Inequalities in Household Food Expenditures in South Africa: Implications for the Burden of Non-Communicable Diseases (NCDs) and Health Inequality

Abstract

Globally, diets are changing. With rising incomes and increased globalisation, low- and middle-income countries are undergoing a shift from traditional diets to an increasingly western diet that is high in sugar and processed foods. Furthermore, many countries undergoing this nutrition transition are plagued by income and wealth inequalities. The interaction of these inequalities with changing dietary patterns has significant implications for the increased burden of Non-Communicable Diseases (NCDs) and health inequality. This study assesses the relative changes in socio-economic inequality in the distribution of food consumption expenditure in South Africa. The data were drawn from the multiple waves of the 2005/2006 Income and Expenditure Survey (IES) and 2014/2015 Living Conditions Survey (LCS). The study uses both descriptive statistics and the concentration index method. The results show that real food expenditures have increased on average and are concentrated among the rich. However, real food expenditure in certain food groups has become less concentrated over time in the richer populations. This is particularly true for sugary food products, with a reduction of about 34% in their concentration among the rich. Undoubtedly, the concentration of real food expenditure on certain food among the lower socioeconomic groups has grave implications for exacerbating the burden of diet-related NCDs and health inequality.