Deprivation and healthy food access, cost and availability: a cross-sectional study.

Background: 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.

Methods: An ecological, cross-sectional study was conducted in two of the most and two of the least deprived wards in Plymouth. Food retail outlets (FROs) (n = 38) were identified and mapped using Geographic Information Systems to assess 'physical access', by foot, to food retail provision. Healthy food basket (HFB) surveys were conducted (n = 32) to compare the cost and availability of 28 healthy food items between the more and less deprived areas.

Results: 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 HFB 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).

Conclusions: Differences were found with respect to healthy food access, cost and availability in areas of contrasting deprivation. These appeared to be related to FRO type rather than deprivation alone.