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You Can’t Find Healthy Food in the Bush: Poor Accessibility, Availability and Adequacy of Food in Rural Australia

School of Medicine, Global Obesity Centre, Deakin University, Geelong 3220, Australia
Australian Health Policy Collaboration, Victoria University, Melbourne 3000, Australia
Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, St Albans 3021, Australia
School of Exercise and Nutrition Sciences, Deakin University, Geelong 3220, Australia
School of Health and Social Development, Global Obesity Centre, Deakin University, Geelong 3220, Australia
Institute for Physical Activity and Nutrition (IPAN), Deakin University, Geelong 3220, Australia
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2018, 15(10), 2316;
Received: 12 September 2018 / Revised: 10 October 2018 / Accepted: 15 October 2018 / Published: 21 October 2018
(This article belongs to the Special Issue Addressing Food and Nutrition Security in Developed Countries)
PDF [336 KB, uploaded 21 October 2018]


In high-income countries, obesity disproportionately affects those from disadvantaged and rural areas. Poor diet is a modifiable risk factor for obesity and the food environment a primary driver of poor diet. In rural and disadvantaged communities, it is harder to access affordable and nutritious food, affecting both food insecurity and the health of rural residents. This paper aims to describe the food environment in a rural Australian community (approx. 7000 km2 in size) to inform the development of community-relevant food supply interventions. We conducted a census audit of the food environment (ground truthing) of a local government area (LGA). We used the Nutrition Environment Measurement tools (NEMS-S and NEMS-R) to identify availability of a range of food and non-alcoholic beverages, the relative price of a healthy compared to a less healthy option of a similar food type (e.g., bread), the quality of fresh produce and any in-store nutrition promotion. Thirty-eight food retail outlets operated at the time of our study and all were included, 11 food stores (NEMS-S) and 27 food service outlets (NEMS-R). The mean NEMS-S score for all food stores was 21/54 points (39%) and mean NEMS-R score for all food service outlets was 3/23 points (13%); indicative of limited healthier options at relatively higher prices. It is difficult to buy healthy food beyond the supermarkets and one (of seven) cafés across the LGA. Residents demonstrate strong loyalty to local food outlets, providing scope to work with this existing infrastructure to positively impact poor diet and improve food security. View Full-Text
Keywords: rural; food supply; food security; obesity rural; food supply; food security; obesity
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).

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Whelan, J.; Millar, L.; Bell, C.; Russell, C.; Grainger, F.; Allender, S.; Love, P. You Can’t Find Healthy Food in the Bush: Poor Accessibility, Availability and Adequacy of Food in Rural Australia. Int. J. Environ. Res. Public Health 2018, 15, 2316.

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