Measuring Rural Food Environments for Local Action in Australia: A Systematic Critical Synthesis Review.

Penelope Love,Jillian Whelan,Jane Mccracken,Colin Bell

doi:10.3390/ijerph16132416

Penelope Love, Jillian Whelan + Show 2 more

Open Access

https://doi.org/10.3390/ijerph16132416

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Abstract

Poor diet is a significant contributor to obesity and chronic disease. With all being more prevalent in rural than urban Australia, modifying the food environment is a potential intervention point to improve the health of rural populations. This review examined the applicability of measurement tools used in rural food environment research for rural Australia. Six electronic databases were searched for peer-reviewed literature, published in English between 2006 and 2018, including at least one objective measure of the Community or Consumer Food Environment in a rural or mixed rural/urban context. One-hundred and seventy-seven papers were returned after removal of duplicates, with a final review of 25. Most studies were cross-sectional, with one intervention study of quasi-experimental design. Nine studies employed a conceptual model; there was considerable variability in tools used; and few described psychometric testing. The most common attribute measured was price, followed by available healthy options. The findings of this review do not offer a suite of ‘gold standard’ measurement tools known to be reliable, valid and sensitive to change to assess the community or consumer food environments in rural Australian towns. However, recommendations are proposed to progress this important area of research within a rural context.

Highlights

Poor diet is a leading risk factor for preventable disease both in Australia and internationally [1,2].In high-income countries, obesity affects all age groups, disproportionately affecting those from more disadvantaged backgrounds, while in low- and middle-income countries the obesity burden begins with the well-off and shifts to the rural poor as a nation’s gross domestic product increases [3].Fewer than 7% of Australian adults currently consume a diet consistent with the Australian DietaryGuidelines [4], with dietary risks (11%) and overweight and obesity (9%) the leading contributors to the burden of disease in Australia [5]
A 4% reduction in total disease burden could be achieved if all Australians experienced the same level of health as those living in a major city [1]
Further studies were excluded because thethe research: wasaccessed accessedand andassessed assessed eligibility.A A

Summary

Introduction

Poor diet is a leading risk factor for preventable disease both in Australia and internationally [1,2]. Guidelines [4], with dietary risks (11%) and overweight and obesity (9%) the leading contributors to the burden of disease in Australia [5]. This disease burden is not shared evenly across Australia with those in geographically remote areas at greater risk [1]. 61% of adults in major cities, it affects 69% of adults in outer regional and remote areas. A 4% reduction in total disease burden could be achieved if all Australians experienced the same level of health as those living in a major city [1]

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