Food Insecurity among Aboriginal and Torres Strait Islander Communities in Remote Areas

This article discusses the issue of food insecurity among Aboriginal and Torres Strait Islander communities in remote areas. It explores the prevalence, determinants, and consequences of food insecurity in these populations. The article also highlights the need for public health nutritionists to be involved in addressing food access and improving overall nutritional status.

HSN705
PUBLIC HEALTH NUTRITION
Food Insecurity among the Aboriginal and
Torres Strait Islander communities in
remote areas
STUDENT NAME: ARCHANA CHALLAGULLA
STUDENT ID: 218204454

PART A
Food Insecurity among the Aboriginal and Torres Strait Islander communities in
remote areas
Introduction
Food security is defined as the state of having physical, social and economic access to
sufficient, safe and nutritious food which meets their food preferences and dietary needs for
healthy living (1). Often prolong periods of food insecurity leads to malnutrition. Food
security exists as a continuum which often commences from the agricultural practices and
ends in the in food usage and disposal (2). Food security concept is defined based on the
inclusion of both physical and economic access to food which is able to meet the dietary
needs of the population. (3)
Current evidence depicts food insecurity among the Aboriginal and Torres Strait Islanders
population in Australia as being poor (4). The indigenous persons living in remote and rural
parts are often vulnerable to food insecurity. Among the indigenous populations; the
Aboriginals and Torres Islander, they often experience social disadvantage and have a high
gap of life expectancy compared to the general population. (5) The increased burden of diet-
related issues is higher among these populations. They experience increased occurrence of
morbidity and mortality compared to other populations. Majority of the infants are often born
at stillbirths, low birth weights, and generally high malnutrition levels. (6)
Prevalence
It is estimated that 25% of the indigenous population in Australia live in remote and rural
areas. According to a cross-sectional survey study undertaken by Temple & Russell (7), the
prevalence of food insecurity among this population of Aboriginals and the Torres Strait
Islanders is high with about 21% having inadequate food while about 41% have a depletion
of food. Further statistical data obtain by ABS indicates that there is an average of 22% of the
indigenous persons facing food insecurity vis-a-vis 4% of the nonindigenous populations.
(8).The studies have constantly demonstrated that the indigenous populations have about 5-7
risks fold of being food insecure compared to nonindigenous persons.
Determinants
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The overall improvement of food supply access and intake of nutritious foods is an important
aspect in meeting population food insecurity issues. (9) The underlying issues facing food
insecurity revolving around the Aboriginals and Torres Islanders entail the underlying
socioeconomic factors such as the overcrowding, food costs, cultural food factors, education,
food and nutrition literacy, skills and knowledge among other factors. (10)
Many remote populations especially the Aboriginals and Torres Islanders often experience
irregular food security limiting the nutritional choices they make due to irregular food supply
and storage ability of food is inadequate. (11) Community food stores in rural areas play a
crucial role in the nutritional health of the population. They are the major source of foods.
Majority of this population makes food purchases at the food stores, which its supply is
hampered thus food supply is affected across the population. (12)
The influence of geographical locations affects the supply and affordability of nutritious
foods. The food prices in the rural areas are higher by a range of 20-30% compared to the
urban population influencing significant challenges. The high costs difference has been a
greater disadvantage in accessing and affording nutrition foods. Many rural areas in Australia
inhabited by Aboriginals and Torres Islanders often experience food insecurity due to poor
supply of food. (13)
Consequences of the situation
Like other indigenous population settings, Aboriginal and Torres Islander persons often face
considerable high poor health outcomes. The key determinant affecting the overall health
outcomes is associated with limited access to food and the inability to access acceptable safe
foods. (14) Studies have demonstrated that the Aboriginal and The indigenous persons in
remote areas are more likely to face hunger and food insecurity due to the shortage of food
occurring in the short term and impacts on serious health consequences. (15)
The consequential effects of food insecurity among this population are linked to increased
symptoms of depression, multimorbidity, lower self-reported health status, lower dietary
nutrient needs increased isolation, long-standing health associated issues. Furthermore, food
insecurity is more often linked to lowered levels of productivity and deprived social
interaction which has been observed to contribute to increased inequality compare to other
population settings. (16)
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Further, food security among the indigenous populations is an important aspect towards
addressing the underlying issue related to access to safe and nutritious foods and improving
on dietary behaviors which have an overall effect of increasing life expectancy. (17)
Further food insecurity is linked to health inequalities and negative health outcomes. Poor
nutrition among the indigenous population is linked to a poor community and individual
health outcomes contributing to total disease burdens. (18)
PART B
Inclusion of public health nutritionist in the food supply
There is a need for an address to the remote Aboriginal community food access to adequate
rapid and sustained dietary practices and overall nutritional status. There is a need for
involving public health nutritionist in the implementation of various strategies and programs
for the indigenous community to guide on the decision making process among the
community. Currently, gaps have been observed especially on programs such as the Close the
Gap initiative. This program lacks the essential nutrition role perspective in its
implementation. Other initiatives such as the Northern Territory Emergency Response have
often dealt with food accessibility issues. Foods access has been undertaken through the local
store's services in providing essential food services to remote communities. The stores play a
fundamental role in providing food access and improving food security in the community.
The community stores and community members interact frequently making the food stores to
be user-friendly to the indigenous population. The NTER program has been run by the
remote and indigenous communities’ especially in Western Australia and has no direct
funding or subsidy by the government thus relying on the resident’s patronage on trade
issues. Most of the indigenous populations entail between 100-200 people. The food stores
are able to provide food for indigenous persons (19).
In all these programs inclusion of public health nutritionist to guide and offer a proper
selection of healthy foods to the community is lacking. Nutrition interventions have aimed at
improving the nutrition-related health outcomes among the Australian indigenous
populations. There are significant improvements in various interventions implemented in
Australian to manage food insecurity among the indigenous population as both in the short
and long term intervention.
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Nutrition education and health promotion initiatives undertaken by public health nutrition in
this programs is essential in targeting the indigenous populations as this will have potential
benefits across geographically diverse populations (20) Improvements have been
demonstrated across the usage and utilization of food-based and community health promotion
approaches which have been part of the adoption of strong ecological approach towards
strong community engagement. A fundamental aspect of addressing food insecurity among
the indigenous populations has always been addressing the underlying factors affecting
dietary food intake of food in the overall complex mechanism affecting healthy food access.
Strong community engagement between the indigenous community and the implementation
of nutrition intervention has been observed to be crucial.
The fundamental role of public health nutritionists is to ensure there is improved food and
nutrition in order to promote and protect the overall health of the population through
improved food and nutrition. (21) The effective workforce has been shown to have more
benefits in improving the overall teamwork in continuum care. The key underlying aspect of
this implementation is the limited number of public health nutrition workforce in Australia
and thus hinders the potential understanding of the food situation statues in addressing food
security issues across the population. The competencies entailed for public health nutritionist
entail an understanding of factors which contribute to the general health of the population and
nutrition application and understanding of the public health systems. (22)
Hence a fundamental review of this approach to the indigenous population aims at inclusion
of public health nutritionists roles in the food supply interventions such as the NTER and
other food security measures so as to improve the overall dietary knowledge, and selection of
appropriate nutritious food among the indigenous persons is essential in improving and
strengthening community ability to increase access to nutritious foods.
Part C critical appraisal
Food security is attained when there is access to food to offer safe and nutritious foods able to
meet the dietary needs and food preferences for the target population. A study undertaken by
Nsabuwera et al (23) assessed evidence from intervention studies undertaken in Rwanda with
regard to rural population access to foods. The study assessed the changes across food access
continuum and food security intervention at the household level after the implementation of
integrated food security intervention. The study assessed and compared household food
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security access using the Household Food Insecurity Access Scale – HFIAS both at the based
and end line program period. The study included 600 households.
The results of the study showed that there was a significant improvement with a significant
value of p<0.001 using the HFISA scale. There was decreased severe insecurity levels from
79% to 49% while the levels of food consumption among the population improved from
48%-68%. There was significant improvement among households.
This study demonstrated that implementation of Health Food Security and Livelihoods
Program which entrenched various key health care staff such as public health nutrition in
improving household food access and supply was essential in improving the overall food
consumption and overall food security issues among the people. Implementation of the
integrated program is linked to great improvements of household food security; hence
application of a holistic approach to food security is an essential aspect in improving rural
nutrition among the indigenous communities in rural settings.
Moreover, in a study conducted by Ferguson et al (24) on health promotion pricing policies
and decision-making process among indigenous Aboriginal and Torres Islanders community
stores were undertaken. The indigenous community often encounter diet-related diseases and
often occur in environments where there are higher food prices and low cash incomes, thus
affecting food security. The study aimed at addressing food-related pricing policies with
regard to alignment with evidence. The focus of this study aimed at assessing food pricing
policies and the overall decision-making process among the end users with regard to
nutrition-related practices.
The study performed semi-structured interviews, purposefully selecting food retailers and
health professionals who were identified through the snowballing method. Content analysis
was performed on the data obtained while the decision-making process of food was
undertaken through deductive and thematic approaches. Food access in terms of pricing had
varied changes. There was general acceptability, effectiveness, and sustainability in the
process of implementing food policy actions with regard to food access among the
indigenous community. Implementation of policy guide on food process acquisition was
essential in increasing the overall involvement of the Aboriginal and Torres Strait Islanders
and nutritionist in accessing food thus improving the overall intended food security. This
decision making process improvement is essential in improving the overall opportunity in
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incorporating evidence-based approaches in food access.
Thus with this review, it is essential that the nutrition state of the indigenous person remains a
fundamental aspect across the indigenous population. Focusing on ensuring food accessibility
and food availability is essential in improving the overall supply of food across the
population
The focus has been to tighten and incorporate the role of public health nutrition at the food
stores to offer advice and guidance on food being purchased and accessed by the general
indigenous population so as to make nutritious food choices which are essential in improving
the overall health status and being food secure. Improving support towards making nutritious
food accessible to the population is fundamental in the overall health state. Thus this
approach is a relevant community-based approach which is vital in the overall improvement
of the food insecurity state of the indigenous population.
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