title: Testing the price and affordability of healthy and current (unhealthy) diets and the potential impacts of policy change in Australia.
abstract: BACKGROUND
  Price and affordability of foods are important determinants of health. Targeted food pricing policies may help improve population diets. However, methods producing comparable data to inform relevant policy decisions are lacking in Australia and globally. The objective was to develop and pilot standardised methods to assess the price, relative price and affordability of healthy (recommended) and current (unhealthy) diets and test impacts of a potential policy change.
  
  
  METHODS
  Methods followed the optimal approach proposed by INFORMAS using recent Australian dietary intake data and guidelines. Draft healthy and current (unhealthy) diet baskets were developed for five household structures. Food prices were collected in stores in a high and low SES location in Brisbane, Australia. Diet prices were calculated and compared with household incomes, and with potential changes to the Australian Taxation System. Wilcoxen-signed rank tests were used to compare differences in price.
  
  
  RESULTS
  The draft tools and protocols were deemed acceptable at household level, but methods could be refined. All households spend more on current (unhealthy) diets than required to purchase healthy (recommended) diets, with the majority (53-64 %) of the food budget being spent on 'discretionary' choices, including take-away foods and alcohol. A healthy diet presently costs between 20-31 % of disposable income of low income households, but would become unaffordable for these families under proposed changes to expand the GST to apply to all foods in Australia.
  
  
  CONCLUSIONS
  Results confirmed that diet pricing methods providing meaningful, comparable data to inform potential fiscal and health policy actions can be developed, but draft tools should be refined. Results suggest that healthy diets can be more affordable than current (unhealthy) diets in Australia, but other factors may be as important as price in determining food choices.
authors.affiliation: School of Public Health and Social Work, Queensland University of Technology, Brisbane, QLD, Australia. Amanda.Lee@qut.edu.au.
authors.forename: Amanda J
authors.initials: AJ
authors.lastname: Lee
authors.affiliation: School of Public Health and Social Work, Queensland University of Technology, Brisbane, QLD, Australia.
authors.forename: Sarah
authors.initials: S
authors.lastname: Kane
authors.affiliation: School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, QLD, Australia.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Ramsey
authors.affiliation: Preventive Health Branch, Prevention Division, Department of Health, Brisbane, QLD, Australia.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Good
authors.affiliation: Preventive Health Branch, Prevention Division, Department of Health, Brisbane, QLD, Australia.
authors.forename: Mathew
authors.initials: M
authors.lastname: Dick
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001315:Australia; D002648:Child; D002675:Child, Preschool; D002755:Choice Behavior; D003132:Commerce; D004032:Diet / Q000191:economics*; D000072001:Diet, Healthy / Q000191:economics*; D005191:Family Characteristics; D005260:Female; D005502:Food / Q000191:economics*; D006291:Health Policy; D006801:Humans; D007182:Income / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D013660:Taxes / Q000191:economics
keywords: Diet affordability; Diet prices; Food affordability; Food environments; Food policy; Food prices; Healthy diets; INFORMAS; Non-communicable disease; Obesity prevention