Abstract
BackgroundThe perception that healthy foods are more expensive than unhealthy foods has been reported widely to be a key barrier to healthy eating. However, assessment of the relative cost of healthy and unhealthy foods and diets is fraught methodologically. Standardised approaches to produce reliable data on the cost of total diets and different dietary patterns, rather than selected foods, are lacking globally to inform policy and practice.MethodsThis paper reports the first application, in randomly selected statistical areas stratified by socio-economic status in two Australian cities, of the Healthy Diets Australian Standardized Affordability and Pricing (ASAP) method protocols: diet pricing tools based on national nutrition survey data and dietary guidelines; store sampling and location; determination of household incomes; food price data collection; and analysis and reporting. The methods were developed by the International Network on Food and Obesity/NCD Research, Monitoring and Action Support (INFORMAS) as a prototype of an optimum approach to assess, compare and monitor the cost and affordability of diets across different geographical and socio-economic settings and times.ResultsUnder current tax policy in Australia, healthy diets would be 15–17% less expensive than current (unhealthy) diets in all locations assessed. Nevertheless, healthy diets are likely to be unaffordable for low income households, costing more than 30% of disposable income in both cities surveyed. Households spent around 58% of their food budget on unhealthy food and drinks. Food costs were on average 4% higher in Canberra than Sydney, and tended to be higher in high socioeconomic locations.ConclusionsHealth and fiscal policy actions to increase affordability of healthy diets for low income households are required urgently. Also, there is a need to counter perceptions that current, unhealthy diets must be less expensive than healthy diets. The Healthy Diets ASAP methods could be adapted to assess the cost and affordability of healthy and unhealthy diets elsewhere.
Highlights
The perception that healthy foods are more expensive than unhealthy foods has been reported widely to be a key barrier to healthy eating
This paper reports the first application of the Healthy Diets ASAP methods in two major cities in Australia: Canberra and Sydney
Healthy diets can be less expensive than current diets This study found that healthy diets would be less expensive than the current diets reported in the Australian Health Survey (AHS) 2011– 12, in both Sydney and Canberra and across all Statistical Area Level 2 (SA2) locations stratified by SocioEconomic Indexes for Areas (SEIFA) quintiles
Summary
The perception that healthy foods are more expensive than unhealthy foods has been reported widely to be a key barrier to healthy eating. The public perception that healthy foods are expensive has been reported widely as a barrier to healthy diets, in low socioeconomic groups [8], and an important contributor to diet-related health inequities in Australia [9,10,11,12,13]. In Australia, historical monitoring of food environments has had a strong focus on the cost of foods, with ‘food basket’ methods used to assess the cost of a ‘healthy’ diet in different locations and over time [15]. The majority of diet pricing tools included commonly consumed ‘unhealthy’ foods (such as sugar, sausages, soft drinks, meat pies and chocolate) in the ‘healthy’ basket, did not fully align with current Australian Dietary Guidelines [4, 15]. No national survey of food or diet prices from a health perspective has been conducted, and the available state, regional and local data have not been used to improve policy or practice
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