Shopping for groceries at dollar stores may help families stretch their budgets, but new research suggests that relying on these stores for food could come with a hidden health cost.
Researchers at the University of California, Riverside found that greater access to dollar stores was associated with higher rates of obesity, high blood pressure, high cholesterol and type 2 diabetes.
In contrast, communities with better access to traditional grocery stores tended to have healthier outcomes.
The study, published in BMC Public Health, found that these patterns remained even after researchers considered factors such as income and unemployment.
Dollar stores have become an increasingly important source of food in the United States, particularly as grocery prices have risen.
Yet they are often overlooked in research on food access because the U.S. Census classifies them as general merchandise stores rather than grocery stores.
To investigate their potential health impact, researcher Ryan Bruellman analyzed information from the U.S. Centers for Disease Control and Prevention’s 500 Cities Project, which contains health data from many of the country’s largest urban areas.
The study examined four major dollar store chains: Dollar General, Dollar Tree, 99 Cents Only Stores and Family Dollar. Together, they represented about 34,000 locations.
Using geographic mapping software, Bruellman calculated how many dollar stores and traditional grocery stores were located within a 10-minute drive of residential areas. He then compared store access with local health information and measures of social vulnerability, including people’s ability to afford food.
The results showed a significant relationship between dollar store access and poorer health across different parts of the country. However, the strength of the relationship varied by region and city.
The effect appeared particularly important in the South and Midwest, where dollar stores make up a large share of places selling groceries. Local differences also mattered. In cities such as Philadelphia, for example, small independent grocery stores and bodegas may provide additional food choices that were not fully captured by the study.
The researchers stress that the problem is not simply that dollar stores sell inexpensive food. Rather, it is the types of food commonly available in them. Many dollar stores offer large amounts of highly processed and packaged foods while providing fewer fresh fruits, vegetables and other nutritious choices.
Bruellman does not argue that communities should eliminate dollar stores. Instead, he suggests improving the healthy food available inside them.
One possibility would be partnerships between dollar stores and local farmers to provide more fresh produce. Cities could also locate farmers markets and food banks closer to areas where dollar stores are common, making healthier choices easier to reach.
The study shows why researchers and policymakers may need to rethink how they define food access. Traditional supermarkets are no longer the only places where Americans buy groceries.
As more families turn to discount retailers to manage rising food costs, ensuring that affordable food is also nutritious could become increasingly important for protecting public health.
