Geographic patterns and socioeconomic differences in the nutritional quality of household packaged food purchases in the United States.

Abstract Background It is unclear whether dietary quality varies by geography in the US. Purpose Assess patterns in packaged food purchases (PFPs). Methods We characterized variation in PFP quality from 2008 to 2018 by 1) examining geographic clustering and 2) using regression analysis to control for household characteristics. Results Lower quality purchases clustered in the Southeast and Appalachia, whereas higher quality purchases clustered in the West and Northeast. Spatial patterns were similar for low socioeconomic households but not high socioeconomic households. Geographic differences in quality remained after controlling for demographic composition. Conclusion This analysis should inform research into systemic drivers of PFP quality.