Associations between Community Environmental-Level Factors and Diet Quality in Geographically Isolated Australian Communities.

Thomas P Wycherley,Julie K Brimblecombe,Natasha J Howard,Jolieke C Van Der Pols,Mark Daniel,Kerin O’Dea

doi:10.3390/ijerph16111943

Abstract

Remote Indigenous Australians experience disproportionately poor cardio-metabolic health, which is largely underpinned by adverse dietary intake related to social determinants. Little evidence exists about the community environmental-level factors that shape diet quality in this geographically isolated population group. This study aimed to explore the modifiable environmental-level factors associated with the features of dietary intake that underpin cardio-metabolic disease risk in this population group. Community-level dietary intake data were estimated from weekly store sales data collected throughout 2012 and linked with concurrent social, built, and physical environmental dimension data for 13 remote Indigenous Australian communities in the Northern Territory. Statistical analyses were performed to investigate associations. At the community level, store sales of discretionary foods were lower in communities with greater distance to a neighbouring store (r = −0.45 (p < 0.05)). Sales of sugar-sweetened beverages were lower in communities with higher levels of household crowding (r = −0.55 (p < 0.05)), higher levels of Indigenous unemployment (r = −0.62 (p = 0.02)), and greater distance to neighbouring stores (r = −0.61 (p = 0.004)). Modifiable environmental-level factors may be associated with adverse diet quality in remote Indigenous Australian communities and further investigations of these factors should be considered when developing policies to improve dietary intake quality in geographically isolated populations.

Highlights

Indigenous Australians, who have adapted to extreme changes in their environment over millennia and previously experienced minimal chronic disease, because of colonization, experience a reduced life expectancy which can be largely attributed to a greater occurrence of cardio-metabolic disease [1].a relatively higher occurrence of cardio-metabolic disease is experienced by those whoInt
Community store point-of-sale data analysis is increasingly being used as a cost-effective means of estimating dietary intake for remote Indigenous Australian communities and provides powerful information that can be used by community groups to inform decision-making for improved health [13,14]
We have recently reported that in three very remote Indigenous Australian communities the community store per se provided ~98% of the food and beverages that were derived from all food and beverage providers within the community [15]

Summary

Introduction

Indigenous Australians, who have adapted to extreme changes in their environment over millennia and previously experienced minimal chronic disease, because of colonization, experience a reduced life expectancy which can be largely attributed to a greater occurrence of cardio-metabolic disease [1].a relatively higher occurrence of cardio-metabolic disease is experienced by those whoInt. Indigenous Australians, who have adapted to extreme changes in their environment over millennia and previously experienced minimal chronic disease, because of colonization, experience a reduced life expectancy which can be largely attributed to a greater occurrence of cardio-metabolic disease [1]. A relatively higher occurrence of cardio-metabolic disease is experienced by those who. Res. Public Health 2019, 16, 1943; doi:10.3390/ijerph16111943 www.mdpi.com/journal/ijerph

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