Price and availability of healthy food: A study in rural South Africa

Objective: We investigated the availability of healthier food choices and whether a healthier diet costs more than a diet commonly eaten by low-income families in South Africa. Methods: We visited 21 food stores in 14 rural towns of the Western Cape province of South Africa. We recorded the price and availability of 66 food items, including both commonly consumed foods as well as healthy options. Results: Healthier food choices are available in supermarkets. However, many towns only have small food stores with a limited selection of healthy foods. We compared the prices of six commonly consumed foods with healthier versions of those foods (e.g., whole-wheat bread in place of white bread). Healthier foods typically cost between 10% and 60% more when compared on a weight basis (Rand per 100 g), and between 30% and 110% more when compared based on the cost of food energy (Rand per 100 kJ). Next, we compared the extra cost of a healthier diet compared to a typical South African menu. On average, for an adult male, the healthier diet costs Rand 10.2 (US$1.22) per day more (69% more). For a household with five occupants, the increased expenditure on food by eating a healthier diet is approximately Rand 1090 per month (US$140); this represents a high proportion (>30%) of the total household income for most of the population. Conclusion: Healthier food choices are, in general, considerably more expensive than commonly consumed foods. As a result, a healthy diet is unaffordable for the large majority of the population.