Health outcomes of a subsidised fruit and vegetable program for Aboriginal children in northern New South Wales

Andrew P Black, Hassan Vally, Peter S Morris, Mark Daniel, Adrian J Esterman, Fiona E Smith and Kerin O’Dea
Med J Aust 2013; 199 (1): 46-50. || doi: 10.5694/mja13.10445


Objective: To evaluate the impact of a fruit and vegetable subsidy program on short-term health outcomes of disadvantaged Aboriginal children.

Design, setting and participants: A before-and-after study involving clinical assessments, health record audits and blood testing of all children aged 0–17 years (n = 167) from 55 participating families at baseline and after 12 months at three Aboriginal community-controlled health services in New South Wales. All assessments were completed between December 2008 and September 2010.

Intervention: A weekly box of subsidised fruit and vegetables linked to preventive health services and nutrition promotion at an Aboriginal Medical Service.

Main outcome measures: Change in episodes of illness, health service and emergency department attendances, antibiotic prescriptions and anthropometry.

Results: There was a significant decrease in oral antibiotics prescribed ( 0.5 prescriptions/year; 95% CI, 0.8 to 0.2) during 12 months of participation in the program compared with the 12 months before the program. The proportion of children classified as overweight or obese at baseline was 28.3% (38/134) and the proportion in each weight category did not change (P = 0.721) after 12 months. A small but significant increase in mean haemoglobin level (3.1 g/L; 95% CI, 1.4–4.8 g/L) was shown, although the proportion with iron deficiency (baseline, 41%; follow-up, 37%; P = 0.440) and anaemia (baseline, 8%; follow-up, 5%; P = 0.453) did not change significantly.

Conclusion: This fruit and vegetable subsidy program was associated with improvements in some indicators of short-term health status among disadvantaged Aboriginal children. A controlled trial is warranted to investigate the sustainability and feasibility of healthy food subsidy programs in Australia.

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  • Andrew P Black1,2
  • Hassan Vally3
  • Peter S Morris4
  • Mark Daniel1
  • Adrian J Esterman1
  • Fiona E Smith2
  • Kerin O’Dea1

  • 1 Division of Health Sciences, University of South Australia, Adelaide, SA.
  • 2 Bulgarr Ngaru Medical Aboriginal Corporation, Grafton, NSW.
  • 3 School of Public Health and Human Biosciences, La Trobe University, Melbourne, VIC.
  • 4 Department of Paediatrics, Royal Darwin Hospital, Darwin, NT.



We acknowledge the families who participated in this evaluation study and the staff at the three health services, particularly David Ferguson and May Robinson from the Bulgarr fruit and vegetable committee, for the success of the study. Kerry Hampshire, Nicole Turner, Karen Spark, Lea Clayden, Marie Gough and Irina Holmes, Tracy Bradshaw and the team at Giingan Darrunday Marlaanggu Aboriginal Health Service contributed significantly to the clinical assessments. Thanks to Robyn Liddle for database design and Judy Boatswain for assistance with data entry. This study was supported by National Health and Medical Research Council, Australia (PhD scholarship 520681 and Program Grant 320860).

Competing interests:

No relevant disclosures.

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