Economic interventions to improve access to healthy food
Poor nutrition is a major determinant of excess morbidity and mortality among Aboriginal and Torres Strait Islander peoples,1 contributing to over 16% of the burden of disease.2 In this issue of the Journal (page 549), consistent with the “economics of food choice” theory,3 Brimblecombe and O’Dea report that the diet of a remote Aboriginal community was high in energy-dense, nutrient-poor foods — the cheapest options to satisfy hunger.4 This energy–cost differential restricts access to healthy food, and helps explain the persistently poor dietary patterns and deplorable health status of remote Indigenous communities.4 Placing nutrition issues in an economic framework highlights the investment required to improve Indigenous nutrition.4 But what has been learned to date about where resources should be directed?
- 1. National Health and Medical Research Council. Nutrition in Aboriginal and Torres Strait Islander peoples. An information paper. Canberra: NHMRC, 2000. http://www.nhmrc.gov.au/publications/synopses/_files/n26.pdf (accessed Apr 2009).
- 2. Queensland Health. The health of Queenslanders 2008. Prevention of chronic disease. Second report of the Chief Health Officer Queensland. Brisbane: Queensland Health, 2008. http://www.health.qld.gov.au/cho_report/documents/2008choreport.pdf (accessed Apr 2009).
- 3. Drewnowski A, Specter SE. Poverty and obesity: the role of energy density and energy costs. Am J Clin Nutr 2004; 79: 6-16.
- 4. Brimblecombe JK, O’Dea K. The role of energy cost in food choices for an Aboriginal population in northern Australia. Med J Aust 2009; 190: 549-551.
- 5. McMillan SJ. Food and nutrition policy issues in remote Aboriginal communities: lessons from Arnhem Land. Aust J Public Health 1991; 15: 281-285.
- 6. Lee A, Bonson AP, Powers JR. The effect of store managers on Aboriginal diet in remote areas. Aust N Z J Public Health 1996; 20: 212-214.
- 7. Lee AJ, Bonson AP, Yarmirr D, et al. Sustainability of a successful health and nutrition program in a remote Aboriginal community. Med J Aust 1995; 162: 632-635.
- 8. Rowley KG, Daniel M, Skinner K, et al. Effectiveness of a community directed healthy lifestyle program in a remote Australian Aboriginal community. Aust N Z J Public Health 2000; 24: 136-144.
- 9. Leonard D. FoodNorth: food for health in north Australia. Perth: Department of Health, Western Australia, 2003. http://www.healthinfonet.ecu.edu.au/uploads/resources/4053_foodnorth.pdf (accessed Apr 2009).
- 10. Australian Indigenous HealthInfoNet. Remote Indigenous Stores and Takeaways Project. http://www.healthinfonet.ecu.edu.au/health-risks/nutrition/resources/rist (accessed Apr 2009).
- 11. Parliament of Australia. House of Representatives. Inquiry into community stores in remote Aboriginal and Torres Strait Islander communities. Submissions. http://www.aph.gov.au/house/committee/atsia/communitystores/subs.htm (accessed Mar 2009).
- 12. Outback Stores [website]. http://www.outbackstores.com.au/ (accessed Mar 2009).
- 13. Australian Government Department of Health and Ageing. National Public Health Partnership. Strategic Inter-Governmental Nutrition Alliance. National Aboriginal and Torres Strait Islander Nutrition Strategy and Action Plan 2000–2010. Canberra: DoHA, 2001.
- 14. Northern Territory Government Department of Health and Community Services. Northern Territory Market Basket Survey, 2006. Darwin: DHCS, 2007. http://digitallibrary.health.nt.gov.au/dspace/bitstream/10137/136/1/Market_basket_2006.pdf (accessed Apr 2009).
- 15. Tsang A, Ndung’u M, Coveney J, O’Dwyer L. Adelaide Healthy Food Basket. A survey on food cost, availability and affordability in five local government areas in metropolitan Adelaide, South Australia. Nutrition & Dietetics 2007; 64: 241-247.
- 16. Human Rights and Equal Opportunity Commission. Close the Gap: national Indigenous health equality targets. Outcomes from the National Indigenous Health Equality Summit. Canberra: March 18–20, 2008. http://www.hreoc.gov.au/social_Justice/health/targets/health_targets.pdf (accessed Mar 2009).
- 17. Caraher M, Cowburn G. Taxing food: implications for public health nutrition. Public Health Nutr 2005, 8: 1242-1249.
- 18. Powell LM, Chaloupka F. Food prices and obesity: evidence and policy implications for taxes and subsidies. Milbank Q 2009; 87: 229-257.
- 19. Australian Competition and Consumer Commission. Report on ACCC price surveys: general survey. Canberra: ACCC Publishing Unit, 2001.
- 20. Harrison MS, Coyne T, Lee AJ, et al. The increasing cost of the basic foods required to promote health in Queensland. Med J Aust 2007; 186: 9-14. <MJA full text>
- 21. Bere E, Veierød MB, Skare Ø, Klepp KI. Free school fruit — sustained effect three years later. Int J Behav Nutr Phys Act 2007; 4: 5.
- 22. Torzillo PJ, Pholeros P, Rainow S, et al. The state of health hardware in Aboriginal communities in rural and remote Australia. Aust N Z J Public Health 2008; 32: 7-11.
- 23. National Nutrition Networks Conference, 2008. Recommendations arising from the National Nutrition Networks Conference. http://www.ruralhealth.org.au/conferences/nnnc2008/NNNCrecommendations.pdf (accessed Mar 2009).
- 24. FOODcents for Aboriginal and Torres Strait Islander people in WA program. http://www.healthyfuture.health.wa.gov.au/Health_topics/ASTI-FOOD/ATSI_FC_Manual.pdf (accessed Apr 2009).
- 25. United States Department of Agriculture Food and Nutrition Service. Women, infants and children. Alexandria, Va: USDA. http://www.fns.usda.gov/wic/ (accessed Mar 2009).
- 26. United States Department of Agriculture Food and Nutrition Service. Supplemental Nutrition Assistance Program (SNAP). Alexandria, Va: USDA. http://www.fns.usda.gov/FSP/ (accessed Mar 2009).
- 27. d'Espaignet E, Measey ML, Carnegie MA, Mackerras D. Monitoring the “Strong Women, Strong Babies, Strong Culture Program”: the first eight years. J Paediatr Child Health 2003; 39: 668-672.
Publication of your online response is subject to the Medical Journal of Australia's editorial discretion. You will be notified by email within five working days should your response be accepted.