Neighborhood Prices of Healthier and Unhealthier Foods and Associations with Diet Quality: Evidence from the Multi-Ethnic Study of Atherosclerosis

Abstract

It is known that the price of food influences the purchasing and consumption decisions of individuals; however, little work has examined if the price of healthier food relative to unhealthier food in an individual’s neighborhood is associated with overall dietary quality while using data from multiple regions in the United States. Cross-sectional person-level data came from The Multi-Ethnic Study of Atherosclerosis (exam 5, 2010–2012, n = 2765); a food frequency questionnaire assessed diet. Supermarket food/beverage prices came from Information Resources Inc. (n = 794 supermarkets). For each individual, the average price of select indicators of healthier foods (vegetables, fruits, dairy) and unhealthier foods (soda, sweets, salty snacks), as well as their ratio, was computed for supermarkets within three miles of the person’s residential address. Logistic regression estimated odds ratios of a high-quality diet (top quintile of Healthy Eating Index 2010) associated with healthy-to-unhealthy price ratio, adjusted for individual and neighborhood characteristics. Sensitivity analyses used an instrumental variable (IV) approach. Healthier foods cost nearly twice as much as unhealthier foods per serving on average (mean healthy-to-unhealthy ratio = 1.97 [SD 0.14]). A larger healthy-to-unhealthy price ratio was associated with lower odds of a high-quality diet (OR = 0.76 per SD increase in the ratio, 95% CI = [0.64–0.9]). IV analyses largely confirmed these findings although—as expected with IV adjustment—confidence intervals were wide (OR = 0.82 [0.57–1.19]). Policies to address the large price differences between healthier and unhealthy foods may help improve diet quality in the United States.

Healthy Diets in Rural Victoria—Cheaper than Unhealthy Alternatives, Yet Unaffordable

“…At a policy level, food pricing options exist in the form of taxation, subsidisation, or a combination of these [ 22 , 52 ]. The taxing of unhealthy foods is considered of benefit for raising revenue as well as an effective strategy to improve dietary behaviours [ 53 ]; and subsidising healthy food is considered of benefit in making these foods more affordable and also, though to a smaller effect, appear to improve dietary behaviours [ 21 , 52 ]. For Australia, the exemption of ‘healthy’ foods from goods and sales tax (GST) is a means of reducing ‘food stress’ for low income families.…”

Use of Online Food Delivery Services to Order Food Prepared Away-From-Home and Associated Sociodemographic Characteristics: A Cross-Sectional, Multi-Country Analysis

“…Online food delivery service use could reduce home cooking, which might have implications for the overall diet quality of customers. Whilst it is possible to meet dietary guidelines through consumption of food prepared away-from-home, it may be more difficult and more expensive than through food prepared at home [42,43], and bound by the types of food outlet available [44].…”

Improvement of nutritional intake for the low-income urban dwellers with hypertension in Malaysia

“…This is probably due to food price which the low income cannot afford to spend. 42 Change in saturated fatty acid (SFA) was associated with reduction of weight. 43 However, the SFA and weight show no significant reduction in this study, probably due to the type of the whole food consumed was generally the same with some changes based on their dietary assessment.…”