Understanding food security issues in remote Western Australian Indigenous communities

Indigenous people throughout the world experience higher morbidity rates and lower life expectancy than non-Indigenous people.¹ Although wealthier nations generally have better health outcomes than poorer countries for both Indigenous and non-Indigenous people, Australia seems to be an exception to this rule.² Among the Indigenous people of richer nations, Australian Aboriginals and Torres Strait Islander people experience social disadvantage, and are recognised as having an unacceptable gap in life expectancy compared with non-Indigenous people.^2,3 The World Health Organization states, 'The diets people eat, in all their cultural variety, define to a large extent people's health, growth and development'.^2,4 The burden of diet-related diseases, including obesity, hypertension, high cholesterol, cardiovascular disease, diabetes and renal failure, is higher in Indigenous Australians. Indigenous Australians experience a higher prevalence of mortality and morbidity from these diseases than non-Indigenous Australians.^5,6 Australian Indigenous infants are more likely to be still-born, have low birthweight and suffer from anaemia and malnutrition than non-Indigenous children.^7,8 A poor diet, including low fruit and vegetable intake, has been estimated to contribute to ~19% of the Indigenous health gap in Australia.⁹

Around 25% of Australia's Indigenous people live in remote communities,¹⁰ and improving the supply, access to and consumption of nutritious food in remote areas is an important strategy for improving the health of Indigenous people.^11-13 Food insecurity has been associated with negative health outcomes¹⁴ and therefore is an important public health food policy priority.

Food security is defined by the Council of Australian Governments as 'the ability of individuals, households and communities to acquire appropriate and nutritious food on a regular and reliable basis using socially acceptable means'.¹⁵

The problem of food affordability and accessibility in remote communities

Geographical location influences the supply and affordability of nutritious foods. Pricing surveys have demonstrated that food can cost ~20-30% more in rural and remote Australian communities.^16-19 This disparity in cost between urban and remote settings has remained relatively unchanged for many years, and the more remote the greater the disadvantage.²⁰ In Western Australia (WA) in 2010, the fortnightly mean cost of a healthy food basket was 23.5% more in very remote areas...