Testing the price and affordability of healthy and current (unhealthy) diets and the potential impacts of policy change in Australia

Abstract

BackgroundPrice and affordability of foods are important determinants of health. Targeted food pricing policies may help improve population diets. However, methods producing comparable data to inform relevant policy decisions are lacking in Australia and globally. The objective was to develop and pilot standardised methods to assess the price, relative price and affordability of healthy (recommended) and current (unhealthy) diets and test impacts of a potential policy change.MethodsMethods followed the optimal approach proposed by INFORMAS using recent Australian dietary intake data and guidelines. Draft healthy and current (unhealthy) diet baskets were developed for five household structures. Food prices were collected in stores in a high and low SES location in Brisbane, Australia. Diet prices were calculated and compared with household incomes, and with potential changes to the Australian Taxation System. Wilcoxen-signed rank tests were used to compare differences in price.ResultsThe draft tools and protocols were deemed acceptable at household level, but methods could be refined. All households spend more on current (unhealthy) diets than required to purchase healthy (recommended) diets, with the majority (53–64 %) of the food budget being spent on ‘discretionary’ choices, including take-away foods and alcohol. A healthy diet presently costs between 20–31 % of disposable income of low income households, but would become unaffordable for these families under proposed changes to expand the GST to apply to all foods in Australia.ConclusionsResults confirmed that diet pricing methods providing meaningful, comparable data to inform potential fiscal and health policy actions can be developed, but draft tools should be refined. Results suggest that healthy diets can be more affordable than current (unhealthy) diets in Australia, but other factors may be as important as price in determining food choices.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-016-2996-y) contains supplementary material, which is available to authorized users.

A new model of collaborative research: experiences from one of Australia’s NHMRC Partnership Centres for Better Health

“…It showed that healthy diets were 12% cheaper than less healthy diets for an average family. 22 Finally, data from our evidence reviews on chronic disease prevention interventions in children and young adults, and on the costs and benefits of urban form on health, have been used in the National Strategic Framework for Chronic Conditions, and NSW Ministry of Health urban planning with local districts, respectively. These all highlight early examples of the Prevention Centre's research being relevant and useful.…”

Costing a healthy diet: measurement and policy implications

“…The results of that pilot suggested that healthy diets can be more affordable than the current Australian diet, particularly because people currently spend a relatively large proportion of their household budget on alcohol and discretionary foods (a family of two adults and two children was found to spend over 58 % of its food dollars on discretionary choices). Nevertheless, the individual prices of some healthy foods, particularly meat, dairy and vegetables, were found to be relatively expensive compared with energy-dense discretionary foods (8) . Also, the study found that while a diet consistent with dietary guidelines was affordable for families on a median income (18 % of disposable income), it was less affordable for low-income families (28 % of their household disposable income) (8) .…”

“…Nevertheless, the individual prices of some healthy foods, particularly meat, dairy and vegetables, were found to be relatively expensive compared with energy-dense discretionary foods (8) . Also, the study found that while a diet consistent with dietary guidelines was affordable for families on a median income (18 % of disposable income), it was less affordable for low-income families (28 % of their household disposable income) (8) . Another remarkable finding from the systematic review featured in this issue (6) was that ten of eleven identified 'healthy basket' food pricing tools did not fully align with the principles of the most recent Australian Dietary Guidelines.…”

“…Recently, standardized methods to assess the relative price difference between a healthy and current diet have been piloted in Australia (8) . The results of that pilot suggested that healthy diets can be more affordable than the current Australian diet, particularly because people currently spend a relatively large proportion of their household budget on alcohol and discretionary foods (a family of two adults and two children was found to spend over 58 % of its food dollars on discretionary choices).…”

Removing the Australian tax exemption on healthy food adds food stress to families vulnerable to poor nutrition

“…28 A recent study looked at the impacts of GST changes on the affordability of two theoretical diets, healthy and current (unhealthy), and used food costs from stores in two locations in Queensland. 14 The healthy diet basket was modelled against the Australian Dietary Guidelines with the foods chosen indicative of the minimum requirements to meet dietary guidelines rather than a real world meals-based menu plan. However, to date, there has been no modelling of the potential impacts of changes to the GST on food affordability, with food prices collected in-store from a representative sample of Australian supermarkets.…”