Mapping the Healthiness of Community Food Environments and Their Association With the Socioeconomic Index for Areas ( <scp>SEIFA</scp> ) in the <scp>S</scp> outh <scp>C</scp> oast of <scp>NSW</scp>

Abstract

ISSUE ADDRESSED: The community food environment may influence consumers' dietary behaviours, particularly in socioeconomically disadvantaged areas. There is a paucity of evidence on the distribution of food outlets and their association with socioeconomic position in regional Australia. This study mapped the healthiness of food environments in the South Coast of NSW and examined associations with socioeconomic advantage and disadvantage. METHODS: A cross-sectional study using registered food outlet data, supplemented by Google Maps search, was conducted. The Food Environment Score (FES) was used to assign a three-category healthiness score to food outlets, then categorised into a binary variable (unhealthy and healthy/less healthy). Multiple logistic regression was used to identify associations between food outlet types, administrative cluster, and the Index of Relative Socioeconomic Advantage and Disadvantage (IRSAD; Quintiles 1-5), using quintile 3 as the reference. RESULTS: Of the 2321 identified food outlets, nearly half (n = 1040; 44.8%) were categorised as unhealthy, while only a small proportion (n = 345; 14.9%) were categorised as healthy. Advantaged areas (IRSAD quintile 5 and 4) had 40% less (AOR 0.60 [0.5, 0.8]) and 42% less (AOR 0.58 [0.4, 0.8]) unhealthy food outlets than IRSAD quintile 3 areas, respectively, after adjusting for the administrative cluster. No difference was found between the disadvantaged areas (IRSAD quintiles 1 and 2) and IRSAD quintile 3. CONCLUSIONS: In the South Coast of NSW, unhealthy food outlets dominated the community food environment, particularly in socioeconomically disadvantaged and middle-income areas. This study extends the existing evidence in the selected states and metropolitan areas to regional Australia. SO WHAT?: Targeted interventions, including public policy and public health initiatives, are needed to increase access to healthy food outlets and restrict unhealthy options, particularly in middle and disadvantaged socioeconomic communities.