Introduction by Croakey: While consumers bear the brunt of increases in food and grocery prices, supermarkets are making record profits, according to the Select Committee on Supermarket Prices report tabled this week.
“The supermarket duopoly in this country is operating without proper oversight and restraint, thanks to outdated and ineffectual consumer and competition law,” it says.
Meanwhile, as highlighted by Marie McInerney recently, the “cost-of-living” crisis does not impact everyone equally and more should be done to address the “inequality crisis”.
Below, Sarah Birtwistle, public health academic at University of Queensland, discusses the impacts of increased costs on people living with coeliac disease who have to adhere to a strict gluten-free diet.
Sarah Birtwistle writes:
With a cost-of-living crisis currently gripping the nation, it is reasonable that many Australians are waiting in anticipation to understand what the 2024-25 Federal Budget, to be released on 14 May, will mean for them.
In Australia, the cost-of-living crisis has seen inflation rise to highs of 7.8 percent in December 2022 – most recent figures indicate it is currently sitting at 3.6 percent, still higher than the recommended two percent over time.
This has seen basic necessities including food, housing and energy soar in price, and as wages have not increased at the same speed, we are getting less bang for our buck.
Whilst the cost-of-living crisis impacts individuals to varying degrees, there are some communities that may feel the pinch more than others.
One group is people living with coeliac disease where, in the current economic climate, the cost of disease management – strict adherence to a lifelong gluten-free diet – has the potential to be more than just financial.
The real cost of living gluten-free
Research published around the globe concludes a gluten-free diet is more expensive than one with gluten-containing equivalents.
Evidence from Australia, the United Kingdom and the United States show gluten-free substitutes – for example, bread, pasta, cereals – can range from being two to eight times more expensive than their gluten-containing counterparts. As gluten-free alternatives are often smaller in size, comparisons in these studies are made on the basis per 100g of product.
An Australian research study published in 2016 exploring the cost and affordability of a gluten diet concluded that eating gluten-free can cost up to 17 percent more compared to a diet containing gluten. Recent data from the Coeliac UK has suggested this has since increased to approximately 20 percent.
Income has been used as an indicator of gluten-free diet adherence. With increasing food inflation and gluten-free alternatives becoming more expensive, there is anecdotal evidence to suggest that individuals with coeliac disease are not adhering to their gluten-free diet.
To save money, individuals are instead choosing to consume gluten options, with adverse health impacts observed including gastrointestinal problems and weight loss.
Further, this is disproportionality impacting groups already facing multiple forms of social disadvantage including individuals in lower socioeconomic groups, individuals living in rural or remote communities and culturally and linguistically diverse people.
Whilst the data is anecdotal, it provides insight into being gluten-free during a cost-of-living crisis, and highlights food insecurity and widening health inequities not only between individuals with coeliac disease and not, but also within the coeliac disease community.
The role of government
Multiple countries around the world including Canada, Italy, and the United Kingdom have developed government policies to protect people living with coeliac disease. Tax deductions, monthly vouchers and gluten-free staples – cereals, bread and flour – on prescription are some of the measures in place globally to help lessen the financial burden associated with living gluten-free.
In turn, these promote dietary adherence and more favourable health outcomes including improved quality of life.
In Australia, there is currently no government subsidy programs that support the ongoing management of living gluten-free.
In a cost-of-living crisis this raises concerns about the heath and wellbeing of individuals living with the disease, especially amongst individuals from already disadvantaged groups.
We know tax cuts will form part of the budget, but such measures often benefit those in privileged positions – high income earners – for whom adhering to a gluten-free diet is more attainable.
When the budget is announced next week, will Australia follow in the footsteps of other countries and offer fairer approaches to support those living with coeliac disease?
It is important that those in the coeliac disease community continue raising awareness of the challenges they face living gluten-free.
Continuing public awareness through advocacy and research can place pressure on policymakers to take action – it would be good to see government interventions that help ensure favourable and positive health outcomes are achieved for all with a diagnosis of coeliac disease.
Moving forward
Much of the evidence used in this report is from countries outside of Australia. Whilst this provides a global perspective on the challenges being faced, it is not to say these experiences can be generalised to other countries, especially as the context of different countries – such as political party in power – can influence individual experiences.
As such, this highlights the research needed in Australia to understand how the cost-of-living crisis is being experienced by a range of individuals living with coeliac disease. Doing so will help provide an overview of the current landscape and inform decisions on how best to move forward.
About the author
Sarah Birtwistle is an academic in Public Health at the University of Queensland with an interest in Coeliac Disease following her own diagnosis in 2023.
See Croakey’s archive of articles on the social determinants of health.
