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

Abstract

Aboriginal and Torres Strait Islander peoples suffer higher rates of food insecurity and diet-related disease than other Australians. However, assessment of food insecurity in specific population groups is sub-optimal, as in many developed countries. This study tailors the Healthy Diets ASAP (Australian Standardised Affordability and Pricing) methods protocol to be more relevant to Indigenous groups in assessing one important component of food security. The resultant Aboriginal and Torres Strait Islander Healthy Diets ASAP methods were used to assess the price, price differential, and affordability of healthy (recommended) and current (unhealthy) diets in five remote Aboriginal communities. The results show that the tailored approach is more sensitive than the original protocol in revealing the high degree of food insecurity in these communities, where the current diet costs nearly 50% of disposable household income compared to the international benchmark of 30%. Sixty-two percent of the current food budget appears to be spent on discretionary foods and drinks. Aided by community store pricing policies, healthy (recommended) diets are around 20% more affordable than current diets in these communities, but at 38.7% of disposable household income still unaffordable for most households. Further studies in urban communities, and on other socioeconomic, political and commercial determinants of food security in Aboriginal and Torres Strait Islander communities appear warranted. The development of the tailored method provides an example of how national tools can be adapted to better inform policy actions to improve food security and help reduce rates of diet-related chronic disease more equitably in developed countries.

Food Insecurity and Hunger in Rich Countries—It Is Time for Action against Inequality

“…There is a key role for academia to provide the evidence base and independent voice to inform and evaluate policy and programs and to challenge existing paradigms and assumptions. The International Journal of Environmental Research and Public Health Special Issue on Addressing Food Insecurity in Developed Countries is a good example of how the research community can come together to provide evidence to guide policy and practice [66,67,68,69,70,71,72,73,74,75,76,77,78,79,80,81,82,83,84,85,86]. There are many opportunities for academics to partner with government, industry, and the third sector to translate research to practice to improve the lives of people rendered food insecure in rich nations.…”

Costs, equity and acceptability of three policies to prevent obesity: A narrative review to support policy development

“…Lack of acceptability may revolve around the distribution of the benefits, harms and costs of a given intervention; its undesirable short-term effects despite desirable long-term effects (benefits); or the ethical principles or judicial considerations involved' (pp. [127][128].…”

“…Conversely if they do not want something it is impossible to give it away' 127. One survey of Aboriginal communities found over 60% of household food budget is spent on less healthy (discretionary) foods, despite a very low level of per capita income, and interventions to increase the price of these foods through taxation would likely serve to restrict even further the amount spent on core, healthier products 128. Further evidence on price elasticities assessed separately for specific population groups and specific contexts is needed.…”

Addressing Food and Nutrition Security in Developed Countries

“…The absence of robust food insecurity monitoring and surveillance systems in the households of Australia, Scotland and Europe has led researchers to undertake a secondary analysis of related surveys, such as Scotland’s Living Costs and Food Survey [14] and Australia’s Household Expenditure Survey [6], in order to determine the nature and prevalence of household food insecurity [15]. Food affordability, a key component of food security, has been determined using comparisons of the weekly food expenditure and its ratio to equalized income for households with varying income levels in Scotland [14] and Australia [16,17]. Analysis trends in the relationship between food affordability at the household level and diet quality in Scotland found that poorer households were less likely to achieve recommended dietary intakes over time [14].…”

“…In rural Australia, the price of the contemporary (unhealthy) diet was shown to be more expensive than the recommended healthy diet [18]. Furthermore, a tailored Aboriginal and Torres Strait Islander version tested in five remote communities found similar results, with food alarmingly found to not be affordable in either of these areas [17]. A version was also developed for the contemporary New Zealand diet and assessed with consideration of their dietary recommendations.…”