What Drives Nutritional Disparities? Retail Access and Food Purchases Across the Socioeconomic Spectrum

Abstract

The poor diets of many consumers are often attributed to limited access to healthy foods. In this paper, we use detailed data describing both the healthfulness of household food purchases and the retail landscapes facing consumers to measure the role that access plays in explaining why some people in the United States eat more nutritious foods than others. We first confirm that households with lower income and education purchase less healthful foods. We then measure the spatial variation in the average nutritional quality of available food products across local markets, revealing that healthy foods are less likely to be available in low-income neighborhoods. Though significant, spatial differences in access are small and explain only a fraction of the variation that we observe in the nutritional content of household purchases. Systematic socioeconomic disparities in household purchases persist after controlling for access: even in the same store, more educated households purchase more healthful foods. Consistent with this result, we further find that the nutritional quality of household purchases responds very little to changes in the retail environment, especially among households with low levels of income and education. Together, our results indicate that policies aimed at improving access to healthy foods in underserved areas will leave most of the socioeconomic disparities in nutritional consumption intact.