Background – In developed countries, persons of low socioeconomic status (SES), particularly women, are less likely to consume diets consistent with dietary guidelines. Little is known about the mechanisms that influence SES differences in eating behaviours and food purchases. Cost is a strong influence on food purchases and given that persons of low SES often have more limited budgets, healthier foods such as fruit and vegetables may be overlooked in favour of less healthy, more energy-dense lower cost options.
Objective – To investigate the importance of the available household food budget as a predictor of food purchasing choices among women of low and high SES.
Design – This study used a novel experimental design which included a mixture of quantitative and qualitative methods. A sample of 74 women (37 low SES women and 37 high SES women) was selected on the basis of their household income and sent an itemized shopping list in order to calculate their typical weekly household shopping expenditure. The women were also asked to indicate those foods they would add to their list if they were given an additional 25% of their budget to spend on food and what foods they would remove if they were restricted by 25% of their budget.
Outcomes – Total food expenditure and expenditure on fruit and vegetables, meat products and alcohol were lower among low SES households compared with high SES households. However, expenditure on ‘extra foods’ such as biscuits and convenience foods was higher in low SES households. When the women were asked what foods they would add to their shopping list with a larger household food budget, low SES women chose more foods from the ‘healthier’ categories.
Conclusion – This study highlights the importance of cost when making food purchasing choices among low SES groups. Public health strategies aimed at reducing SES inequalities in diet might focus on promoting healthy diets that are low cost.