10 M. Pickford

low income groups only. One study reported variedresults, dependent on the indicator of SEP exam-ined.

Conclusions: The effectiveness of WOC inter-ventions across socioeconomic strata appears tobe variable, however the majority of medium tohigh quality studies suggest that these interven-tions have the potential to provide equal or greaterbenefit for lower socioeconomic groups.

http://dx.doi.org/10.1016/j.orcp.2014.10.018

14

SHOP@RIC Food affordability andpricing

Julie Brimblecombe

Menzies School of Health Research,Casuarina, NT, Australia

The food system for Indigenous Australians haschanged drastically from a bio-diverse diet of leananimal foods and nutrient-rich plant foods to onecharacterized by much less variety and a prolifer-ation of convenient, nutrient-poor, highly-refinedprocessed foods. Such dietary changes have wors-ened health inequality of Indigenous peoples acrossthe globe. In Australia, colonization of the diethas occurred in the living memory of Indigenouspeople, who now experience the highest burdenof disease in Australia. Sixty-six percent of Indige-nous Australians, similar to the rest of Australia,are overweight or obese. The consequences of thisare devastating with those experiencing obesity 7times more likely to have type 2 diabetes, and 5times as likely to have a high triglyceride, com-pared to those with a normal weight — and stillmore likely than obese non-Indigenous Australiansto experience chronic disease (e.g., 17% with type2 diabetes compared to 11%; 20% with chronic kid-ney disease compared to 13%). Risk is increasedagain for Indigenous Australians living in remotecommunities. Diet is key to preventing this enor-mous burden of disease and the impact it has onthe daily lives of people. Shifting diet is chal-lenging and especially so for populations of lowersocio-economic position. Food costs in remote com-munities are high meaning Australia’s poorest arepaying the most for food. This inequity is wideningwith the increasing dominance of Australian super-markets and their lower prices campaign. Remotecommunities however do have an advantage —they are uniquely placed to determine their foodsupply and make the healthiest choice the easi-est choice for consumers. Firstly, their geographicremoteness, while it has its disadvantages in terms

of freight costs and seasonal delivery disruptions,means that communities have relatively closed foodsystems. Secondly, the community stores are mostlycommunity owned and governed by a store boardcomprising elected community members. Lastly,community leaders recognise the role of the store inthe health and wellbeing of the community and areeager to support change. The ‘Good Food Systems:Good Food For All’ project developed an approachto capitalise on this opportunity and support storeboards use the 4Ps of marketing to promote healthyfood and use store sales data to track progress.This approach, when used in the context of sup-portive national and local policy and communitywide nutrition promotion, looks promising. Dietaryimprovement for Indigenous Australians and closingthe life expectancy gap will be achieved only withsupport for stores to provide an affordable foodsupply. A study funded by the National Health andMedical Research Council, SHOP@RIC, will providemuch needed evidence on the role of price subsidiesin improving diet in remote Indigenous Australia.This study has successfully been implemented in20 remote communities in the NT. All communi-ties received a 6 month 20% price discount onfresh and frozen fruit and vegetables, water anddiet soft drinks. Ten communities also received a6-month interactive nutrition education program.Study findings will be available in 2015.

http://dx.doi.org/10.1016/j.orcp.2014.10.019