Is the Focus on Food Deserts Fruitless? Retail Access and Food Purchases Across the Socioeconomic Spectrum

Abstract

Despite an absence of causal evidence showing that limited access to healthy foods is to blame for unhealthful consumption, policies aimed at improving poor diets by improving access are ubiquitous. In this paper, we use novel 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 relative to the spatial differences in store sales 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 access is equated: even in the same store, wealthier and 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 their retail environment, especially among households with low levels of income and education. Together, our results indicate that even if spatial disparities in access are entirely resolved, over two-thirds of the existing socioeconomic disparities in consumption would remain.