Abstract
Background: As the only place in a store where all customers must pass through and wait, the checkout lane may be particularly influential over consumer purchases. Because most foods and beverages sold at checkout are unhealthy (e.g., candy, sweets, sugar-sweetened beverages, and salty snacks), policymakers and advocates have expressed growing interest in healthy checkout policies. To understand the extent to which such policies could improve nutrition equity, we assessed the prevalence and sociodemographic correlates of purchasing items found at (i.e., from) checkout. Methods: We assessed self-reported checkout purchasing and sociodemographic characteristics in a national convenience sample of adults (n = 10,348) completing an online survey in 2021. Results: Over one third (36%) of participants reported purchasing foods or drinks from checkout during their last grocery shopping trip. Purchasing items from checkout was more common among men; adults < 55 years of age; low-income consumers; Hispanic, non-Hispanic American Indian or Alaska Native, and non-Hispanic Black consumers; those with a graduate or professional degree; parents; and consumers diagnosed with type 2 diabetes or pre-diabetes (p-values < 0.05). Conclusions: Purchasing foods or beverages from store checkouts is common and more prevalent among low-income and Hispanic, American Indian or Alaska Native, and Black consumers. These results suggest that healthy checkout policies have the potential to improve nutrition equity.
Highlights
Two thirds of calories in the US diet come from grocery stores [1,2], making the retail food environment a key opportunity for improving diet quality
Consistent with the hypothesis that stocking checkout with poor-quality foods and beverages may contribute to inequities, we found that the lowestincome participants were more likely to purchase foods and drinks from checkout than the highest-income participants, as were Hispanic, NH American Indian or Alaska Native, and NH Black participants compared to NH White participants
This study’s finding that purchasing foods or drinks from checkout was more prevalent among low-income and Hispanic, NH American Indian or Alaska Native, and NH Black consumers, together with prior research documenting the poor quality of foods and beverages at checkout, indicate that healthy checkout policies hold promise for improving nutrition and health equity
Summary
Two thirds of calories in the US diet come from grocery stores [1,2], making the retail food environment a key opportunity for improving diet quality. Multiple reviews have found that the characteristics of store food environments influence consumer purchases, especially product placement and pricing [3,4,5]. The store food environment may affect health outcomes. Higher exposure to store displays for sugar-sweetened beverages and foods high in added sugars has been associated with higher customer body mass index [6]. Checkout lanes represent a promising target for intervention. Checkout lanes are the only place in the store where all customers must pass through and wait
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