Disparities in the Availability and Price of Low-Fat and Higher-Fat Milk in US Food Stores by Community Characteristics

Abstract

BackgroundNational surveillance data identify disparities in low-fat milk consumption by race/ethnicity and income. Some localized studies have shown disparities in access to low-fat milk by community characteristics. ObjectiveOur aim was to assess the availability and price of low-fat and higher-fat milk in food stores throughout the United States and examine associations with community characteristics. DesignWe conducted a cross-sectional study involving observational data collection in 2010, 2011, and 2012. Participants/settingsThe study included 8,959 food stores in 468 communities where nationally representative samples of students attending traditional public middle and high schools resided. Main outcome measuresWe studied the availability and price of whole, 2%, 1%, and skim milk. Statistical analyses performedMultivariate logistic regression and ordinary least squares regression analyses were performed. Models included store type, race/ethnicity, median household income, urbanicity, US Census division, and year of data collection. ResultsLess than half of all stores carried 1% and skim milk, and more than three-quarters of stores carried whole and 2% milk. Regression results indicated that the odds of carrying any type of milk were 31% to 67% lower in stores in majority black and 26% to 45% lower in other/mixed race compared with majority white communities. The odds of carrying specifically low-fat milk were 50% to 58% lower in majority Hispanic compared with majority white communities, and 32% to 44% lower in low-income compared with high-income communities. Some significant differences in milk prices by community characteristics were observed in grocery and limited-service stores. On average, low-fat milk options were more expensive in grocery stores in majority black and rural and suburban communities compared with such stores in majority white and urban communities. ConclusionsThis is the first nationwide study to examine the availability and price of low-fat and higher-fat milk in food stores and show disparities in access by community characteristics. Policies and programs can play a role in increasing accessibility of low-fat milk in stores in nonwhite and low-income communities.