Are healthy diets really more expensive?
Project title: The price and affordability of healthy and current (less healthy) diets in Australia
Project start date: March 2015
Project end date: March 2016
This project is finished. Click on the image to read the Findings Brief.
What is the issue?
Unhealthy diets are the major preventable risk factor contributing to the burden of chronic disease in Australia. Data from the Australian Health Survey 2011-12 show that less than 7% of Australians consume diets that are consistent with the Australian Dietary Guidelines, and that at least 35% of the energy intake of adults and up to 41% of the energy intake of children comes from unhealthy (‘junk’) food and drinks. (Unhealthy foods are energy-dense food and drinks high in saturated fat, added sugar, salt and/or alcohol.)
While there is a public perception that healthy foods are expensive, despite several studies it is not clear whether healthy dietary patterns really cost more than less healthy diets.
Generally, the more people spend on food, the healthier their diet. Research has shown that low-income groups are at much greater risk of poor diet because, although they spend less per person on food, they spend a greater proportion of their income on food. In Australia, a healthy diet costs lowest-income families between 28% and 40% of their disposable income while a healthy diet only costs average-income families around 20% of their disposable income.
Although basic healthy foods don’t incur GST in Australia, the cost of healthy food has increased more rapidly than that of unhealthy food in Australia over the past 15 years.
While we know some information about food affordability in Australia, there is a lack of real-life data to inform relevant debates about fiscal policy from a health and diet perspective in Australia.
There are no nationally standardised tools or protocols to benchmark, compare and monitor food prices and affordability. While jurisdictions and research groups have used different food baskets as survey instruments, none is entirely consistent with current Australian Dietary Guidelines nor accurately reflects the current Australian diet. There are more than six different methods used throughout Australia to determine the cost of food from a health perspective but the tools that are generally used include healthier items abut also some unhealthy items, such as sugar and sausages.
How did the project address the issue?
- Developed and tested standardised baskets of foods reflecting healthy (NHMRC-recommended Foundation Diets) and unhealthy (current intakes reported in the Australian Healthy Survey 2011-12) diets of representative Australian households
- Costed the standardised healthy and unhealthy (current) diet baskets in high and low socioeconomic areas in two major capital cities
- Determined the differential between the cost and affordability of healthy and unhealthy (current) diets of Australian households
- Determined the impact of factors that might influence the cost and affordability of different diets.
What were the outcomes?
This project developed the first nationally standardised tools and protocols to determine the relative price and affordability of healthy and unhealthy (current) diets. The new approach is now called the Healthy Diets ASAP (Australian Standardised Affordability and Price) method. By working out the real price of different diets, these standardised methods will help to determine whether the affordability of healthy food is a barrier to following a healthy diet.
Relevance for practice
The project determined the real price of healthy and unhealthy diets to inform health and fiscal policy decisions. The new standardised methods will help to answer the key policy questions of what is the difference in price and affordability of healthy and current (unhealthy) diets, and how these would change under different policy scenarios.
Professor Amanda Lee, Sax Institute
- Ms Megan Cobcroft, NSW Ministry of Health
- Mr Mathew Dick, Queensland Health
- Ms Elizabeth Good, Queensland Health
- Ms Sarah Kane, Research Assistant, Queensland University of Technology
- Dr Paul Kelly, ACT Health
- Mr Timothy Landrigan, WA Australian Bureau of Statistics
- Ms Meron Lewis, Research Assistant, Queensland University of Technology
- Dr Christina Pollard, WA Health and Curtin University
- Dr Rebecca Ramsay, Queensland University of Technology
This project was funded by the NHMRC, Australian Government Department of Health, NSW Ministry of Health, ACT Health and the HCF Research Foundation.
This project has now been completed. The final outcomes are listed below.
Development of methods
- Development, for the first time, of draft nationally standardised tools to determine the relative cost and affordability of ‘healthy’ (recommended) compared to ‘unhealthy’ (current) diets (pilot – Brisbane)
- Assessment of the cost and relative cost of ‘healthy’ (recommended) compared to ‘unhealthy’ (current) diets for a range of Australian households in a high and low SES area (pilot – Brisbane)
- Assessment of the impact of potential GST policy actions on cost and relative cost, for the first time, of ‘healthy’ (recommended) compared to ‘unhealthy’ (current) diets (pilot – Brisbane)
- Development, for the first time, of agreed national standardised tools, survey protocols, data collection and analysis systems, to determine the relative cost and affordability of ‘healthy’ (recommended) compared to ‘unhealthy’ (current) diets
- Assessment of the robust cost, relative cost and household affordability of ‘healthy’ (recommended) and ‘unhealthy’ (current) diets in 6 selected locations in NSW and ACT and identification of the implications of results for policy and practice
- Provision, for the first time, of unique, real world, comparable data on the price, relative price and affordability of ‘healthy’ (recommended) and ‘unhealthy’ (current) diets, to help improve the affordability of healthy food, help inform potential fiscal and health policy actions, and help inform effective nutrition promotion and obesity prevention strategies at state/territory jurisdictional level
- Informing the development of methods to monitor and benchmark food price and affordability globally under the International Network for Food and Obesity/non-communicable diseases (NCDs) Research, Monitoring and Action Support (INFORMAS). (INFORMAS is being incorporated under the Lancet Commission on Obesity)
- Production of data feeding into broader computer modelling systems to determine estimates of projected health impacts and costs under different fiscal policy scenarios.
- Increased capacity of academic colleagues and policy and practice staff in state, territory and national government jurisdictions to monitor, report and/or interpret food prices impacting on health
- Supervision of final year dietetics research student
- Trained two research assistants in data handling, analysis and presentation
- Trained data collection staff.
- Lee AJ, Kane S , Lewis M, Good E, Pollard CM, Landrigan TJ and Dick M. Healthy diets ASAP – Australian Standardised Affordability and Pricing methods protocol. Nutrition Journal 2018;17:88. doi: org/10.1186/s12937-018-0396-0
- Mackay S, Buch T, Vandevijvere S, Goodwin R, Korohina E, Funaki-Tahifote M, Lee A and Swinburn B. Cost and affordability of diets modelled on current eating patterns and on dietary guidelines, for New Zealand Total Population, Māori and Pacific households. Int. J. Environ. Res. Public Health 2018:15(6);1255. doi:10.3390/ijerph15061255. Available from: www.mdpi.com/1660-4601/15/6/1255
- Lee AJ, Kane S, Ramsey R, Good E, Dick M. Testing the price and affordability of healthy and current (unhealthy) diets and the potential impacts of policy change in Australia. BMC Public Health 2016;16:315. doi: 10.1186/s12889-016-2996-y
- Lewis M, Lee A. Costing ‘healthy’ food baskets in Australia – a systematic review of food price and affordability monitoring tools, protocols and methods. Public Health Nutr 2016;19(16);2872–86. doi: 10.1017/S1368980016002160
- Lee A, Kane S and Lewis M, Are heathy diets really more expensive?, International congress of Obesity, World Obesity, Vancouver, Canada, 1-4 May 2016 (poster presentation).
- Lee A, Measuring the price of healthy and current diets, International Conference on Diet and Activity Methods, Brisbane September 2015.
- Lee A, Monitoring and benchmarking food price and affordability internationally; Third INFORMAS meeting, QUT Brisbane, September 2016.
- Lee A, Food Prices Symposium, ISBNPA Conference, Edinburgh June 2015 (con-convenor).
- Lee A, Measuring the cost of healthy diets, Food Prices Methods Symposium, ISBNPA Conference, Edinburgh June 2015.
- Lee A, Nutrition policy and the price of healthy food, Research Collaboration meeting, Australian China Centre for Public Health, Sun Yat Sen University, Guangzhou, PR China, 10-12 May 2015.
National Healthy Diets ASAP Forum, to seek agreement on final methods for nationally standardised food price and affordability surveys. Brisbane, 10 March 2016.
The Sydney Morning Herald: How garbage food became normal
Professor Lee’s presentation at the Dietitians Association of Australian national conference in May 2017 generated widespread media interest, including:
- Fairfax Media: A healthy diet is cheaper, but we’re still spending big on junk foods
- 9 News: Research reveals Aussies spend half their food budget on ‘junk food’
- Plus interviews with ABC News
Prevention Centre news: Putting a price on food: is price a barrier to healthy eating?