Increased access to dollar stores, such as Dollar General, Dollar Tree, Family Dollar, and the 99 Cent Store, is associated with higher rates of obesity, high blood pressure, high cholesterol, and type 2 diabetes, according to a study by the University of California, Riverside. The research also found that greater access to traditional grocery stores correlated with better health outcomes.
The study analyzed health data from the Centers for Disease Control and Prevention’s 500 Cities Project, which encompasses major metropolitan areas and cities across the continental United States. Researchers used geographic mapping software to determine the density of dollar stores and traditional grocery stores within a 10-minute drive of residential areas. They also incorporated a social vulnerability index, which considers factors like affordability of groceries.
Dollar stores, which comprise approximately 34,000 locations nationwide, are often classified as general merchandise outlets by the Census Bureau, leading to their exclusion from many studies on food consumption. This classification means their impact on consumer diets and health may be overlooked.
"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," said Ryan Bruellman, the study's first author and a doctoral student at UC Riverside. He noted that across the U.S., the number of dollar stores now exceeds that of traditional grocery stores.
The findings indicated that dollar stores were significantly linked to adverse health outcomes across all studied regions, although the intensity of this effect varied. In the South and Midwest, where the ratio of dollar stores to traditional grocery stores is nearly even, the influence appeared more pronounced. Bruellman suggested this could be due to the higher sheer number of dollar stores in these areas.
Differences were also observed between cities. For example, in Philadelphia, the study's data did not account for smaller bodegas and independent grocery stores, which may have influenced the apparent impact of dollar-store shopping.
Bruellman proposed that instead of reducing the number of dollar stores, the focus should be on expanding healthier food options within these existing retailers. One potential solution suggested is establishing partnerships with local farmers to offer more fresh fruits and vegetables on dollar store shelves. "Ideally you’d have the healthier options available inside the dollar store," he stated.
The study's findings held true even after researchers controlled for socioeconomic factors such as income and unemployment levels. The analysis covered major metropolitan areas including greater Los Angeles and the Inland Empire.