The Food Environment of the Illawarra: Food outlet types, diet quality, shopping practices and socio-economic factors

The prevalence of obesity and overweight in Australian adults is on the rise. Many health-related problems in Australia are associated with poor diet quality of individuals, and there is evidence that this is especially challenging in regional, remote and socially disadvantaged areas. The food environment has an important influence on dietary choice. Previous literature has proposed useful ways to assess individuals’ food environments in neighbourhoods, including through the measurement of the number, type and location of food outlets. The availability and accessibility of food outlets with healthy products has been associated with better dietary patterns, shopping behaviours and health outcomes in residents. However, most prior research about food environments and the relationship with dietary intake has been conducted in the United States (US), with few studies investigating food environments and diet quality in Australia. This research gap is addressed in this thesis. The development of a food environment measurement tool, allowing the evaluation of community food environments in Australian neighbourhoods, is a central component of the present study. This research was conducted in the Illawarra region of New South Wales (NSW), Australia and had four main aims: firstly, to develop a new measure to assess the community food environment, suitable for use in an Australian regional location; secondly, to identify the association between community food environments and dietary habits using the new food outlets classification tool and a short dietary questionnaire; thirdly, to investigate the association between community food environments and the socio-economic status of neighbourhoods; and finally, to evaluate the association between community food environment and residents’ shopping habits.