Poster Presentation ANZOS Annual Scientific Meeting 2021

Cost and affordability of healthy, equitable, and more sustainable diets in low socioeconomic groups in Australia (#216)

Meron Lewis 1 2 , Sarah McNaughton 3 , Lucie Rychetnik 2 , Amanda J Lee 1
  1. School of Public Health, The University of Queensland, Herston, QLD, Australia
  2. The Australian Prevention Partnership Centre, The Sax Institute, Sydney, New South Wales, Australia
  3. Institute for Physical Activity and Nutrition, Deakin University, Geelong, Victoria, Australia

Purpose: This study meets an identified need for better evidence to support policies to improve food environments and help drive healthier diets in low socioeconomic groups (SEGs) in Australia, by modifying the Healthy Diets Australian Standardised Affordability and Pricing (HD-ASAP) protocol. It investigates cost and affordability of habitual (based on dietary intake data) and recommended (healthy, equitable, more sustainable) diets in low SEGs.

Method: HD-ASAP protocol components were modified to align with reported dietary intakes, household structures, food purchasing habits and incomes of three low SEGs reference households. Household A included two adults and two children; Household B included one adult and two children; and Household C included two older, retired adults. Feasibility and utility of the modified protocol was tested using food pricing data of ‘standard brands’, and ‘cheapest options’ products, reflecting a common coping strategy of low SEGs.


While total energy intake was similar, habitual diets of low SEGs included more discretionary food and drinks (particularly takeaway and soft drinks) and less healthy food than habitual diets of the mean population. When ‘standard brands’ were purchased, habitual diets were more expensive than recommended diets for all three reference households. However, when the ‘cheapest options’ were purchased, habitual diets were less expensive than recommended diets for Household B, and equal cost with recommended diets for Household C. In Households A and B, reliance on unemployment benefits resulted in both habitual and recommended diets being unaffordable (>30% of household income) unless the cheapest food and drinks (usually ‘own brands’) were purchased.

Conclusions: Among low SEGs recommended diets can be more expensive than habitual diets, contributing to perceptions that healthy food is unaffordable. Policies to improve affordability of healthy diets by decreasing relative healthy food and drink costs and ensuring adequate incomes amongst low SEGs are needed urgently.