Research

Disparities in the Availability and Price of Low-Fat and Higher-Fat Milk in U.S. Food Stores by Community Characteristics

Rimkus L, Isgor Z, Ohri-Vachaspati P, Zenk SN, Powell LM, Barker DC and Chaloupka FJ. Journal of the Academy of Nutrition and Dietetics, 2015. [E-pub ahead of print]

Background: National surveillance data identify disparities in low-fat milk consumption by race/ethnicity and income. Some localized studies have shown disparities in access to low-fat milk by community characteristics.

Objective: To assess the availability and price of low-fat and higher-fat milk in food stores throughout the U.S. and examine associations with community characteristics.

Design: Cross-sectional study involving observational data collection in 2010, 2011, and 2012.

Participants/settings: 8,959 food stores in 468 communities where nationally representative samples of students attending traditional public middle and high schools resided.

Main outcome measures: Availability and price of whole, 2%, 1% and skim milk.

Statistical analyses performed: Multivariate logistic regression and ordinary least squares regression analyses were performed. Models included store type, race/ethnicity, median household income, urbanicity, U.S. Census division, and year of data collection.

Results: Less than half of all stores carried 1% and skim milk, while more than three-quarters of stores carried whole and 2% milk. Regression results indicated that the odds of carrying any type of milk were 31-67% lower in stores in majority black and 26-45% lower in other/mixed race compared to majority white communities. The odds of carrying specifically low-fat milk were 50-58% lower in majority Hispanic compared to majority white communities, and 32-44% lower in low-income compared to high-income communities. Some significant differences in milk prices by community characteristics were observed in grocery and limited service stores. On average, low-fat milk options were more expensive in grocery stores in majority black and rural and suburban communities compared to such stores in majority white and urban communities.

Conclusions: This is the first nationwide study to examine the availability and price of low-fat milk in food stores and show disparities in access by community characteristics. Policies and programs can play a role in increasing accessibility of low-fat milk in stores in non-white and low-income communities.

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