The Healthfulness of Foods Purchased at Dollar Stores: Insights from Household Scanner Data from 2008 to 2020

Abstract

Background: Dollar stores are the fastest-growing food retailer over the past decade. Although their offerings are less nutritious, the relationship between dollar store food purchase behavior and the overall healthfulness of household food purchases from all retail formats is unknown. Objective: This study analyzed the healthfulness and energy content of foods purchased in dollar stores compared with other retail channels. Design: This repeated, cross-sectional study analyzed yearly, nationally representative household consumer purchase records (2008-2020) from the Circana Consumer Network. Participants/setting: Participants included 183 283 households from 2008 to 2020 for calorie calculations, and 76 520 households from 2017 to 2018 for Healthy Eating Index 2015 (HEI-2015) calculations. Main Outcome Measures: Household-level calorie shares in dollar stores from 2008 to 2020 and HEI-2015 scores from 2017 to 2018 for household food purchases are the main outcome measures. Statistical Analyses Performed: The statistical analyses included summarizing how the share of calories purchased in dollar stores changed over time, performing a fractional logistic regression to estimate factors associated with more calories purchased in dollar stores, and comparing the healthfulness of foods purchased in dollar stores and other retail channels, controlling for multiple sociodemographic characteristics. Data extraction was performed in SQL and R. HEI-2015 calculation was performed in SAS. All statistical analyses were performed in Stata 18. Results: Dollar stores’ share of household calorie purchases increased from 3.4% (2008) to 6.5% (2020). More calories purchased in dollar stores were associated with multiple factors, including race/ethnicity, rurality, and income. Foods purchased in dollar stores were generally less healthy compared with other outlets. The overall healthfulness of household food purchases was similar between those who shopped at dollar stores and those who did not, with average HEI-2015 scores of 50.5, 48.2, and 46.3 across households with no, moderate, or substantial shares of purchases in dollar stores, respectively. Conclusions: The rise of dollar stores depicts a major change in the food retail landscape. Although foods purchased in dollar stores are less healthy, households may compensate through healthier purchases elsewhere.