Abstract
Obesity prevalence is inequitably distributed across geographic areas. Food environments may contribute to health disparities, yet little is known about how food environments are evolving over time and how this may influence dietary intake and weight. This study aimed to analyse intra-city variation in density and healthiness of food outlets between 2008 and 2016 in Melbourne, Australia. Food outlet data were classified by location, type and healthiness. Local government areas (LGAs) were classified into four groups representing distance from the central business district. Residential population estimates for each LGA were used to calculate the density of food outlets per 10,000 residents. Linear mixed models were fitted to estimate the mean density and ratio of ‘healthy’ to ‘unhealthy’ food outlets and food outlet ‘types’ by LGA group over time. The number of food outlets increased at a faster rate than the residential population, driven by an increasing density of both ‘unhealthy’ and ‘healthy’ outlets. Across all years, ratios of ‘unhealthy’ to ‘healthy’ outlets were highest in LGAs located in designated Growth Areas. Melbourne’s metropolitan food environment is saturated by ‘unhealthy’ and ‘less healthy’ food outlets, relative to ‘healthy’ ones. Melbourne’s urban growth areas had the least healthy food environments.
Highlights
Worldwide obesity prevalence has tripled since 1975 and no country has managed to reverse this trend [1]
The total number of food outlets increased by 35% from 10,777 to 13,580 and density increased by 3.1 outlets per 10,000 population from 24.9 to 28.0 (Table 2)
‘Supermarket’ density was higher in the Inner and Middle Ring compared to Growth Areas; mean difference 0.52 (95%CI: 0.16, 0.88) and 0.41 (0.1, 0.72) respectively (Figure 4e)
Summary
Worldwide obesity prevalence has tripled since 1975 and no country has managed to reverse this trend [1]. Increasing prevalence of obesity has been linked to supply-side drivers within the global food system, with increased production, retail, marketing and subsequent consumption of high energy, nutrient poor and highly palatable convenience foods [3,4]. Over time, this has contributed to rapid dietary changes. The different ways in which the global food system interacts with local environmental factors have contributed to the wide variation in obesity prevalence between populations [4]. Global recommendations indicate that governments should play a leading role in addressing these supply-side drivers by introducing fiscal measures and policies around promoting
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