Competitive pricing for healthy foods

Competitive pricing assigns higher costs to non-nutritious foods than nutritious foods. Competitive pricing can include incentives, subsidies, or price discounts for healthy foods and beverages as well as disincentives or price increases for unhealthy foods and beverages. Competitive pricing can be implemented in various settings, including schools, worksites, grocery stores or other food retail outlets, cafeterias, and vending machines.

Expected Beneficial Outcomes (Rated)

  • Increased sales of healthy foods

Other Potential Beneficial Outcomes

  • Increased healthy food consumption

  • Reduced energy use

Evidence of Effectiveness

There is strong evidence that competitive pricing increases sales of healthy foods, including low-fat foods, fruits, vegetables, and water (Gittelsohn 2017, Grech 2015*, Jaime 2009*, Kocken 2012*, An 2013*, AHA-Mozaffarian 2012). Price discounts or subsidies for healthier foods can also increase healthier food consumption (Gittelsohn 2017, An 2013*, AHA-Mozaffarian 2012).

Pricing affects individual behavior; adults and teenagers have been shown to purchase items that are lower in cost, whether those items are healthy or unhealthy (French 2001*). Reductions in the price of low-fat snacks, fruits, and vegetables increase sales of these products (Gittelsohn 2017, Fox 2005a*, Jaime 2009*, Kim 2006, Kocken 2012*, An 2013*). The size of the price difference matters; larger price differences between lower cost healthy foods and higher cost unhealthy foods are linked to greater improvements in healthy food consumption (AHA-Mozaffarian 2012). Overall, pricing incentives improve dietary choices and change consumer behavior when implemented alone or in combination with other interventions such as nutrition education (Gittelsohn 2017).

Preliminary evidence from price discount interventions suggests that there is a strong demand for healthy foods such as fruits and low-fat snacks, such that a 1% price decrease is associated with more than a 1% increase in quantity demanded (An 2013*). In some studies, positive behavior changes following subsidies that reduce the price of fruits and vegetables have been sustained several months after subsidies end. Other studies suggest that populations with lower incomes may be more sensitive to prices than those with higher incomes, and youth more sensitive than adults (AHA-Mozaffarian 2012).

Competitive pricing of healthier foods and beverages along with healthy food marketing strategies has been shown to improve weight status for children and adolescents, especially as part of a broader multi-component school-based intervention to improve the food environment (CG-Obesity).

Competitive pricing that increases the purchase and consumption of fresh fruits and vegetables, especially those grown locally and in season, instead of unhealthy, highly processed items may reduce fossil fuel energy used to produce, process, and transport food (Ringling 2020, SSSA-McIvor 2017, CCAFS-Campbell 2012). Competitive pricing initiatives may also reduce the energy intensity of an individual’s diet if more plant-based foods are consumed in place of animal products (Ringling 2020, Hamerschlag 2017).

Lowering the price of healthy foods or raising the price of unhealthy foods has not been shown to significantly decrease revenue in school settings (Fox 2009*, Kim 2006, Kocken 2012*), and in some cases, has increased revenue and total profits (Gittelsohn 2017).

Impact on Disparities

No impact on disparities likely

Implementation Examples

Many schools have implemented competitive pricing in their cafeterias and vending machines, including North Community High School in Minneapolis, MN; Vista High School in Vista, CA; the Fayette County Public School District in Lexington, KY (Fox 2005a*); Marshall County Schools in AL; and Boston Public Schools (IPHI-HCFS).

Workplace wellness policies often include competitive pricing strategies in vending machines and cafeterias. For example, in Michigan, worksite wellness guides encourage large and small workplaces to adopt competitive pricing for healthy foods (MI DCH-WW guide 2008). 

There are also many grocery stores, convenience stores, and other food retail outlets using competitive pricing to market healthy food options and promote fruit and vegetable sales as part of a healthy food retail model, for example, the Healthy Neighborhood Store Project in Omaha, Nebraska and Northgate Market in Inglewood, California (PolicyLink-HFA case studies).

Implementation Resources

PolicyLink-HFA portal - PolicyLink, The Food Trust, Reinvestment Fund. Healthy food access portal: Research your community, change policy, launch a business, resources & tools.

AHA-VFHK toolkits - American Heart Association (AHA), Robert Wood Johnson Foundation (RWJF). Voices for healthy kids (VFHK): Toolkits to make the healthy choice the easy choice in the places where children live, learn and play.

CETRT-Pricing - Center of Excellence for Training and Research Translation (CETRT). Healthy food environments pricing incentives: Implementation.

ISU-Food and sustainability resources - Iowa State University (ISU), Sustainable Food Processing Alliance. Online resources for food and sustainability.

Citations - Evidence

* Journal subscription may be required for access.

Gittelsohn 2017 - Gittelsohn J, Trude ACB, Kim H. Pricing strategies to encourage availability, purchase, and consumption of healthy foods and beverages: A systematic review. Preventing Chronic Disease. 2017;14(E107):170213.

Grech 2015* - Grech A, Allman-Farinelli M. A systematic literature review of nutrition interventions in vending machines that encourage consumers to make healthier choices. Obesity Reviews. 2015;16(12):1030-1041.

Jaime 2009* - Jaime PC, Lock K. Do school based food and nutrition policies improve diet and reduce obesity? Preventive Medicine. 2009;48(1):45-53.

Kocken 2012* - Kocken PL, Eeuwijk J, Van Kesteren NMC, et al. Promoting the purchase of low-calorie foods from school vending machines: A cluster-randomized controlled study. Journal of School Health. 2012;82(3):115–22.

An 2013* - An R. Effectiveness of subsidies in promoting healthy food purchases and consumption: A review of field experiments. Public Health Nutrition. 2013;16(7):1215-28.

AHA-Mozaffarian 2012 - Mozaffarian D, Afshin A, Benowitz NL, et al. Population approaches to improve diet, physical activity, and smoking habits: A scientific statement from the American Heart Association (AHA). Circulation. 2012;126(12):1514-63.

French 2001* - French SA, Story M, Jeffrey RW. Environmental influences on eating and physical activity. Annual Review of Public Health. 2001;22:309-35.

Fox 2005a* - Fox S, Meinen A, Pesik M, Landis M, Remington PL. Competitive food initiatives in schools and overweight in children: A review of the evidence. Wisconsin Medical Journal. 2005;104(5):38-43.

Kim 2006 - Kim D, Kawachi I. Food taxation and pricing strategies to “thin out” the obesity epidemic. American Journal of Preventive Medicine. 2006;30(5):430-7.

CG-Obesity - The Guide to Community Preventive Services (The Community Guide). Obesity.

Ringling 2020 - Ringling KM, Marquart LF. Intersection of diet, health, and environment: Land grant universities’ role in creating platforms for sustainable food systems. Frontiers in Sustainable Food Systems. 2020;4(70).

SSSA-McIvor 2017 - McIvor K. Soils in the city: Community gardens. Soil Science Society of America (SSSA). 2017.

CCAFS-Campbell 2012 - Campbell B. Is eating local good for the climate? Thinking beyond food miles. Research Program on Climate Change, Agriculture and Food Security (CCAFS), CGIAR Research Programs. 2012.

Hamerschlag 2017 - Hamerschlag K, Kraus-Polk J. Shrinking the carbon and water footprint of school food: A recipe for combating climate change. A pilot analysis of Oakland Unified School District's food programs. Friends of the Earth; February 2017.

Fox 2009* - Fox MK, Dodd AH, Wilson A, Gleason PM. Association between school food environment and practices and body mass index of US public school children. Journal of the American Dietetic Association. 2009;109(2 Suppl):S108-S117.

Citations - Implementation Examples

* Journal subscription may be required for access.

Fox 2005a* - Fox S, Meinen A, Pesik M, Landis M, Remington PL. Competitive food initiatives in schools and overweight in children: A review of the evidence. Wisconsin Medical Journal. 2005;104(5):38-43.

IPHI-HCFS - Illinois Public Health Institute (IPHI). Controlling junk food and the bottom line: Tip sheet 5: Improving cafeteria strategies to support healthier competitive foods standards (HCFS).

MI DCH-WW guide 2008 - Michigan Department of Community Health (MI DCH). Michigan's healthy workplaces resource guide: A worksite wellness resource guide for Michigan worksites - large and small (WW guide). 2008.

PolicyLink-HFA case studies - PolicyLink, The Food Trust, Reinvestment Fund. Healthy food access (HFA) portal: Our webinars and case studies.

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