Health Knowledge or Value of Health? Understanding Socioeconomic Differences in Food Consumption

"How can we induce people to look after their health?" was recently chosen as the most pressing question in the social sciences (Giles, 2011). Given the strong disparities in health behavior across socioeconomic groups (e.g., Cutler and Lleras-Muney 2010), the biggest challenge will be to make the poor and lower educated behave healthily. In this paper we aim to understand differences in unhealthy food choices across socioeconomic groups. We do so by using an economic theory of unhealthy consumption (Galama and Van Kippersluis, 2010) to help designing a Discrete Choice Experiment (DCE), in which individuals are offered two hypothetical food options between which they have to choose. The DCE is implemented in a Dutch internet panel with over 3,000 respondents.

The DCE enables us to estimate which attributes of food choice are most important, and how this differs across socioeconomic groups. The theory predicts that differences in the “health cost” play a large role. The health cost is the ‘value’ people attach to health, multiplied by the reduction in health due to unhealthy choice of food. This reduction in health affects food choice to the extent that the individual “knows” about the health consequences of her choice. Our second aim is therefore to investigate the relative roles of (i) health knowledge and (ii) value of health in explaining socioeconomic differences in food choice.

To be able to assess the role of health knowledge, we set up two alternative scenarios. In both alternative scenarios, we exclude health consequences as a single attribute but provide the respondents with a number of health related attributes of the alternative, i.e. calories, sodium, and saturated fat. Difference between the two alternative scenarios is that in one scenario we include dietary guidelines about what is healthy and what is not, and in the other scenario we exclude this information. The results of the study will help in understanding socioeconomic differences in unhealthy food consumption – do the poor eat unhealthier because they know less or because they care less?