Journal of Urban Health

, Volume 94, Issue 4, pp 494–505 | Cite as

Healthy and Unhealthy Food Prices across Neighborhoods and Their Association with Neighborhood Socioeconomic Status and Proportion Black/Hispanic

  • David M. Kern
  • Amy H. Auchincloss
  • Lucy F. Robinson
  • Mark F. Stehr
  • Genevieve Pham-Kanter
Article
  • 557 Downloads

Abstract

This paper evaluates variation in food prices within and between neighborhoods to improve our understanding of access to healthy foods in urbanized areas and potential economic incentives and barriers to consuming a higher-quality diet. Prices of a selection of healthier foods (dairy, fruit juice, and frozen vegetables) and unhealthy foods (soda, sweets, and salty snacks) were obtained from 1953 supermarkets across the USA during 2009–2012 and were linked to census block group socio-demographics. Analyses evaluated associations between neighborhood SES and proportion Black/Hispanic and the prices of healthier and unhealthy foods, and the relative price of healthier foods compared with unhealthy foods (healthy-to-unhealthy price ratio). Linear hierarchical regression models were used to explore geospatial variation and adjust for confounders. Overall, the price of healthier foods was nearly twice as high as the price of unhealthy foods ($0.590 vs $0.298 per serving; healthy-to-unhealthy price ratio of 1.99). This trend was consistent across all neighborhood characteristics. After adjusting for covariates, no association was found between food prices (healthy, unhealthy, or the healthy-to-unhealthy ratio) and neighborhood SES. Similarly, there was no association between the proportion Black/Hispanic and healthier food price, a very small positive association with unhealthy price, and a modest negative association with the healthy-to-unhealthy ratio. No major differences were seen in food prices across levels of neighborhood SES and proportion Black/Hispanic; however, the price of healthier food was twice as expensive as unhealthy food per serving on average.

Keywords

Nutrition guidelines Food price Socioeconomic status Race 

Supplementary material

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ESM 1(DOCX 41 kb)

References

  1. 1.
    U.S. Department of Health and Human Services and U.S. Department of Agriculture. 2015–2020 Dietary Guidelines for Americans. 8th Edition. Washington, DC. Available at http://health.gov/dietaryguidelines/2015/guidelines/.
  2. 2.
    Beydoun MA, Wang Y. Do nutrition knowledge and beliefs modify the association of socio-economic factors and diet quality among US adults? Prev Med. 2008;46(2):145–53.CrossRefPubMedGoogle Scholar
  3. 3.
    Forshee RA, Storey ML. Demographics, not beverage consumption, is associated with diet quality. Int J Food Sci Nutr. 2006;57(7–8):494–511.CrossRefPubMedGoogle Scholar
  4. 4.
    Walker RE, Keane CR, Burke JG. Disparities and access to healthy food in the United States: a review of food deserts literature. Health Place. 2010;16(5):876–84.CrossRefPubMedGoogle Scholar
  5. 5.
    Breyer B, Voss-Andreae A. Food mirages: geographic and economic barriers to healthful food access in Portland, Oregon. Health Place. 2013;24:131–9.CrossRefPubMedGoogle Scholar
  6. 6.
    Powell LM, Zhao Z, Wang Y. Food prices and fruit and vegetable consumption among young American adults. Health & Place. 2009;15:1064–70.CrossRefGoogle Scholar
  7. 7.
    Frazao E, Andrews M, Smallwood D, Prell M. Food Spending Patterns of Low-Income Households Will Increasing Purchasing Power Result in Healthier Food Choices? Can Food Stamps Do More to Improve Food Choices? An Economic Perspective. 2007;Economic Information Bulletin Number 29–4. Washington, D.C.: U.S. Department of Agriculture, Economic Research Service.Google Scholar
  8. 8.
    Ogden CL, Carroll MD, Kit BK, Flegal KM. Prevalence of childhood and adult obesity in the United States, 2011-2012. JAMA. 2014;311(8):806–14.CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Andrieu E, Darmon N, Drewnowski A. Low-cost diets: more energy, fewer nutrients. Eur J Clin Nutr. 2006;60(3):434–6.CrossRefPubMedGoogle Scholar
  10. 10.
    Drewnowski A. The cost of US foods as related to their nutritive value. Am J Clin Nutr. 2010;92(5):1181–8.CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Drewnowski A, Darmon N. Food Choices and diet costs: an economic analysis. J Nutr. 2005;135(4):900–4.PubMedGoogle Scholar
  12. 12.
    Lipsky LM. Are energy-dense foods really cheaper? Reexamining the relation between food price and energy density. Am J Clin Nutr. 2009;90(5):1397–401.CrossRefPubMedGoogle Scholar
  13. 13.
    Monsivais P, McLain J, Drewnowski A. The rising disparity in the price of healthful foods: 2004-2008. Food Policy. 2010;35(6):514–20.CrossRefPubMedPubMedCentralGoogle Scholar
  14. 14.
    Gustafson A, Hankins S, Jilcott S. Measures of the consumer food store environment: a systematic review of the evidence 2000-2011. J Community Health. 2012;37(4):897–911.CrossRefPubMedGoogle Scholar
  15. 15.
    Zenk SN, Schulz AJ, Israel BA, James SA, Bao S, Wilson ML. Fruit and vegetable access differs by community racial composition and socioeconomic position in Detroit, Michigan. Ethn Dis. 2006;16(1):275–80.PubMedGoogle Scholar
  16. 16.
    Leibtag E. Where You Shop Matters: Store Formats Drive Variation in Retail Food Prices. https://www.ers.usda.gov/amber-waves/2005/november/where-you-shop-matters-store-formats-drive-variation-in-retail-food-prices/ Last accessed April 17 2017: USDA - ERS; 2005.
  17. 17.
    Jetter KM, Cassady DL. The availability and cost of healthier food alternatives. Am J Prev Med. 2006;30(1):38–44.CrossRefPubMedGoogle Scholar
  18. 18.
    Andreyeva T, Blumenthal DM, Schwartz MB, Long MW, Brownell KD. Availability and prices of foods across stores and neighborhoods: the case of New Haven, Connecticut. Health Aff (Millwood). 2008;27(5):1381–8.CrossRefGoogle Scholar
  19. 19.
    IRI. Academic Data Set. Available at: http://www.iriworldwide.com/solutions/Academic-Data-Set. Accessed June 22, 2015.
  20. 20.
    Bronnenberg BJ, Kruger MW, Mela CF. Database paper—the IRI marketing data set. Mark Sci. 2008;27(4):745–8.CrossRefGoogle Scholar
  21. 21.
    Symphony IRI. About Us. 2015. Available at https://www.iriworldwide.com/en-US/company/about-IRI. Accessed 12 March 2015.
  22. 22.
    United States Food and Drug Administration. CFR - Code of Federal Regulations Title 21, 21CFR101.12. http://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/cfrsearch.cfm?fr=101.12 Accessed June 22 2015; 2014.
  23. 23.
    Kern DM, Auchincloss AH, Ballister L, Robinson LF. Neighbourhood variation in the price of soda relative to milk and its association with neighbourhood socio-economic status and race. Public Health Nutrition. 2016;19(18):3386–3396Google Scholar
  24. 24.
    Turcsik R. Wiping out the competition. November 1, 2014. Available at: http://www.groceryheadquarters.com/2014/11/paper-products/. Accessed June 17, 2015.
  25. 25.
    California Center for Public Health Advocacy, PolicyLink, The UCLA Center for Health Policy Research. Designed for Disease: The Link Between Local Food Environments and Obesity and Diabetes. 2008. Available at http://healthpolicy.ucla.edu/publications/Documents/PDF/Designed%20for%20Disease%20The%20Link%20Between%20Local%20Food%20Environments%20and%20Obesity%20and%20Diabetes%203.pdf
  26. 26.
    Diez Roux AV, Stein Merkin S, Arnett D, et al. Neighborhood of residence and incidence of coronary heart disease. N Engl J Med. 2001;345(2):99–106.CrossRefPubMedGoogle Scholar
  27. 27.
    United States Department of Agriculture, Economic Research Service. Urban Influence Codes: Documentation. May 10, 2013. Available at: http://www.ers.usda.gov/data-products/urban-influence-codes/documentation.aspx. Accessed June 22, 2015.
  28. 28.
    Grimm KA, Moore LV, Scanlon KS. Access to healthier food retailers - United States, 2011. MMWR Surveill Summ. 2013;62(Suppl 3):20–6.Google Scholar
  29. 29.
    Lamichhane AP, Warren J, Puett R, et al. Spatial patterning of supermarkets and fast food outlets with respect to neighborhood characteristics. Health Place. Sep 2013;23:157–64.CrossRefPubMedGoogle Scholar
  30. 30.
    Jesse E, Cropp B. Basic Milk Pricing Concepts for Dairy Farmers. University of Wisconsin Extension – Cooperative Extension. 2008;Publication a3379. Available from: http://future.aae.wisc.edu/publications/a3379.pdf. Accessed June 22, 2015.
  31. 31.
    Rehm CD, Monsivais P, Drewnowski A. The quality and monetary value of diets consumed by adults in the United States. Am J Clin Nutr. Nov 2011;94(5):1333–9.CrossRefPubMedPubMedCentralGoogle Scholar
  32. 32.
    Kearney J. Food consumption trends and drivers. Philos Trans R Soc B. 2010;365(1554):2793–807.CrossRefGoogle Scholar
  33. 33.
    Powell LM, Wada R, Kumanyika SK. Racial/ethnic and income disparities in child and adolescent exposure to food and beverage television ads across the U.S. media Markets. Health Place. 2014;29:124–31.CrossRefPubMedPubMedCentralGoogle Scholar
  34. 34.
    Chandon P, Wansink B. Does food marketing need to make us fat? A review and solutions. Nutr Rev. 2012;70(10):571–93.CrossRefPubMedPubMedCentralGoogle Scholar
  35. 35.
    Drewnowski A. Obesity, diets, and social inequalities. Nutr Rev. 2009;67(Suppl. 1):S36–9.CrossRefPubMedGoogle Scholar
  36. 36.
    Appelhans BM, Milliron B-J, Woolf K, et al. Socioeconomic status, energy cost, and nutrient content of supermarket food purchases. American Journal of Preventative Medicine. 2012;42(4):398–402.CrossRefGoogle Scholar
  37. 37.
    Andreyeva T, Long MW, Brownell KD. The impact of food prices on consumption: a systematic review of research on the price elasticity of demand for food. Am J Public Health. 2010;100(2):216–22.CrossRefPubMedPubMedCentralGoogle Scholar
  38. 38.
    Okrent A, Alston JM. The Demand for Disaggregated Food-Away-From-Home and Food-at-Home Products in the United States. ERR-139, U.S. Department of Agriculture, Economic Research Service. August 2012.Google Scholar
  39. 39.
    Duffey KJ, Gordon-Larsen P, Shikany JM, Guilkey D, Jacobs DR Jr, Popkin BM. Food price and diet and health outcomes: 20 years of the CARDIA study. Arch Intern Med. 2010;170(5):420–6.CrossRefPubMedPubMedCentralGoogle Scholar
  40. 40.
    Powell LM, Bao Y. Food prices, access to food outlets and child weight. Econ Hum Biol. 2009;7(1):64–72.CrossRefPubMedGoogle Scholar
  41. 41.
    The Council for Community and Economic Research (C2ER). Cost of Living Index Manual. Available at: https://www.coli.org/surveyforms/colimanual.pdf; 2015. Last accessed: June 25, 2016.
  42. 42.
    USDA/CNPP. Development of the CNPP prices database. 2008. Available from: http://www.cnpp.usda.gov/sites/default/files/usda_food_plans_cost_of_food/PricesDatabaseReport.pdf; Last accessed: June 25, 2016.
  43. 43.
    Glanz K, Bader MD, Iyer S. Retail grocery store marketing strategies and obesity: an integrative review. Am J Prev Med. 2012;42(5):503–12.CrossRefPubMedGoogle Scholar
  44. 44.
    United States Department of Agriculture. Food Expenditures - Table 15. In: Service ER, ed. http://www.ers.usda.gov/data-products/food-expenditures.aspx; 2014. Last accessed: June 1, 2016.
  45. 45.
    Drewnowski A, Moudon AV, Jiao J, Aggarwal A, Charreire H, Chaix B. Food environment and socioeconomic status influence obesity rates in Seattle and in Paris. Int J Obes. 2014;38(2):306–14.CrossRefGoogle Scholar
  46. 46.
    Todd JE, Leibtag E, Penberthy C. Geographic Differences in the Relative Price of Healthy Foods. U.S. Department of Agriculture, Economic Research Service. June 2011;EIB-78.Google Scholar
  47. 47.
    Burns C, Sacks G, Rayner M, Bilenkij G, Swinburn B. Correctly calculating the cost of food. Nutr Rev. 2010;68(3):182–3. author reply 184-185CrossRefPubMedGoogle Scholar
  48. 48.
    Stewart H, Hyman J, Buzby JC, Frazao E, Carlson A. How much do fruits and vegetables cost? United States Department of Agriculture, Economic Research Service. February 2011;EIB-71.Google Scholar
  49. 49.
    Morris A. Impact of Orange Juice Market Dynamics on Fruit Prices. Presented at the International Citrus Economics Conference. October 27, 2011. Orlando, Florida. 2011.Google Scholar
  50. 50.
    Beverage World. Market share of the leading soft drink companies in the United States in 2014. Available at: http://www.statista.com/statistics/237687/market-share-of-the-leading-us-soft-drink-companies/. Last accessed: May 18, 2016.
  51. 51.
    Grocery Headquarters. Leading vendors of potato chips in the United States in 2016, based on sales (in million U.S. dollars). Available at: http://www.statista.com/statistics/188220/leading-potato-chips-vendors-in-the-united-states-in-2011/. Last accessed: May 18, 2016.
  52. 52.
    Grocery Headquarters. Sales of the leading chocolate candy brands of the United States in 2016 (in million U.S. dollars)*. Available at: http://www.statista.com/statistics/190393/top-chocolate-candy-brands-in-the-united-states/ Last accessed: May 18, 2016.
  53. 53.
    Beverage Industry Magazine. Sales of the leading refrigerated orange juice brands of the United States in 2015 (in million U.S. dollars). Available at: http://www.statista.com/statistics/188749/top-refrigerated-orange-juice-brands-in-the-united-states/. Last accessed: May 18, 2016.
  54. 54.
    Grocery Headquarters. Supermarket categories with the highest private label share in the United States in 2012, based on unit market share. Available at: http://www.statista.com/statistics/259966/private-label-share-in-us-supermarket-categories/ Last accessed: May 18, 2016.
  55. 55.
    Store Brands. Dollar sales share of the private label frozen and canned fruit and vegetables category in U.S. retail stores in 2015, by segment. Available at: http://www.statista.com/statistics/419674/us-dollar-sales-share-of-private-label-frozen-and-canned-fruit-and-vegetables-by-segment/ Last accessed: May 18, 2016.

Copyright information

© The New York Academy of Medicine 2017

Authors and Affiliations

  • David M. Kern
    • 1
  • Amy H. Auchincloss
    • 1
  • Lucy F. Robinson
    • 1
  • Mark F. Stehr
    • 2
  • Genevieve Pham-Kanter
    • 3
  1. 1.Department of Epidemiology and Biostatistics, Dornsife School of Public HealthDrexel UniversityPhiladelphiaUSA
  2. 2.School of Economics, LeBow College of BusinessDrexel UniversityPhiladelphiaUSA
  3. 3.Department of Health Management and Policy, Dornsife School of Public HealthDrexel UniversityPhiladelphiaUSA

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