Socioeconomic inequalities in food purchasing: The contribution of respondent-perceived and actual (objectively measured) price and availability of foods K. Giskes a,b, ⁎ , F.J. Van Lenthe a , J. Brug a , J.P. Mackenbach a , G. Turrell b a Department of Public Health, Erasmus Medical Centre, The Netherlands b School of Public Health and Centre for Health and Biomedical Innovation, Queensland University of Technology, Australia Available online 25 April 2007 Abstract Background. Research has shown that lower socioeconomic groups purchase foods that are less consistent with dietary recommendations. The price and availability of foods are thought to be important mediating factors between socioeconomic position and food purchasing. Objectives. We examined the relative contribution of the perceived and objectively measured price and availability of recommended foods to household income differences in food purchasing. Methods. Using a face-to-face interview, a random sample of Brisbane residents (n = 812) were asked about their food purchasing choices in 2000. They were also asked about their perceptions of the price and availability of ‘recommended’ foods (i.e. choices lower in fat, saturated fat, sugar, salt or higher in fibre) in the supermarkets where they usually shopped. Audits measuring the actual availability and price of identical foods were conducted in the same supermarkets. Results. Lower socioeconomic groups were less likely to make food purchasing choices consistent with dietary guideline recommendations. Objective availability and price differences were not associated with purchasing choices, nor did they contribute to socioeconomic inequalities in food purchasing choices. Perceived availability and price differences were associated with the purchase of recommended foods. Perceived availability made a small contribution to inequalities in food purchasing, however perceived price differences did not. Conclusion. Socioeconomic inequalities in food purchasing are not mediated by differential availability of recommended foods and differences in price between recommended and regular foods in supermarkets, or by perceptions of their relative price. However, differential perceptions of the availability of recommended foods may play a small role in food purchasing inequalities. © 2007 Elsevier Inc. All rights reserved. Keywords: Socioeconomic; Food purchasing; Availability; Price; Perceived; Objective Introduction Unhealthy dietary intakes are significant contributors to major chronic conditions such as cardiovascular disease and cancer (National Health and Medical Research Council, 2003). These diseases show marked socioeconomic gradients; lower socio- economic groups experience higher mortality and morbidity rates from cardiovascular disease and some cancers than their more advantaged counterparts (Dalstra et al., 2005; Mackenbach et al., 2000). Unhealthy dietary intakes have been identified as key contributing factors to these health inequalities (Davey Smith and Brunner, 1997; James et al., 1997; Smith and Baghurst, 1992). Dietary guidelines aim to decrease the burden of disease amongst the general population and socioeconomically disad- vantaged groups in particular. The guidelines advocate making food choices that are low in fat, saturated fat, salt and sugar, and higher in dietary fibre (National Health and Medical Research Council, 2003). Lower socioeconomic groups are less likely to make food choices consistent with these recommendations (Turrell et al., 2002; Roos et al., 1996). Much research has focussed on the individual-level determinants of socioeconomic Preventive Medicine 45 (2007) 41 – 48 www.elsevier.com/locate/ypmed ⁎ Corresponding author. School of Public Health and Centre for Health and Biomedical Innovation, Queensland University of Technology, Australia. Fax: +61 7 3138 3130. E-mail address: k.giskes@qut.edu.au (K. Giskes). 0091-7435/$ - see front matter © 2007 Elsevier Inc. All rights reserved. doi:10.1016/j.ypmed.2007.04.007