Cheap as chips: Is a healthy diet affordable?
There is a common belief that healthy eating is unaffordable and that ‘junk food’ is cheap. In 2014, it was reported that ‘Healthy foods cost three times as much as unhealthy foods’ (Telegraph) and that an ‘Affordable healthy diet [is] “too expensive for many”’ (BBC). Helen Stokes-Lampard, the chair of the Royal College of GPs, claims that fruit and vegetables are so expensive that many people cannot afford to follow the government’s advice of eating five portions a day:
‘For people that have got a low income five-a-day is really, really hard. It’s expensive to have five-a-day. I get my five-a-day, no problem, but for many people they can’t afford that five-a-day.’ (Campbell 2016)
Arguing from this premise, it is a not a big leap to claim that obesity and poor nutrition are driven by economic factors and that people on low incomes, in particular, have little choice but to eat ‘cheap’ ready-meals, takeaways and ’junk food’.
It is well documented that people on low incomes tend to eat fewer vegetables, fruits, whole grains, seafood and dairy (excluding whole milk) (Beydoun et al. 2015) and tend to consume more processed meat and sugar (Nelson et al. 2007). It is also well documented that people on low incomes are more likely to be obese than wealthier people. Measured by the Index of Multiple Deprivation, the poorest fifth of English adults have an obesity rate of 29 per cent, compared to 22 per cent in the wealthiest fifth (HSCIC 2016).
Studies have found that people who spend more money on food tend to have better diets (Cade et al. 1999; Rehm et al. 2011; Drewnowski and Specter 2004) but this does not prove that healthy diets are unaffordable.
Affluent consumers may spend more money on food because they shop at more expensive stores and buy premium brands. Cade et al. (1999) found that the wealthiest women were more likely to go to the expense of growing their own food, buy organic produce, and shop in health food shops. They were also more likely to be vegetarian and live in one or two person households. All of these factors increased the cost of their grocery shopping but none of them are inherent costs of healthy eating. In large part, they reflect the discretionary expenditure of those who can afford to spend more money on food.
It is therefore not enough to observe how much money different people spend on groceries. Rehm et al. (2011) reported that higher food expenditure was associated with better quality diets but that some groups, including older adults, women and Hispanics, were able to consume ‘lower-cost yet higher-quality diets’. There are expensive fish and vegetables, such as fresh tuna and kale, but there are also cheap fish and vegetables, such as sardines and carrots. The aim of this study is to use data from the UK to establish whether a healthy diet is less affordable than an unhealthy diet in Britain.