Dollar Store Groceries Linked To Worse Health, Study Finds

Study of 76 Million Americans Ties Dollar Stores to Higher Disease Rates

Walk into almost any dollar store in America and the shelves usually tell a similar story: rows of shelf-stable snacks, sodium-heavy canned goods, and very little fresh fruit, vegetables, or lean protein. For Americans stretching grocery budgets, dollar stores have become an increasingly important food source, particularly in lower-income communities and places with fewer traditional grocery options. A sweeping new study suggests reliance on those stores may carry a hidden cost.

Researchers examined data covering more than 76 million people across over 50 major metro areas and found living near dollar stores was consistently linked to higher rates of obesity, diabetes, and high blood pressure. Living near traditional grocery stores was associated with lower rates of those same conditions. Those links held up even after researchers adjusted for a broad index of neighborhood economic hardship, including income, vehicle access, and unemployment, so the pattern is not simply a byproduct of those factors.

This pattern showed up across nearly every region of the country, from Chicago to Phoenix to Jacksonville. Dollar stores accounted for more than 33% of grocery sources accessible to the typical American neighborhood in the study, and in the Midwest, South, and South Atlantic regions, that figure climbed even higher.

Dollar Stores Have Long Been Left Out of Grocery Research

For years, public health researchers focused on “food deserts,” areas where people live far from a traditional grocery store. Government funding poured into efforts to bring more supermarkets into those areas, but those interventions largely failed to improve health outcomes. This new research helps explain part of why.

Dollar stores have generally not been counted as grocery stores in food policy research. The study, published in BMC Public Health, notes the U.S. Census Bureau classifies dollar stores as general merchandise stores, not grocery outlets, even though many households rely on them for food. Excluding them from the grocery map has left an incomplete picture of where people actually shop.

“Beyond recognizing dollar stores as grocery sources, these results emphasize the need to incorporate grocery quality into food environment research and policymaking,” the authors wrote.

Researchers Mapped 65,000 Stores Against Six Health Conditions

Researchers from UC Riverside and the University of Colorado, Boulder mapped more than 30,900 traditional grocery stores and more than 34,000 dollar stores nationwide using data from 2016 to 2020, then calculated how many fell within a 10-minute drive of neighborhoods across dozens of metro areas.

Traditional grocery stores were classified as higher quality based on their broader selection of fresh produce, whole grains, and lean proteins. Dollar stores were classified as lower quality because they predominantly stock highly processed, shelf-stable products with little fresh food. The study treated stores within each category uniformly, so real-world variation within categories may not be fully captured.

Health data came from a Centers for Disease Control and Prevention (CDC) project tracking disease rates across neighborhoods in large cities, with estimates from 2016 to 2017, covering obesity, diabetes, high blood pressure, high cholesterol, asthma, and poor mental health. Researchers ran statistical models testing how access to each store type related to those outcomes, while also weighing broader neighborhood economic hardship. In total, the analysis covered 19,607 areas representing over 76 million people.

Every Health Condition Studied Was Worse Near Dollar Stores

Nationally, access to dollar stores was associated with higher rates of all six conditions studied, while access to traditional grocery stores was associated with lower rates. Obesity, diabetes, and high blood pressure showed the strongest relationships with store type.

Dollar store access and poor health outcomes were most pronounced in the Midwest and South, where dollar stores made up the highest share of accessible grocery sources. In the Pacific region, dollar stores made up less than 25% of accessible sources on average, and that region had the lowest rates of the conditions studied. In Chicago, dense clusters of dollar stores in the western and southern parts of the city overlapped with above-average rates of diabetes and high blood pressure, with similar patterns in Phoenix and Jacksonville.

Researchers Say Fixing Dollar Store Shelves May Matter More Than Adding Grocery Stores

This study shows a strong pattern, not proof that dollar stores themselves cause the problem. The researchers speculate that food quality helps explain it, but they can’t rule out that dollar stores are simply a marker of broader neighborhood disinvestment. Health data reflected community-level trends rather than individual medical records, a limitation known as ecological inference, so findings speak to neighborhood patterns rather than any one person’s experience. Smoking and low physical activity were not factored in either.

Still, the authors argue the findings carry weight for food policy. Rather than focusing almost exclusively on opening new grocery stores in underserved areas, they suggest improving food quality already inside dollar stores. Survey research cited in the paper found dollar store shoppers, including those with lower incomes, want more fresh options on the shelves. Partnerships with local farmers or policy incentives could be one path forward.

With dollar stores making up a substantial share of accessible grocery sources in many of the communities studied, treating them as invisible in public health conversations means missing a major piece of the puzzle. What sits on those shelves is not just a retail question. According to this research, it is a health question too.

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Disclaimer: This article is based on a peer-reviewed study and reflects the interpretations and speculation of its authors. It is intended for general informational purposes and is not a substitute for personalized nutrition or medical advice.

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