effects on frequency of purchase for both farmers’ markets and farm stands.