Dariush Mozaffarian

Dariush Mozaffarian

Off the cuff: The $1.50 difference

Spring 2014 ]

Dariush Mozzafarian, Associate Professor in the Department of Epidemiology

In a recent study, you found that the cost per person of a healthy diet was $1.50 more per day— $550 more per year—than the cost of an unhealthy diet. What are the policy implications of this dollar calculation?

“For the majority of Americans, this is the cost of a daily cup of coffee. For 30 to 40 percent of low-income Americans—including more than 40 million people on the SNAP, or food stamp, program, and many more who are having trouble making ends meet—$550 per year, or $2,200 for a family of four, is a pretty big barrier to healthy eating. Yet even for these individuals, the cost is far less than the cost of treating chronic diseases.

For decades, we’ve been telling people to eat healthier. But the effects have been negligible. Instead, we need strong policies in government, schools, workplaces, and communities to influence diet. For example, based on the evidence, it is clear that we should tax unhealthy foods and subsidize healthy foods. Unhealthy foods include processed, rapidly digested foods, such as sugary beverages, refined carbohydrates, and processed meats. Healthy foods include minimally processed fruits, vegetables, fish, nuts, whole grains, beans, and vegetable oils.

Over the last several decades, most of the public health focus has been on taking out unhealthy foods. Yet, we haven’t focused enough on increasing healthy foods. This highlights the advantage of taxing unhealthy foods and simultaneously subsidizing healthy foods. If one only taxes unhealthy products, it can be seen as regressive and hurting the poorest people. But if one also subsidizes healthy foods, then we can actually promote a healthy diet for everyone, without additional expense.

The most direct approach would be enacting policy at the federal level. Updating SNAP so that only healthier foods can be purchased, preferably at a discount, would be transformative for many Americans. Other options could include a subsidy for farmers to grow healthy foods, for food manufacturers and restaurants to buy wholesome ingredients, or for supermarket customers to buy nutritious items. For taxing unhealthy foods, one needs at least a 10 percent boost in price to create a meaningful change in intake. We know from taxing tobacco and alcohol that the higher the tax—20 percent, 30 percent—the better. That’s important to recognize, because diet has replaced smoking as the single biggest modifiable cause of disease in the U.S. and around the world.”

— Madeline Drexler

Photo: Kent Dayton / HSPH

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