Changes in online food access during the COVID-19 pandemic and associations with deprivation: a longitudinal analysis .
JMIR public health and surveillance 2023
DOI : 10.2196/41822
PubMed ID : 36848236
PMCID : PMC10131934
URL : https://publichealth.jmir.org/2023//e41822/
Abstract
Food prepared out-of-home is typically energy-dense and high in fat and salt. Online food delivery services have become a popular way to purchase this food. The number of food outlets that can be accessed (ordered from) through these services can influence how frequently they are used. There have been anecdotal reports of increased access to online food delivery services in England between 2020 and 2022, in the context of the COVID-19 pandemic. However, to date, whether and how this access changed has not been investigated in a systematic manner.
We aimed to investigate monthly changes in online access to food prepared out-of-home in England in the context of the first two years of the COVID-19 pandemic compared with pre-pandemic levels, and the extent to which any changes were associated with socioeconomic position.
In November 2019, and monthly between June 2020 and March 2022, we used automated data collection to construct a dataset containing information about all food outlets in England registered to accept orders through the leading online food delivery service. Across postcode districts, we identified the number and percentage of food outlets registered to accept orders online, and the number that was accessible. We used generalized estimating equations (adjusted for population density, the number of food outlets in the physical food environment, and rural/urban classification) to investigate changes in outcomes compared to pre-pandemic levels (November 2019). We stratified analyses by deprivation quintile (Q).
Across England, the summed number of food outlets registered to accept orders online increased from 29,232 in November 2019 to 49,752 in March 2022. The median percentage of food outlets registered to accept orders online increased from 14.3 (IQR: 3.8, 26.0) in November 2019 to 24.0 (IQR: 6.2, 43.5) in March 2022. The median number of accessible food outlets decreased from 63.5 (IQR: 16.0, 156.0) in November 2019 to 57.0 (IQR: 11.0, 163.0) in March 2022. However, we observed variation across deprivation quintiles. In March 2022, the median number of outlets accessible online was 175.0 (IQR; 104.0, 292.0) in the most deprived areas (Q5) compared to 27.0 (IQR: 8.5, 60.5) in the least deprived (Q1). In adjusted analyses, we estimated that the number of outlets accessible online in the most deprived areas was 10% higher in March 2022, compared to November 2019 (IRR: 1.10; 95% CI: 1.07, 1.13). In contrast, in the least deprived areas, we estimated a 19% decrease (IRR: 0.81; 95% CI: 0.79, 0.83).
The number of food outlets accessible online increased only in the most deprived areas in England. Future research might attempt to understand the extent to which changes in online food access during were associated with changes in online food delivery service use, and implications on diet-quality and health.
Lay Summary
How did you last purchase takeaway food?
If the answer to that question was through an online takeaway, then you’re not alone. It’s estimated that 1 in 4 adults living in the UK use services like Just Eat or Deliveroo at least once a week.
But what about before the COVID-19 pandemic?
Maybe the answer would have been different.
Maybe not.
Regardless, it’s been reported that online takeaways became increasingly popular during the first two to three years of the COVID-19 pandemic. In some ways, this might have been because at times since 2020, purchasing food from restaurants or takeaways in person wasn’t always possible. Online takeaways could, however, continue to be used, even when places couldn’t be visited in person. To meet an apparent demand and to maintain a source of income during a particularly turbulent and financially difficult time, business owners might have registered to accept orders through online takeaways.
We think this is really quite important because broadly speaking, takeaways sell food that’s high in calories, fat and salt, (often referred to simply as “unhealthy”), and more frequent consumption of this food is linked to having a higher bodyweight and poorer diet and health. In addition to that, we have previously identified that adults living in England with the highest number of food outlets to order from through Just Eat, which is the market leading online takeaway in England, reported more frequent online takeaway use. Together then, being able to order from more outlets selling less healthy food could influence food purchasing, diet, and health.
All of this leads to our research published in April 2023 where we aimed to better understand how the opportunity to use online takeaways changed between 2019 and 2022.
To investigate this, we collected data from Just Eat using an innovative technique known as web-scraping. This approach allowed us to collect data on a monthly basis, automatically, saving us a lot of time and resource.
In our publication, we report that for England as a whole the number of places registered to accept orders through Just Eat increased from around 30,000 in November 2019 to just under 50,000 in March 2022. However, it was only in more deprived areas that the number of places that could be ordered from (i.e. accessed) increased.
Let’s focus on the number of food outlets that can be ordered from, because we think this is important for online food takeaway use. There’s evidence that takeaways tend to locate in more deprived areas and that they cluster together in these areas. This means that there’s a higher number of takeaways that could possibly register to accept orders, and because they’re close to one another and can only deliver their food so far, they deliver to the same nearby areas. This needs to be researched more, and speaking with business owners to understand their experiences of registering with online takeaways could help.
It’s been suggested that the COVID-19 pandemic led to irreversible changes to takeaway food purchasing. The data we collected indicated that there was a stabilisation in the number of places that could be ordered from online, which could mean that online takeaways become the default for purchasing takeaway food in the future. We’ll continue to monitor the opportunity to use online takeaways to understand changes in the future.