Chapter 4 Updates to the Cost and Affordability of a Healthy Diet

The indicators for the cost and affordability of a healthy diet in this report are updated for 2021 in the ECA region. The affordability series this year is based on income distributions in years 2020 and 2021, thus accounting not only for price shocks but also for income shocks induced by the COVID-19 pandemic.3 3 In the 2022 report, affordability in 2020 reflected only the price shock induced by the COVID-19 pandemic, since it was obtained by applying the cost of a healthy diet in 2020 to income distributions in 2019. The indicators of affordability are now expressed in 2017 purchasing power parity (PPP) rather than in 2011 PPP, as in previous years. In fact, the World Bank has adopted new PPPs for 2017 to express all its monetary indicators, including income distributions that are a crucial component of the affordability series (see FAO et al., 2023, for more information).

Rising inflation since 2021 (IMF, 2023) has translated into an increased average cost of a healthy diet in almost all subregions in Europe and Central Asia (FIGURE 22). The exceptions are the EFTA countries and the EU-27 and the United Kingdom, where the costs have declined. At the regional level, the average cost of a healthy diet in 2021 was 3.20 PPP dollars per person per day, which is a 1.6 percent increase from 2020 and a 2.3 percent increase from 2019 (TABLE 14). On average, a healthy diet cost less in the ECA region than in the world (3.66 PPP dollars) in 2021. The cost in the ECA region has increased at a slower rate than the global average from 2019 and 2020.

From 2020 to 2021, the Caucasus (7.5 percent) and Central Asia (7.2 percent) had the highest increases in the cost of a healthy diet, followed by CIS Europe and Ukraine (6.3 percent). In 2021, the Western Balkans had the highest cost of a healthy diet (4.03 PPP dollars) in the region, 25.9 percent higher than the ECA average and 9.9 percent higher than the global average. From 2020 to 2021, the increase in the cost of a healthy diet in the Western Balkans was more than double (3.5 percent) the average increase in the region (1.6 percent) but lower than the global increase (4.3 percent).

FIGURE 22

Change in the cost of a healthy diet in Europe and Central Asia by subregion

SOURCE: Adapted from FAO. 2023. Cost and Affordability of a Healthy Diet (CoAHD). In: FAOSTAT. Rome. [Cited July 2023]. https://www.fao.org/faostat/en/#data/CAHD
Download: https://doi.org/10.4060/CC8608EN-fig22
TABLE 14.

Cost of a healthy diet by subregion

Cost (PPP dollars per
person per day)
Change (percent)
201720182019202020212017 to
2018
2018 to
2019
2019 to
2020
2020 to
2021
WORLD3.303.363.433.513.661.82.32.34.3
Europe and Central Asia2.963.023.123.153.202.23.40.81.6
Caucasus2.722.782.852.893.112.22.41.57.5
Central Asia2.802.802.913.103.320.04.06.77.2
CIS Europe and Ukraine2.933.003.093.183.382.42.93.06.3
EFTA countries2.692.762.822.852.802.62.11.2-1.8
EU-27 and the United Kingdom2.912.983.083.103.092.43.40.7-0.2
Other2.662.752.842.742.823.53.2-3.63.0
Western Balkans3.723.783.953.894.031.74.5-1.53.5
SOURCE: Adapted from FAO. 2023. Cost and Affordability of a Healthy Diet (CoAHD). In: FAOSTAT. Rome. [Cited July 2023]. https://www.fao.org/faostat/en/#data/CAHD

The affordability of a healthy diet refers to the cost of a diet relative to income; therefore, changes over time can be the result of changes in diet costs, incomes or both. In 2021, 25.7 million people in the ECA region could not afford a healthy diet (TABLE A1 13). This is about 2.7 million people fewer than in 2020 (FIGURE 23, TABLE 15). The reduction in the number of people unable to afford a healthy diet could be attributed to increased incomes, which is consistent with increased economic activities in 2021 following the COVID-19 pandemic-induced decline in 2020, reflected also in the annual growth domestic product growth in the region (5.9 percent versus negative growth in 2020) (World Bank, 2023). The largest reduction (1.4 million) in the number of people unable to afford a healthy diet was in the EU-27 and the United Kingdom subregion. The numbers also declined in CIS Europe and Ukraine and the Western Balkans, by about 300 000 people in each subregion. Conversely, the number of people unable to afford a healthy diet increased by about 10 000 people in each of the Caucasus and Central Asia. However, due to the lack of key data on Turkmenistan and Uzbekistan, it is likely that the number of people who cannot afford a healthy diet in Central Asia is currently underestimated. This is considering that Turkmenistan has the second-highest PoU and the prevalence of moderate and severe food insecurity in Uzbekistan is among the highest in the region and the second-highest in the subregion.

FIGURE 23

Change in the number of people unable to afford a healthy diet by subregion

SOURCE: Adapted from FAO. 2023. Cost and Affordability of a Healthy Diet (CoAHD). In: FAOSTAT. Rome. [Cited July 2023]. https://www.fao.org/faostat/en/#data/CAHD
Download: https://doi.org/10.4060/CC8608EN-fig23
TABLE 15.

Number of people unable to afford a healthy diet by subregion

Number (millions)Change (millions)
201720182019202020212017 to
2018
2018 to
2019
2019 to
2020
2020 to
2021
WORLD3 124.93 019.13 005.53 191.93 139.5-105.8-13.6186.4-52.4
Europe and Central Asia31.827.428.928.425.7-4.41.5-0.5-2.7
Caucasus1.11.11.11.11.20.00.00.00.1
Central Asia8.47.47.38.68.7-1.0-0.11.30.1
CIS Europe and Ukraine5.04.43.84.23.9-0.6-0.60.4-0.3
EFTA countries0.00.00.00.00.00.00.00.00.0
EU-27 and the United Kingdom8.67.16.76.55.1-1.5-0.4-0.2-1.4
Other5.25.27.66.05.20.02.4-1.6-0.8
Western Balkans3.52.22.32.01.7-1.30.1-0.3-0.3
SOURCE: Adapted from FAO. 2023. Cost and Affordability of a Healthy Diet (CoAHD). In: FAOSTAT Rome. [Cited July 2023]. https://www.fao.org/faostat/en/#data/CAHD

FIGURE 24 presents the percentage of people unable to afford a healthy diet in Europe and Central Asia, by subregion and country.

In 2021, roughly 3.1 percent of people in the ECA region were unable to afford a healthy diet, down from 3.4 percent in 2020. The percentage of people unable to afford a healthy diet in the ECA region in 2021 was much lower than the global estimate of 42.2 percent, which also declined from the previous year (43.3 percent) (TABLE A1 13).

Within the ECA region, there were large variations in the unaffordability of a healthy diet in 2021. By subregion, Central Asia had the highest unaffordability (24.4 percent) in 2021. As data on cost and affordability are not available for two key countries of this subregion (Turkmenistan and Uzbekistan), the percentage of people who cannot afford a healthy diet is likely underestimated. The second-highest unaffordability is found in the Western Balkans (10.9 percent), followed by the Caucasus (8.9 percent). In contrast, the EFTA countries and the EU-27 and the United Kingdom had very low unaffordability in 2020 - 0.1 percent and 1.0 percent, respectively. In 2021, unaffordability declined from the previous year in all subregions except the Caucasus, where unaffordability increased by 0.4 percentage points.

Seven countries in the region had unaffordability estimates above 10 percent in 2021: Albania (15.9 percent), Armenia (41.4 percent), Kyrgyzstan (58.2 percent), North Macedonia (15.5 percent), Montenegro (14.9 percent), Serbia (10.9 percent) and Tajikistan (44.3 percent). In addition, the percentage of people unable to afford a healthy diet increased in Armenia (by 2.4 percent) and Kyrgyzstan (by 2.9 percent). The indicator declined in all other countries of the ECA region apart from the above-mentioned two countries and Iceland, where it increased marginally (by 0.1 percentage points) in 2021.

FIGURE 24

Percentage of people unable to afford a healthy diet by country and subregion

SOURCE: Adapted from FAO. 2023. Cost and Affordability of a Healthy Diet (CoAHD). In: FAOSTAT. Rome. [Cited July 2023]. https://www.fao.org/faostat/en/#data/CAHD
Download: https://doi.org/10.4060/CC8608EN-fig24