A new study found a link between nearby dollar stores and higher rates of obesity, diabetes, and high blood pressure.
Researchers compared access to dollar stores and traditional grocery stores across U.S. metro areas.
The findings suggest that access to healthier food options may matter just as much as access to food itself.
Dollar stores can be an appealing option when grocery prices are putting pressure on household budgets. But new research from the University of California, Riverside suggests that where people shop for food — and the quality of the food available there — could be connected to their health.
The study, published in BMC Public Health, found that communities with greater proximity to dollar stores had higher rates of several health conditions, including obesity, type 2 diabetes, high blood pressure, and high cholesterol. By comparison, greater access to traditional grocery stores was associated with better health outcomes.
The researchers point to differences in the types of foods available. Traditional grocery stores generally offer more fresh produce, whole grains, and lean proteins, while dollar stores tend to have fewer of these healthier options.
“I want to raise awareness that higher grocery costs are pushing people to buy highly processed, lower quality food at dollar stores, and it is negatively impacting their health in a similar way to fast food,” researcher Ryan Bruellman said in a news release.
How the researchers studied the connection
The researchers analyzed data from 2016 through 2020 covering traditional grocery stores and dollar stores across the contiguous United States. They used geographic mapping software called ArcGIS to measure how close different communities were to each type of store.
The analysis focused on census tracts in metropolitan areas included in the CDC's 500 Cities Project. Researchers then used statistical models to examine whether proximity to traditional grocery stores or dollar stores was associated with various health outcomes.
They also accounted for socioeconomic factors using the CDC's Social Vulnerability Index. That was important because factors such as difficulty affording groceries could influence both where people shop and their health.
What the findings mean for consumers
The researchers found that greater proximity to traditional grocery stores was significantly associated with lower rates of adverse health outcomes, including obesity, diabetes, and high blood pressure.
Meanwhile, proximity to dollar stores was significantly associated with all of the health outcomes examined, even after researchers accounted for socioeconomic factors.
That doesn't mean shopping at a dollar store directly causes a particular health condition. Instead, the study identified an association between the food environment and health across communities.
The researchers say the findings highlight the importance of making healthier foods more accessible. Suggestions include increasing the availability of fresh fruits and vegetables at dollar stores and bringing farmers markets and food banks closer to communities where dollar stores are common.
For consumers, the takeaway is less about avoiding dollar stores altogether and more about recognizing that having an affordable place to buy food doesn't necessarily mean having equal access to nutritious choices.
“The overarching thing is we shouldn’t think of traditional grocery stores as the only places to get food. People need to look beyond that,” Bruellman said.