Shifting the System: Food Access and Availability in Latrobe City

Transcription

1 Healthy Food Connect Shifting the System: Food Access and Availability in Latrobe City December 2014 Report prepared by: Nikki Visser 1, Julia McCartan 1,2 1. Monash University 2. Healthy Together Latrobe

2 Shifting the System: Food Access and Availability in Latrobe City December 2014

3 Contact Julia McCartan Food System Research Officer Healthy Together Latrobe P: E: To receive this document in an accessible format phone or Except where otherwise indicated, the images in this publication show models and illustrative settings only, and do not necessarily depict actual services, facilities or recipients of services. Copyright, Healthy Together Latrobe, Nov 2014 Healthy Together Latrobe, supported by the Victorian Government and partners, is improving the health of our community.

4 Contents Executive Summary... 1 Background... 3 Methods... 6 Findings... 8 Discussion References Acknowledgments Appendices... 29

5 Executive Summary Only 7% of Latrobe City residents eat the recommended servings of fruits and vegetables each day. Research has shown that the cost and availability of fresh produce is a significant predictor of eating habits and the consumption of fruits and vegetables. Research was undertaken to assess the cost, availability and level of access to food within Latrobe City. This project forms builds on previous food system research conducted in Latrobe City in The price and availability of fresh produce in Latrobe was investigated by conducting the Victorian Healthy Food Basket (VHFB) survey in 28 food retailers. Access to food within Latrobe City was analysed by mapping different categories of food outlets in a Geographic Information System (GIS) mapping program. This study has identified that the Latrobe City food environment provides inequitable access to affordable, nutritious foods, particularly fruits and vegetables. Key findings of this research include: The cost of a healthy food basket can vary significantly by up to $170 across the region. The satellite towns of Latrobe City are the most expensive area to purchase a healthy food basket for a family of four in Latrobe ($501.78). The major centre of Morwell is the cheapest area to purchase a healthy food basket for a family of four ($449.93). The cost of a healthy food basket in Latrobe is $33.44 more expensive compared with the Victorian average. It is $35.22 cheaper to purchase the fruit and vegetable component of a healthy food basket for a family of four from greengrocers compared to supermarket retailers. Takeaway food outlets account for 32% of the total food outlets in Latrobe City. This is a significant share of the total number of food outlets when compared to retailers that sell fresh produce such as supermarkets (7%), greengrocers (1%), and bakery, butcher, fishmonger and poultry retailers combined (14%). For every one fresh food outlet in Latrobe (supermarket or greengrocer) there are 3.7 takeaway or fast food outlets. Out of the 18 fruit and vegetable items surveyed, some satellite towns were missing up to 16 items, indicating significant gaps in access to fruits and vegetables in these towns. There are also gaps in access to supermarket and greengrocer retailers in the major centres of Latrobe City. Food Access and Availability in Latrobe City 1

6 There are a significant number of food outlets selling unhealthy food items in close proximity to education centres in Latrobe City. Additionally, many food outlets selling discretionary food items are in close proximity to some of the most disadvantaged areas of Latrobe City. There is a clear need for strategies and initiatives that increase the supply of fresh produce in both major centres and the smaller satellite towns in Latrobe City. The findings of this research should be used to advocate for change to the local food system to key decision makers within and external to local government. Additionally, this evidence can inform and assist greater collaboration with the food retail sector in Latrobe City. Recommendations for future action include: Continue to emphasise the importance of considering the food system within council policies, plans, strategies, and legislation using this research as an evidence base. Use the Latrobe Food System GIS mapping information to inform future town planning and development to ensure that there are acceptable levels of access to fresh food outlets. Investigate the logistics of increasing the supply of fresh produce to satellite towns, food deserts and disadvantaged areas in major centres/encourage local greengrocers and supermarket retailers to improve delivery to these areas. Encourage and support takeaway food and dining outlets to offer healthier menu options that include fruits and vegetables. Encourage the development of more community gardens and local food hubs, particularly in smaller towns of Latrobe and outskirts of major centres Support mixed businesses e.g. petrol stations, milk bars and convenience stores to increase their supply of fresh produce. 2 Food Access and Availability in Latrobe City

7 Background The Problem According to preliminary survey findings from the Victorian Population Health Survey Report , rates of overweight and obesity in Latrobe are 10% higher than the Victorian average % of Latrobe residents are considered overweight or obese compared with the Victorian average of 49.8%. 1 Additionally, only 7% of adults in Latrobe meet the recommended daily intake of two serves of fruit and five serves of vegetables a day. 1 This figure exceeded the Victorian average of 5.2%, however these rates are still considerably low. 1 Fruit and vegetable consumption is particularly important as a nutritious diet high in fibre, vegetables and fruit protects against chronic diseases such as heart disease, cancer, diabetes and obesity. 2, 3 A nutritious diet is recognised as important in maintaining and improving health and wellbeing. 4, 5 Additionally, the cost and availability of nutritious food is a recognised as an important determinant of health. 5 Factors influencing healthy eating The factors influencing healthy eating habits are complex. However, the availability and cost of nutritious foods are widely accepted as factors which influence eating habits. 4, 6 Physical access to nutritious foods is an important determinant of health. 4, 7 Research has shown that individuals who have access to good nutritious food are more likely to consume a healthy diet and are less likely to be obese than those who do not have the same level of access. 8 Additionally, access to good, affordable food makes more difference to what people eat than health education, therefore it is important to ensure that individuals have access to a nutritious food supply and are not just educated on the right way to eat. 6 Cost is also a large predictor of healthy eating habits as studies have shown that diets high in fruit and vegetables are more expensive than diets which are high in sugar, salt and saturated fat. 2 This means that for low income or welfare dependant individuals and families it can cost a significant proportion of their income to purchase the foods required for a healthy and nutritious diet. Studies in Australia have shown that low income households are less likely to buy and eat healthy food, with income shown to be Food Access and Availability in Latrobe City 3

8 the biggest predictor of food purchasing behaviour, compared to education and occupation. 9 Furthermore, it should be noted that Latrobe City has lower rates of median total weekly family income than Victoria with $1236 the average in Latrobe compared to $1460 in Victoria. 10 This is a difference of $224. The lower rates of total family income for families in Latrobe may be a factor contributing to the lower rates of fruit and vegetable consumption occurring in the region. However, there is currently little understanding of the level of access, cost and availability of food across all regions within Latrobe City. The purpose of this report To present a visual representation of food access and availability within Latrobe City by conducting Geographic Information System (GIS) mapping. To report on the findings of the Victorian Healthy Food Basket (VHFB) survey regarding the cost of and access to food within Latrobe City. To provide evidence-informed strategies to relevant stakeholders to improve Latrobe residents access to healthy and affordable food. This project will address the first two steps of the Victorian Government s Healthy Food Connect framework: Undertake a local food needs assessment and Identify and prioritise actions and builds on 11, 12 previous food system research conducted in Latrobe City in Healthy Together Victoria Healthy Together Victoria is a state wide systems-based initiative that aims to improve the health of people where they live, learn, work and play. 13 The Healthy Together Victoria initiative focuses on the underlying causes of poor health in workplaces, communities and children s settings by encouraging healthy eating and physical activity, and reducing smoking and harmful alcohol use. 13 Twelve locally led Healthy Together Communities operate throughout Victoria, including within Latrobe City. 13 Latrobe City Council and Latrobe Community Health Service together form Healthy Together Latrobe. Previous Research Research was previously conducted on Latrobe City s food system by Monash Nutrition and Dietetics students in A situational analysis of the natural, socio-cultural, economic and built environments within the Latrobe food system was conducted and identified a number of potential opportunities for future action. This research also identified that in recent years, two local fruit and vegetable wholesalers and four sole fruit and vegetable retailers had closed, which has implications for fruit and vegetable access and consumption rates in Latrobe City over the past few years. 12 This report acknowledges and builds on this previous research conducted in Food Access and Availability in Latrobe City

9 Context The City of Latrobe is located approximately 150kms east of Melbourne and contains the four major centres of Traralgon, Morwell, Moe/Newborough and Churchill. 14 Smaller townships located within Latrobe City include: Boolarra, Glengarry, Toongabbie, Tyers, Traralgon South, Yallourn North and Yinnar. 14 There were over 73,788 residents living in Latrobe in 2011, with that population expected to increase to 78,215 in The Socio-Economic Indexes for Areas (SEIFA) ranking is a measure of the relative level of advantage and disadvantage in an area. The lower the ranking the more disadvantage in an area. Conversely, the higher the ranking the less disadvantage in an area. Latrobe City has a SEIFA ranking of 940 and is ranked 133 out of 564 in all local government areas in Australia. 16 Furthermore, Morwell and Moe are ranked in the top 10 percent of the most disadvantaged towns in Australia, and are also ranked as the fourth and sixth most disadvantaged towns in Victoria respectively. 17 There are also considerably higher levels of unemployment in persons aged 15 years and over in Latrobe compared to Victoria, 7.9% and 5.4% respectively. 10 Food Access and Availability in Latrobe City 5

10 Methods Victorian Healthy Food Basket Survey The Victorian Healthy Food Basket (VHFB) is a tool developed by Monash University to measure the cost of a healthy food basket for four different family types: a family of four (two adults and two children), a single mother with two children, a single male, and an elderly woman. 18 During this study, VHFB surveys were conducted in Latrobe City and data was collected from food retailers including supermarkets, greengrocers, convenience stores and mixed businesses (n = 28) using the VHFB tool. See Appendix 1 for a list of stores where surveys were conducted. VHFB data was collected over a one month time frame from late August to end of September 2014, with the majority of stores surveyed within a three week timeframe to reduce the variability of price in seasonal produce. The price was recorded for each cheapest, non-generic product, with promotional or special prices ignored as per VHFB protocols. All supermarkets and green grocers within Latrobe City were surveyed except for one supermarket where management refused. Although greengrocers typically do not stock all the items included in the survey, they were included in the data collection so that comparisons could be made between the cost of fresh fruit and vegetables in greengrocer retailers compared with supermarket retailers. Data analysis was conducted on only the fruit and vegetable component of both baskets. Several convenience stores and mixed businesses were included in the data collection as these can be the only or nearest food access point for many Latrobe residents, particularly those living in some of the smaller satellite towns. Whilst many of these businesses were missing items from the VHFB survey it was important to include these in the data collection as each of these businesses have the potential to stock all items contained in a healthy food basket. All stores were grouped into four area codes as seen in Figure 1. Major centres were each given their own area code and the smaller satellite towns of Latrobe City were combined into one area code so that no individual businesses could be identified in the data analysis, as per VHFB protocols. Comparisons could then be made in the cost of a healthy food basket between the major centres (area codes 1, 3 and 4) and the satellite towns of the region (area code 3). Analysis was conducted on the mean, median, standard deviation, minimum and maximum values for each of the four area codes as well as for Latrobe City as a whole. Averages were also calculated for the percentage of income that a healthy food basket would cost a family of four (two adults and two children) receiving Centrelink benefits. An analysis of the availability of fruit and vegetables was also conducted in the satellite towns. This was done to better understand the level of fruit and vegetable access away from Latrobe s major centres as often there was only one food access point for residents in these towns. 6 Food Access and Availability in Latrobe City

11 Figure 1: Area codes for VHFB analysis Area Code Township/s 1 Moe, Newborough 2 Morwell 3 Churchill, Boolarra, Yinnar, Yallourn North, Glengarry, Toongabbie, Tyers, Traralgon South 4 Traralgon, Traralgon East Significance tests were conducted on the following data comparisons: satellite versus major centres, and greengrocers versus supermarkets (fruit and vegetables only). These non parametric data sets were analysed using SPSS (version 21.0). A Mann-Whitney U-test was conducted and a significance limit of p=0.05 was set. Where the p-value was less than 0.05 the results were deemed to be statistically significant. Where p-value equalled greater than 0.05 the results were deemed to be not statistically significant. GIS Mapping Geographic Information System [GIS] mapping was undertaken for all food access points within Latrobe City. GIS mapping is a tool that assists in the collection and display of data in relation to its place and is a useful public health tool. 19 GIS data can be mapped in relation to other key infrastructure and public health information including transport routes, schools, hospitals, and other amenities. GIS mapping was used in this project to gain a better understanding of geographical distributions of different types of outlets throughout Latrobe City, the density of different types of food outlets, and to identify any food deserts that may exist within Latrobe where there is limited access to fresh food and produce. Using data obtained from both the Latrobe City Council s Health Services and Economic Sustainability teams, the Prime Safe online database and desktop research, a database of all the food outlets and food access points within the Latrobe City was developed. Each food outlet was allocated to one of 15 categories, which can be seen in Appendix 2. Pubs, clubs, hotels and motels where meals may be served were excluded from this analysis. This data was then uploaded to the Intramaps database. Data was then analysed through the development of a series of GIS maps that could analyse the placement and distribution of different food outlet categories throughout the entire Latrobe City municipality. Food Access and Availability in Latrobe City 7

12 Findings Victorian Healthy Food Basket Survey The following are the findings of the VHFB data analysis for Latrobe City. Note that all analyses are based on the cost of a healthy food basket for a family of four (two adults and two children). The cost of a healthy food basket for a family of four in Latrobe City ranged from $ to $ (see Appendix 3). This is a difference of $ from the cheapest to the most expensive basket. The average price of a healthy food basket for a family of four was $ in Latrobe City. Based on this price a healthy food basket would cost 35% of a family of four s total fortnightly government assistance from Centrelink (see Appendix 3). The Victorian average price of a healthy food basket for a family of four is $ Therefore the healthy food basket is $33.44 more expensive in Latrobe City compared with the Victorian average. The cheapest area to purchase food was within Morwell, with an average cost of $ (see Appendix 3). The most expensive area to purchase foods was area 3, which contains the satellite towns of the region, with an average cost in of $ It should be noted that the cost in area code 3 ranged from $ to $586.18, a difference of $ (see Appendix 3). The average cost for major centres combined (area codes 1, 2 and 4) was $ (see Appendix 3). This was $32.09 less expensive than the cost in area code 3, the satellite towns of Latrobe City. The cost of healthy food basket for major centres ranged from $ to $532.23, a difference of $ (see appendix 3). Additionally, the difference in the range between satellite towns and major centres can be seen in Appendix 4, a box plot analysis of the cost of a healthy food basket of major centres versus satellite towns, which differences in the range between these two groups. The statistical significance of the cost difference between major centres and satellite towns was tested with a Mann-Whitney U-test with this test indicating that these results were not statistically significant (p=0.93). However, the results can be classed as clinically significant since $32.09 is still a substantial amount of money for a low-income family. When comparing the cost of fruits and vegetables in greengrocers versus supermarkets it was found that the average cost of fruit and vegetables was $ at supermarket retailers and $92.45 at greengrocer retailers (see Appendix 5). This shows that on average it is $35.22 cheaper to purchase 8 Food Access and Availability in Latrobe City

13 the fruit and vegetable component of healthy food basket for a family of four from a greengrocer than from a supermarket in Latrobe City. See Appendix 6 for a box plot analysis of the cost of fruit and vegetables in supermarkets versus greengrocers that shows a clear difference in the range of costs between these two categories. For the supermarket and greengrocer fruit and vegetable cost comparison a Mann-Whitney U-test indicated that these results were statistically significant (p=0.002). Availability of fruit and vegetables When analysing the availability of fruit and vegetables within the satellite towns of Latrobe City (area 3), it was found that out of 18 items of fresh, tinned and frozen fruits and vegetables, some towns had up to 16 missing items. Therefore residents in these towns only had access to two fruit and/or vegetable items if they were unable to travel to another location where there was greater access. Additionally, it was reported by retailers in satellite towns that stocking fresh produce such as fruits and vegetables was often inconsistent and sporadic, which has further implications for the level of access that residents have to fresh produce in these areas. Food outlet database The food outlet database developed for the purpose of providing data for GIS mapping assisted in discovering the following findings: As of October 2014, there were 89 takeaway food outlets, 82 cafés and restaurants, 20 supermarkets and 4 greengrocers in Latrobe City (see Appendix 2). The takeaway outlets represent 32% percent of the total number of food outlets in Latrobe City, whilst supermarkets represented 7%, greengrocers 1%, and fresh retailers such as butchers, and bakery combined represented 14%, see figure 2 below. There is a disproportionate number of fresh food outlets compared with outlets which provide discretionary choices. For every one fresh food outlet in Latrobe (supermarket or greengrocer) there are 3.7 takeaway or fast food outlets. Food Access and Availability in Latrobe City 9

14 Figure 2: Composition of food outlets by type in Latrobe City (%) Composition of food outlets by type in Latrobe City (%) 8% 7% 1% Supermarket Greengrocer 14% Fresh (Bakery, Butcher, Fishmonger, Delicatessen) 29% 1% Cultural Supermarket 9% Mixed Business & Petrol Station Takeaway food outlet 32% Café & Restaurant Other (Aged Care, Hospitals, Community Gardens) Mapping of the Latrobe City food system By utilising the GIS Mapping program Intramaps, a number of maps were developed to show a visual representation of the Latrobe City food system. The most telling data has been included in this report with Figures 3 to 19 spatially mapping the subsets of the food system across Latrobe City. A 500 metre radius has been applied to each food outlet type which is deemed as a reasonable walking distance for accessing food. 20 Above 500 metres and the area may be considered a food desert. 20 Figures 3 and 4 focus on Morwell. Access to fresh fruit and vegetables (supermarkets and greengrocers) is compared with access to takeaway food outlets, mixed businesses and petrol stations, all of which typically sell discretionary food items. These maps show that there is a major difference between access to supermarkets and greengrocers compared to the access to food businesses that typically sell unhealthy items. Figures 5 and 6 show this data again overlaid with the SEIFA index for each area within Morwell. This indicates that there are significant gaps in access to supermarkets and greengrocers in Morwell where there are higher levels of disadvantage according to the SEIFA index. In comparison there are many takeaway food outlets, mixed businesses and petrol stations that surround these areas of higher disadvantage in Morwell. Figures 7 and 8 show that Traralgon has better retail access to fresh fruit and vegetables and lower levels of disadvantage as depicted by the SEIFA ranking overlaid on these maps compared to 10 Food Access and Availability in Latrobe City

15 Morwell. However, there are still many areas where there is no access to fruit and vegetables, or any food outlets of any category particularly around the outskirts of Traralgon as seen in Figure 9. Figures 10 and 11 show that the proximity of supermarkets and greengrocers to education centres in Moe and Newborough compared to takeaway outlets, mixed businesses and petrol stations which typically sell discretionary food items. These figures indicate that there is a considerable amount of takeaway food outlets, mixed businesses and petrol stations in close proximity to education centres in the Moe and Newborough area. Figures 12 to 19 show the level of access and types of food outlets accessible in the satellite towns of Latrobe City. All food outlets and access points have been included in these maps to give a greater understanding of the types of businesses that residents have access to. As can be seen by the maps, access is often lacking, with just the presence of one mixed business such as a petrol station, general store or milk bar in some towns. As stated previously, many of these stock few lines of fruit and vegetables. Food Access and Availability in Latrobe City 11

16 Figure 3: Supermarket and greengrocer access in Morwell Figure 4: Takeaway food outlet, mixed business and petrol station access in Morwell The compilation of this map is subject to copyright laws and regulations, no part of this map 12 Food Access and Availability in Latrobe City

17 Figure 5: Supermarket and greengrocer access in Morwell with SEIFA ranking for areas Figure 6: Takeaway food outlets, mixed business and petrol station access in Morwell with SEIFA ranking for areas Food Access and Availability in Latrobe City 13

18 Figure 7: Supermarket and greengrocer access in Traralgon with SEIFA ranking for areas Figure 8: Takeaway food outlet, mixed business and petrol station access in Traralgon with SEIFA ranking for areas 14 Food Access and Availability in Latrobe City

19 Figure 9: All food access points in Traralgon Food Access and Availability in Latrobe City 15

20 Figure 10: Supermarket and greengrocer access in relation to education centres in Moe and Newborough Education centres legend Figure 11: Takeaway outlets, mixed businesses and petrol station access in relation to education centres in Moe and Newborough 16 Food Access and Availability in Latrobe City

21 Food access in satellite towns Figure 12: Food access points in Churchill Food Access and Availability in Latrobe City 17

22 Figure 13: Food access points in Glengarry Figure 14: Food access points in Toongabbie 18 Food Access and Availability in Latrobe City

23 Figure 15: Food access points in Tyers Figure 16: Food access points in Yinnar Food Access and Availability in Latrobe City 19

24 Figure 17: Food access points in Traralgon South Figure 18: Food access points in Yallourn North 20 Food Access and Availability in Latrobe City

25 Figure 17: Food access points in Boolarra Public transport and food access As seen in Figures 12 to 19, residents in the satellite towns of Latrobe tend to have access to retailers that do not stock the range of food items that are required for a healthy diet. Due to this limited access, these residents would have to travel to Latrobe s larger centres to access a wider variety of fresh produce. Using the example of the town of Boolarra, which has only one mixed business (see Figure 19), a resident from this town may choose to travel to Churchill to access a greater range of foods. If this resident is reliant on public transport, a bus service to Churchill passes through Boolarra every two hours and return services leave one hour after arrival in Churchill. 21 Therefore, it may take three hours or more to travel and shop for food. The reliance on public transport may influence food purchasing behaviours as the resident would need to carry their purchases, influencing how much and what sort of foods they would purchase. Also the length of this trip may mean that they shop infrequently therefore may be more likely to purchase non-perishable and packaged foods rather than fresh produce. Discussion As stated earlier in this report Latrobe City has significantly higher rates of overweight and obesity than the Victorian average, 60.6% and 49.8% respectively. Additionally, only 7% of adults consume the recommended daily servings of fruits and vegetables each day. We also know that access, availability Food Access and Availability in Latrobe City 21

26 and cost are significant predictors of food purchasing behaviours and will influence an individual s eating habits and their consumption of a healthy diet more so than education. Therefore, in order to improve healthy eating habits we must ensure that individuals have easy access to affordable and nutritious foods. The research conducted in this study has identified that the Latrobe City food environment provides inequitable access to affordable, nutritious foods, particularly fruits and vegetables. There are quite significant gaps and disparities in the level of access to, and the cost of fresh produce throughout the entire region. Overview of key findings The cost of a healthy food basket can vary significantly by up to $170 across the region. The satellite towns of Latrobe City are the most expensive area to purchase a healthy food basket for a family of four in Latrobe ($501.78). The major centre of Morwell is the cheapest area to purchase a healthy food basket for a family of four ($449.93). The cost of a healthy food basket in Latrobe is $33.44 more expensive compared with the Victorian average. It is $35.22 cheaper to purchase the fruit and vegetable component of a healthy food basket for a family of four from greengrocers compared to supermarket retailers. Takeaway food outlets account for 32% of the total food outlets in Latrobe City. This is a significant share of the total number of food outlets when compared to retailers that sell fresh produce such as supermarkets (7%), greengrocers (1%), and bakery, butcher, fishmonger and poultry retailers combined (14%). For every one fresh food outlet in Latrobe (supermarket or greengrocer) there are 3.7 takeaway or fast food outlets. Out of the 18 fruit and vegetable items surveyed, some satellite towns were missing up to 16 items, indicating significant gaps in access to fruits and vegetables in these towns. There are also gaps in access to supermarket and greengrocer retailers in the major centres of Latrobe City. There are a significant number of food outlets selling unhealthy, discretionary food items in close proximity to education centres in Latrobe City further increasing access to unhealthy food items for young people. Additionally, many food outlets selling discretionary foods are in close proximity to some of the most disadvantaged areas of Latrobe. There is a clear need for strategies and initiatives that increase the supply of fresh produce in both major centres and the smaller satellite towns in Latrobe City. The findings of this research should be used to advocate for change to the local food system to key decision makers within and external to local government. Additionally, this evidence can inform and assist greater collaboration with the food retail sector in Latrobe City. 22 Food Access and Availability in Latrobe City

27 Limitations A limitation of the Victorian Healthy Food Basket tool is that benchmark prices must be entered where missing items occur. Therefore values may not fully reflect the true cost of food for residents within Latrobe City. Additionally, although Churchill can be considered a major centre in itself, its healthy food basket data was analysed as part of the satellite town area code. There were concerns that the supermarket retailers would be identified in terms of price if Churchill was given its own area code. The inclusion of Churchill as part of the satellite towns area code may have reduced the average cost of a healthy food basket in this area code. Another limitation of this study was that different data was used to create the food outlet database compared to the research conducted in previous years. It is likely that the latest data is more accurate, given it was cross-checked across four databases, however both data sets give a good indication of the current mix of food retailers in Latrobe. Implications for wider research in Victoria Monash University Department of Nutrition and Dietetics have committed to further exploring the cost of fruit and vegetable items in greengrocers and supermarkets. Reflecting the results from this study, greengrocers have also been found to be significantly less expensive in metropolitan Melbourne. 22 However, further evidence is needed to tell the story from a rural perspective and assess whether the Latrobe results reflect trends across Victoria. Collecting cost data from greengrocers will be built into the Summer 2014/2015 State-wide Victorian Healthy Food Basket data collection. This evidence may facilitate mutually beneficial partnerships between local government/health agencies and greengrocers, the Melbourne Market Authority and other relevant businesses that supply fruit and vegetables. Recommendations for future action Council Continue to emphasise the importance of considering the food system within council policies, strategies, and legislation using this research as an evidence base. Disseminate these results to relevant stakeholders within Latrobe City Council: Councillors Senior Management and Executives Relevant Team Meetings Use the Latrobe Food System GIS mapping information to inform future town planning and development to ensure that there are acceptable levels of access to fresh food outlets. Advocate for a review of planning permits issued to food outlets selling discretionary food items in close proximity to education centres and areas of high disadvantage. Latrobe food system Continue to conduct VHFB surveying in Latrobe City to monitor the price of food over time. Food Access and Availability in Latrobe City 23

28 Set protocols to ensure that additions and deletions of food outlets are updated in the GIS Mapping software on a regular basis. Investigate the logistics of increasing the supply of fresh produce to satellite towns, food deserts and disadvantaged areas in major centres/encourage local greengrocers and supermarket retailers to improve delivery to these areas. Encourage and support takeaway food and dining outlets to offer healthier menu options that include fruits and vegetables. Encourage the development of more community gardens and local food hubs, particularly in smaller towns of Latrobe. Support mixed businesses eg: petrol stations, milk bars and convenience stores to increase their supply of fresh produce. Future research in Latrobe Investigate public transport connectivity and timetabling throughout Latrobe City. Investigate the footpath connectivity to fresh food access points in Latrobe, particularly in satellite towns of the region. Investigate the level of access to alcohol in both major centres and satellite towns as this was observed to be higher than access to fruits and vegetables. Continue to map all petrol stations, sporting kiosks and school canteens in Intramaps to tell a more comprehensive story of food access and availability in Latrobe City. 24 Food Access and Availability in Latrobe City

29 References 1. Department of Health. Victorian Population Health Survey : Selected Preliminary Results - Gippsland Melbourne: Department of Health2013 Oct. 6p. Available from: Preliminary-Results--Gippsland 2. Kettings C, Sinclair AJ, Voevodin M. A healthy diet consistent with Australian health recommendations is too expensive for welfare dependent families. Australian and New Zealand journal of public health. 2009;33(6): World Health Organization. Promoting fruit and vegetable consumption around the world 2014 [cited 2014 Nov 10]. Available from: 4. Palermo C. The cost of nutritious food: a determinant of health. Nutrition & Dietetics. 2011;68(4): Wilkinson RG, Marmot MG. Social determinants of health: the solid facts: World Health Organization; Lee A, Mhurchu CN, Sacks G, Swinburn B, Snowdon W, Vandevijvere S, et al. Monitoring the price and affordability of foods and diets globally. Obesity Reviews. 2013;14(S1): World Health Organization. The determinants of health: Food and agriculture [Internet] [cited 2014 Nov 18]. Available from: 8. Larson NI, Story MT, Nelson MC. Neighborhood environments: disparities in access to healthy foods in the US. American journal of preventive medicine. 2009;36(1): e Turrell G, Hewitt B, Patterson C, Oldenburg B, Gould T. Socioeconomic differences in food purchasing behaviour and suggested implications for diet related health promotion. Journal of Human Nutrition and Dietetics. 2002;15(5): Food Access and Availability in Latrobe City 25

30 10. Australian Bureau of Statistics Census of Population and Housing Basic Community Profile [Internet] [cited 2014 Nov 21]. ABS cat. no [Available from: Department of Health. Healthy Food Connect: A support resource [Internet] [updated 28 April 2014; cited 2014 Dec 15]. Available from: Food-Connect:-A-support-resource 12. Healthy Together Latrobe. Directions For Connections. Morwell: Healthy Together Latrobe: 2013 October 42p. 13. Department of Health. Healthy Together Victoria [Internet] [cited 2014 Nov 21]. Available from: Latrobe City Council. Snapshot of Our Region Morwell, Victoria 2012 [cited Oct]. Available from: Department of Health. Projected Estimated Resident Population: Latrobe Sep. Available from: 4.pdf 16. REMPLAN. SEIFA Index of Disadvantage (2011) n.d. Available from: McRae L. Most disadvantaged. Latrobe Valley Express [Internet] 2013, Apr 13 [cited 2014 Nov 18]. Available from: Palermo C, Wilson A. Development of a healthy food basket for Victoria. Australian and New Zealand journal of public health. 2007;31(4): Graham SR, Carlton C, Gaede D, Jamison B. The benefits of using geographic information systems as a community assessment tool. Public Health Reports. 2011;126(2): Food Access and Availability in Latrobe City

31 20. VicHealth. Food for All: How local government is improving access to nutritious food [Internet] [cited 2014 Nov 19]. Available from: eating/food for all/food_for_all_web_singlepages.ashx 21. Public Transport Victoria. Churchill - Boolarra via Yinnar (Route 4) [Internet] [cited 2014 Dec 15]. Available from: Rossimel A, Han SS, Larsen K, Palermo C. Access and affordability of nutritious food in metropolitan Melbourne. Nutrition & Dietetics Food Access and Availability in Latrobe City 27

32 Acknowledgments This report would not have been made possible without the unwavering support, assistance and enthusiasm from Julia McCartan, Food Systems Research Officer and placement supervisor at Healthy Together Latrobe/Latrobe City Council. Also a special thanks to Cheryl Morahan, GIS Support Officer at Latrobe City Council for her invaluable work and support in the GIS mapping required for this project. Thanks to Linda Davies and Fiona Peatey Administrative Technical Officers for the Health Services team, and Shannon Little, Business Development Officer at Latrobe City Council for providing data to assist in the development of the Latrobe City food outlet database. Thanks to Vinay Parankusham, Public Health Officer at the Department of Health for assistance identifying key demographic data for Latrobe City. Thanks to Pieta Bucello, Health Promotion Officer at Latrobe Community Health Service/Healthy Together Latrobe for her support throughout the project. 28 Food Access and Availability in Latrobe City

33 Appendices Appendix 1: Stores where VHFB surveys conducted in Latrobe City (Note only 28 stores participated in surveying) Store Name Address Town Postcode Foodworks 25 Boolarra Avenue Newborough 3825 Woolworths Moe Anzac Street Moe 3825 Coles Moe 92 Albert Street Moe 3825 IGA Moe Elizabeth Street Moe 3825 Mannys Market Moe Shop 9 Moe Plaza, Moore Street Moe 3825 Safeway MidValley Midvalley Shopping Cntr, Princes Hwy Morwell 3840 Coles Morwell 82 George Street Morwell 3840 Mannys Market Morwell Commercial Road Morwell 3840 Foodworks Morwell 61 Bridle Road Morwell 3840 Coles Midvalley Midvalley Shopping Cntr, Princes Hwy Morwell 3840 Traralgon South General Store 25 Keith Morgan Drive Traralgon South 3844 Boolarra Store 9 Tarwin Street Boolarra 3870 Ritchies Supa IGA 8 Georgina Pl Churchill 3842 Woolworths Churchill Cnr Balfour Pl & Monash Way Churchill 3842 IGA Glengarry Main Street Glengarry 3854 The Rail Trail Store Main Road Toongabbie 3856 United Petrol Station Main Road Tyers 3844 Yinnar General Store 44 Main Street Yinnar 3869 Foodworks 42 North Rd Yallourn North 3825 Foodworks Henry Street Cellars 63 Henry Street Traralgon 3844 Foodworks West End 211 Grey Street Traralgon 3844 Woolworths Seymour Street Traralgon 3844 Coles Stockland Plaza Franklin St Traralgon 3844 Foodworks Hyland Street Traralgon 3844 Mannys Market 39 Post Office Pl Traralgon 3844 Tripodi Brothers Deakin Street Traralgon 3844 McNairn Convenience Store 49 Tulloch Way Traralgon 3844 Cameron St Four Square Mini Mart 45 Cameron St Traralgon East 3844 Food Access and Availability in Latrobe City 29

34 Appendix 2: Mix of food outlets and retailers in Latrobe City by category Category Number of outlets Percentage of total number of outlets Supermarket 20 7% Greengrocer 4 1% Bakery Retailer 14 5% Delicatessen 3 1% Butcher & Poultry 15 5% Fishmonger 3 1% Cultural 2 1% Mixed Business 11 4% Petrol Station/Convenience Store 15 5% Café & Restaurant 82 29% Takeaway Foods 89 32% Aged Care/Hospital 3 1% Community Garden 9 3% Sporting Club/Kiosk 7 3% Other 2 1% Total number of outlets Food Access and Availability in Latrobe City

35 Appendix 3: Analysis of healthy food basket cost for a family of four (2 adults, 2 children) by area Note: all calculations are for a family of four (2 adults, 2 children). Area Township/s Average Median Minimum Maximum Standard Proportion of Code cost cost cost cost deviation Centrelink income (%) 1 Moe, Newborough $ $ $ $ $ % 2 Morwell $ $ $ $ $ % 3 Churchill, Boolarra, Yinnar, Yallourn North, Glengarry, Toongabbie, Tyers, Traralgon South 4 Traralgon, Traralgon East - Major Centres (area codes 1, 2 and 4) $ $ $ $ $ % $ $ $ $ $ % $ $ $ $ $ % - Latrobe City $ $ $ $ $ % Food Access and Availability in Latrobe City 31

36 Appendix 4: Box plot analysis of major centres versus satellite towns VHFB cost Town 1: Major Centres (area codes 1, 2, 4) Town 2: Satellite Towns (area code 3) Appendix 5: Average cost for supermarkets versus greengrocers for a healthy food basket for a family of four: fruit and vegetables only Category Average cost Median cost Standard Deviation Minimum cost Maximum cost Supermarket $ $ $12.23 $ $ Greengrocer $92.45 $92.65 $5.15 $86.00 $ Food Access and Availability in Latrobe City

37 Appendix 6: Box plot analysis of cost for supermarkets versus greengrocers for a healthy food basket for a family of four: fruit and vegetables only Storetype 1: Supermarkets Storetype 2: Greengrocers Food Access and Availability in Latrobe City 33

38 34 Food Access and Availability in Latrobe City