Deprivation and Healthy Food Access, Cost and Availability: A Cross-Sectional Study

Abstract

<jats:title>Abstract</jats:title><jats:sec><jats:title>Background</jats:title><jats:p>Food access, cost and availability have been identified as determinants of dietary choice. It has been suggested that these are socio‐economically patterned; however, the evidence is inconclusive. The present study investigated whether differences exist with respect to healthy food access, cost and availability between areas of contrasting deprivation.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>An ecological, cross‐sectional study was conducted in two of the most and two of the least deprived wards in Plymouth. Food retail outlets (<jats:styled-content style="fixed-case">FRO</jats:styled-content>s) (<jats:italic>n</jats:italic> = 38) were identified and mapped using Geographic Information Systems to assess ‘physical access’, by foot, to food retail provision. Healthy food basket (<jats:styled-content style="fixed-case">HFB</jats:styled-content>) surveys were conducted (<jats:italic>n</jats:italic> = 32) to compare the cost and availability of 28 healthy food items between the more and less deprived areas.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Areas of poor access to food retail provision were identified in both study areas, with a higher number of households in the more‐deprived areas being affected than in the less‐deprived areas, after accounting for car ownership levels. Median [IQR] HFB availability was lower in more‐deprived than the less‐deprived areas (48%, [39‐71%] vs. 75%, [68‐82%]; P=0.003), and in convenience stores than supermarkets (54%, [43‐72%] vs. 78%, [72‐96%]; P=0.001). Descriptive summaries revealed negligible differences in total median <jats:styled-content style="fixed-case">HFB</jats:styled-content> cost between the more‐deprived and less‐deprived areas (£55.97 versus £55.94) and a larger cost difference between convenience stores and supermarkets (£62.39 versus £44.25).</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>Differences were found with respect to healthy food access, cost and availability in areas of contrasting deprivation. These appeared to be related to <jats:styled-content style="fixed-case">FRO</jats:styled-content> type rather than deprivation alone.</jats:p></jats:sec>