Diet quality and diet-related diseases are not experienced equally by all Australians. Those in the highest income groups, with higher levels of education, and living in more advantaged neighbourhoods, are more likely to eat a healthy diet, be a healthy weight and have better health outcomes. Indigenous Australians, minority culturally and linguistically diverse (CALD) groups, people living in socioeconomically disadvantaged or remote areas, and those living a disability are less likely to eat a healthy diet. In understanding drivers of inequalities related to diet, it is critical to monitor and assess ways in which food environments differ for different population groups.
| Indicator | Result | Assessment* | What was measured? | Source |
|---|---|---|---|---|
Food prices and affordability |
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Cost of healthy diet as a proportion of incomeˆ |
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Low-income groups: |
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Queensland, Sydney, Canberra |
26-28% 39%
|
Cost of recommended (healthy) dietˆ as a proportion of indicative disposable household income |
Lee, Patay et al. (in press) Lee, Lewis et al. (2020) |
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Median income groups: |
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– Sydney – Rural Victoria |
32% 30% |
Cost of recommended (healthy) dietˆ as a proportion of indicative disposable household income |
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Cost of a healthy diet for a family per fortnightˆ |
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High socioeconomic urban areas |
$619-$629 |
Cost of recommended dietˆ consistent with the Australian Dietary Guidelines for family of two adults and two children per fortnight, in different locations (Queensland, Canberra, Sydney and Remote Victoria) |
Lee, Patay et al. (in press) |
|
Food promotion |
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Proportion of community sports clubs that have unhealthy food sponsors in regional vs metropolitan areas |
33% vs 20% |
Unhealthy food sponsorship agreements across 216 clubs from top eight Victorian junior sports codes (2019) |
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Supermarket shelf space |
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Proportion of shelf space allocated to discretionary food and drinks (compared with healthy items), between the most and least disadvantaged areas |
9.7% |
Shelf space of key healthy foods (fruit and vegetables) and unhealthy foods (chocolate, confectionery, chips, sweet biscuits, soft drinks and energy drinks) in a sample of all major supermarket chains (n=104) in Victoria (2019) |
* Green = ‘Promotes health’; Amber = ‘Needs further improvement to promote health’; Red = ‘Does not promote health’. Refer to Indicator Assessment Criteria at the bottom of the page.
ˆ The current diet includes the type and quantity of food and drinks for a reference household of two adults and two children per fortnight, based on intakes reported in the most recent national nutrition survey. The healthy diet reflects the recommendations of the Australian Dietary Guidelines, and comprises the healthy food and drinks commonly consumed in the current diet in optimal quantities. The healthy diet is more equitable and more sustainable than the current diet.
Key Findings
There are inequalities in the healthiness of food environments in Australia. In several respects, food environments in the most disadvantaged areas are less healthy than those in the least disadvantaged areas.
Food prices and affordability
- Currently in Australia, people on low income are likely to experience food stress (when diets cost more than 25% of household income) (1,2).
- For people on low income living in rural or remote areas, a healthy diet is simply unaffordable (diet costs more than 30% of household income) (1, 2). Healthy diets are also unaffordable for people on median incomes living in Sydney and rural Victoria.
- The costs of both current and healthy diets are higher in very remote areas in Australia, compared with other areas. For example, in the Northern Territory, the average cost of a ‘Healthy Food’ basket was 56% higher in remote stores than in district centre supermarkets, while the ‘Current Diet’ (unhealthy food) basket was 40% more expensive in remote stores than in district centre supermarkets.
Food promotion:
- People living in low socio-economic areas, are exposed to more promotions for unhealthy food. For example, in Perth, in low socio-economic areas, there was found to be a significantly higher ratio of unhealthy food ads to healthy ads within 500m of schools, compared to high socio-economic areas (Trapp et al, 2020).
- Community sports clubs located in regional areas are more likely to be affiliated with an unhealthy food sponsor compared to community sports clubs in metro areas.
Supermarkets
- The proportion of shelf space allocated to unhealthy food compared to healthy items, was found to be almost 10% higher in the most disadvantaged areas (compared with the least disadvantaged areas).
Key Recommendations
- Every Australian should have equal access to affordable healthy food. The capacity to enjoy a healthy diet should not be dependent on where people live and buy their food.
- To improve population diets and health, urgent policy action is needed to increase household income and/or reduce the price of healthy foods, especially in low socioeconomic and very remote areas.
- Increasing income of welfare dependent and low-income households would increase the affordability of healthy, equitable and sustainable diets, and hence improve food security, in Australia.
- In very remote communities, funding of community stores as essential services, and subsidising freight and in-store price of healthy foods, would increase the affordability of healthy, equitable and sustainable diets.
- Food retailers, fast food companies and food and beverage manufacturers must reduce unhealthy food marketing in all areas and particularly in disadvantaged areas. Communities in regional or more disadvantaged areas should not be disproportionately exposed to unhealthy food and beverage marketing, in comparison to other areas.
- Comprehensive restrictions on marketing of unhealthy foods would assist in addressing existing health inequalities.
For more information
Journal Articles
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Gonzalez S, Kingsland M, Hall A, Clinton‐McHarg T, Lecathelinais C, Zukowski N, Milner S, Sherker S, Rogers B, Doran C, Brooke D. Alcohol and fast food sponsorship in sporting clubs with junior teams participating in the ‘Good Sports’ program: a cross‐sectional study. Australian and New Zealand journal of public health. 2020 Apr;44(2):145-51.
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Martino F, Chung A, Potter J, Heneghan T, Chisholm M, Riesenberg D, Backholer . (2021) A state-wide audit of unhealthy sponsorship within junior sporting clubs in Victoria, Australia. Public Health Nutrition, 1-21.
- Lee AJ, Patay D, Herron L-M, Parnell Harrison E and Lewis M, Affordability of current, and healthy, more equitable, sustainable diets by area of socioeconomic disadvantage and remoteness in Queensland: Insights into food choice, International Journal for Equity in Health (in press).
- Lee, A.J., Kane, S., Herron, L.M., Matsuyama, M., & Lewis, M. (2020). A tale of two cities: the cost, price-differential and affordability of current and healthy diets in Sydney and Canberra, Australia. Int J Behav Nutr Phys Act, 17, 80.
- Lee, A., & Lewis, M. (2018). Testing the Price of Healthy and Current Diets in Remote Aboriginal Communities to Improve Food Security: Development of the Aboriginal and Torres Strait Islander Healthy Diets ASAP (Australian Standardised Affordability and Pricing) Methods. International Journal of Environmental Research and Public Health, 15, 2912.
- Love, P., Whelan, J., Bell, C., Grainger, F., Russell, C., Lewis, M., et al. (2018). Healthy Diets in Rural Victoria – Cheaper than unhealthy alternatives, yet unaffordable. Int J Environ Res Public Health, 15, 2469.
- Schultz, S, Cameron, AJ, Grigsby-Duffy, L, Robinson, E, Marshall, J, Orellana, L & Sacks, G (2020) Availability and placement of healthy and discretionary food in Australian supermarkets by chain and level of socio-economic disadvantage. Public health nutrition, pp. 1–12.
- Trapp G, Hooper P, Thornton L, Mandzufas J, Billingham W. (2020) Audit of outdoor food advertising near Perth schools: Building a local evidence base for chance. Australia: Telethon Kids Institute; 2020.
Reports:
- Lee A, Lewis M, Herron L, Patay D. Summary Results Brief: Healthy, Equitable and Sustainable Diets: Cost and Affordability in Queensland. 2020.
- Summons S, Lewis M, Patay D, Nona F, Herron L, Ferguson M, et al. (2020) Summary Results Brief. Cost and affordability of healthy, sustainable and equitable diets in the Torres Strait Islands. 2020.
- Deakin University: Inside our Supermarkets Australia 2020: Assessment of the healthiness of Australian supermarkets
- Northern Territory Department of Health (2019): Northern Territory Market Basket Survey 2019
| Indicator Assessment Criteria | |||
|---|---|---|---|
Cost of a healthy diet as a proportion of income* |
< 25% |
25-29% |
≥ 30% |
Cost of a healthy diet** per fortnight, for a family (by level of socioeconomic status/remoteness) |
Low socioeconomic / remote areas |
N/A |
Low socioeconomic / remote areas |
Proportion of community sports clubs that have unhealthy food sponsors in regional versus metropolitan areas |
No difference between regional and metropolitan |
N/A |
Difference between regional and metropolitan |
Proportion of shelf space allocated to disretionary food and drinks, compared with healthy items, between the most and least disadvantaged areas. |
No difference between most and least disadvantaged |
N/A |
Difference between most and least disadvantaged |
* Food stress occurs when diets cost more than 25% of household income; healthy diets are unaffordable when they cost more than 30% of household income (1, 2).
Sources
(1) Ward PR, Verity F, Carter P, Tsourtos G, Coveney J, Wong KC. Food stress in Adelaide: the relationship between low income and the affordability of healthy food. J Environ Public Health. 2013;2013:968078.
(2) Lee AJ, Kane S, Lewis M, Good E, Pollard CM, Landrigan TJ, et al. Healthy diets ASAP – Australian Standardised Affordability and Pricing methods protocol. Nutrition journal. 2018;17(1):88.