This work aimed to identify the social and cultural perceptions regarding food security and health in the departments of Bolivar and La Guajira, in the Colombian Caribbean region. As a result, poverty and illiteracy were transversal conditions affecting food security and health of researched communities in both departments. Food security conditions are affected by external factors (low income, location, and natural resources availability). Distrust of public health institutions was a dominant factor. Thus, there is a strong need for public policies with a territorial approach to promote local food production, capacity development, and transfer of knowledge and to improve the public health service.