Hidden Health Costs of Shopping for Groceries at Dollar Stores

A new University of California, Riverside study links greater access to dollar stores with higher rates of obesity, diabetes, high blood pressure, and high cholesterol. According to researchers, rising grocery costs are pushing shoppers toward cheaper, highly processed foods at chains like Dollar General and Family Dollar, creating public health risks that mirror the impacts of fast food.

The study, published in the journal BMC Public Health, examines how neighborhood store density impacts community wellness metrics across the United States. Researchers mapped 30,920 traditional grocery stores and 34,021 dollar stores across 19,607 census tracts, covering more than 76 million people in major metropolitan areas.

While consumers save money on initial purchases, they face hidden health costs due to the nutritional profile of available inventory. Traditional grocery stores typically stock fresh produce, whole grains, and lean proteins, whereas dollar stores rely heavily on shelf-stable, highly processed items with lower nutritional value.

Mapping Food Access and Health Metrics

Ryan Bruellman, a doctoral student in genetics, genomics, and bioinformatics at UCR and lead author of the study, started the project out of curiosity regarding unconventional retail food outlets. To evaluate consumer impact, his team utilized data from the Centers for Disease Control and Prevention’s 500 Cities Project, which tracks health indicators across major continental American urban areas, including Los Angeles and the Inland Empire.

The research team used ArcGIS mapping software to determine how many stores sat within a 10-minute drive of residential census tracts between 2016 and 2020. They combined these spatial measurements with the CDC Social Vulnerability Index, a metric assessing community challenges like income, vehicle access, and unemployment.

Across the country, neighborhoods with higher exposure to dollar stores registered elevated rates of obesity, high blood pressure, and type 2 diabetes. Access to traditional grocery stores showed the exact opposite pattern, correlating with healthier outcomes even after researchers adjusted for income and local unemployment rates.

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.

Ryan Bruellman, UCR doctoral student and study first author

Regional Disparities and Store Concentrations

The influence of dollar stores varied significantly by geography, according to the findings. In the South and the Midwest, the ratio of dollar stores to traditional grocery stores reached approximately 50/50, and the Midwest, South, and South Atlantic recorded the highest average shares of nearby dollar stores, exceeding 40 percent of accessible grocery sources.

By contrast, the Pacific region reported the lowest share at under 25 percent. Bruellman notes that the sheer volume of dollar stores in southern and midwestern regions amplifies their dietary influence on local residents.

Urban environments also presented unique local factors. In Philadelphia, for example, the study data could not fully capture the impact of independent bodegas or smaller neighborhood grocers, though their presence likely buffered residents from exclusive reliance on dollar store inventories.

Potential Policy Solutions and Next Steps

Researchers emphasize that the physical distance to a store tells only part of the story, as store inventory dictates actual nutrition. Because the census currently designates dollar stores as general merchandise outlets rather than grocery stores, they frequently escape inclusion in traditional food consumption studies.

Bruellman argues that simply reducing the number of dollar stores is not a practical solution. Instead, policymakers could explore structural adjustments to improve food quality within existing retail footprints.

Ideally you’d have the healthier options available inside the dollar store.

Ryan Bruellman

Suggested interventions include encouraging dollar chains to partner with local agricultural producers to introduce fresh fruits and vegetables. For locations unable to support fresh produce supply chains, cities might strategically position farmers markets and food banks closer to dollar stores to better meet consumers where they shop.