Disparities in the Availability and Price of Low-Fat and Higher-Fat Milk in US Food Stores by Community Characteristics

J Acad Nutr Diet. 2015 Dec;115(12):1975-85. doi: 10.1016/j.jand.2015.04.002. Epub 2015 Jun 2.


Background: National surveillance data identify disparities in low-fat milk consumption by race/ethnicity and income. Some localized studies have shown disparities in access to low-fat milk by community characteristics.

Objective: Our aim was to assess the availability and price of low-fat and higher-fat milk in food stores throughout the United States and examine associations with community characteristics.

Design: We conducted a cross-sectional study involving observational data collection in 2010, 2011, and 2012.

Participants/settings: The study included 8,959 food stores in 468 communities where nationally representative samples of students attending traditional public middle and high schools resided.

Main outcome measures: We studied the availability and price of whole, 2%, 1%, and skim milk.

Statistical analyses performed: Multivariate logistic regression and ordinary least squares regression analyses were performed. Models included store type, race/ethnicity, median household income, urbanicity, US Census division, and year of data collection.

Results: Less than half of all stores carried 1% and skim milk, and more than three-quarters of stores carried whole and 2% milk. Regression results indicated that the odds of carrying any type of milk were 31% to 67% lower in stores in majority black and 26% to 45% lower in other/mixed race compared with majority white communities. The odds of carrying specifically low-fat milk were 50% to 58% lower in majority Hispanic compared with majority white communities, and 32% to 44% lower in low-income compared with high-income communities. Some significant differences in milk prices by community characteristics were observed in grocery and limited-service stores. On average, low-fat milk options were more expensive in grocery stores in majority black and rural and suburban communities compared with such stores in majority white and urban communities.

Conclusions: This is the first nationwide study to examine the availability and price of low-fat and higher-fat milk in food stores and show disparities in access by community characteristics. Policies and programs can play a role in increasing accessibility of low-fat milk in stores in nonwhite and low-income communities.

Keywords: Disparities; Food access; Food environment; Food store; Low-fat milk.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Blacks
  • Commerce / statistics & numerical data*
  • Cross-Sectional Studies
  • Diet, Fat-Restricted
  • Dietary Fats / analysis*
  • Ethnicity
  • Hispanic or Latino
  • Humans
  • Income
  • Logistic Models
  • Milk / chemistry
  • Milk / economics*
  • Milk / supply & distribution*
  • Nutrition Policy
  • Nutrition Surveys
  • Residence Characteristics / statistics & numerical data*
  • Rural Population / statistics & numerical data
  • Socioeconomic Factors
  • United States
  • Urban Population
  • Whites


  • Dietary Fats