Food Security Review Paper 2018 Part A

Primary Author: Meg Montague - Social Policy, Research & Facilitation Services
Subject Expert Review: Nourish Food Fairness Network Outer East

Food security is defined here as having a sustainable food system that ensures access for all to nutritionally adequate, affordable, culturally acceptable and safe food. It encompasses the issues of:

• Sustainability
• Accessibility
• Affordability
• Cultural appropriateness
• Nutritionally adequacy
• Food safety

Sustainability incorporates the idea that the supply of and access to food is ongoing, regular and enduring. Emergency food distribution can meet a crisis situation where adequate food is not available because of community or family events (such as fire, flood or drought situations, or personal accident, loss of employment or income). But a sustainable and secure food supply is one that provides healthy food to meet the on-going food needs of all parts of the community while at the same time maintaining healthy ecosystems that can provide food for current and future generations with minimal negative impact on the environment.

Thinking about a sustainable food system brings into focus a number of food supply issues. Some areas have worked to improve local supply by supporting meals on wheels or café meals for older or disabled people, mobile food vans or pop ups, famers or local markets, food co-ops or bulk buying programs, farm to fork initiatives, by fostering urban agriculture, by educating people on how to grow food in their backyard or community gardens, how to preserve food in times of plenty and how to reduce food waste. In other areas, local organisations have worked on ways and co-ordinating and improving food rescue and re-distribution mechanisms.

At the regional level where food producers and urban food consumers co-exist, food supply initiatives have included working to limit urban growth and to retain agricultural land, building new channels of distribution to ensure the viability of food producers, adopting local food procurement policies, shortening distribution networks and delivering fresh local food at lower prices, and building links between residents and producers to increase access and reduce price.

Accessibility is a term used to describe the factors that can inhibit people’s capacity to find, purchase and acquire the food they need: food outlets need to stock affordable, nutritionally adequate and culturally appropriate food. Outlets need to be close to where people live or work, and easy for people to get to. People need the means to travel to the food outlets and to carry the food home: location, physical capacity and appropriate transport to travel to these food outlets are all critical to accessibility.

Affordability means that can people afford to buy nutritionally adequate and culturally appropriate food locally or to be able to acquire such food on a regular basis. There are two aspects to affordability: the cost of accessible, nutritionally adequate and culturally appropriate food and the disposable income that people have to spend on food. Thus while cheap fresh food may be available at a market 10 kilometres from where someone lives, they cannot purchase this if they do not have personal transport and there is little or no public transport to the market. On the other hand, access issues may be minimal but income to purchase food limited. Food relief agencies are reporting an increase in demand from working families where their income can barely meet housing, utilities and transport costs and there is insufficient to buy adequate food.

Cultural appropriateness means that nutritionally adequate food is available and affordable that supports the health of people from culturally diverse backgrounds and enables them to retain traditional eating and cooking traditions, for example access to kosher or halal food, or to local shops that supply familiar types of grains, bread, fruits and vegetables with which to prepare traditional meals.

Nutritional adequacy means that food that supports health and wellbeing is accessible, affordable and culturally appropriate. The concept of nutritional adequacy also incorporates issues associated with individual and household capacity to acquire, prepare and consume food that supports their health and wellbeing. Many factors affect this: lack of skills, education or cultural understanding of what foods are nutritionally adequate, limited knowledge of how to plan or prepare a healthy meal, limited household resources to store or cook food (for example people living on the street, in boarding houses or caravans) and impaired capacity through ill health, addiction, or mental impairment. This area has seen a good deal of focus by the health and community sectors where the emphasis has been on informing and educating people on how to adopt and maintain a healthy and nutritional diet. Work here has included the development of resources and education programs for people at risk of food insecurity in areas such as meal planning, shopping, meal preparation, feeding children, maintaining a healthy family diet, avoiding obesity and overweight, catering on a low income and learning how to save and to budget.

Food safety means that food handling, transportation, food preparation and food storage facilities and practices are adequate to ensure the food is not contaminated and does not threaten people’s health. We tend to think of food safety in terms of commercial activity, but the safety of food in the domestic situation is also important. If people do not have the resources to buy a refrigerator, or they live in a setting where there is limited food storage space, or they do not know about the risks of food contamination then their food may be not be safe to consume.

Food Security Environment

Food insecurity at the global level can refer to a breakdown in the food supply system because of extreme climate events, industrial action, oil shortages, and drought leading to lower production levels, and so on. It may also occur because of environmental degradation, economic imbalances, climate change, war or insurgency.

Food insecurity at the national and state level may also occur because the food supply chain has broken down or been disrupted by similar environmental issues, but it has also been noted that food insecurity is likely to increase under the influence of certain factors such as urban growth and the alienation of food producing land, agribusiness and supermarket trends, production and transport costs, food pricing etc.

Certain communities may experience high levels of food insecurity because of a variety of economic and social factors, for example communities in remote parts of Australia are reported to experience high levels of food insecurity under the influence of their remote location, their limited options regarding food growing and food purchase, the high transport costs, poor storage facilities, high unemployment and low income circumstances of the residents. In cities, some communities are described as food insecure and this is usually associated with high unemployment rates, lower incomes, and low car ownership rates, local food outlets being of the convenience or fast food type rather than fresh food and public transport being limited.

At the individual or household level, food insecurity refers to when people do not have regular access to the food they need for a healthy life. The experience of food insecurity can refer to periods of food shortage, feeling anxious about where the next meal is coming from, eating a poor quality diet as a result of poor food options, or to more extreme situations including feelings of hunger, running out of food and not being able to afford more and having to rely on emergency relief services or other coping mechanisms.

Strategic & Legislative Context

National Policy Context

The National Food Plan was Australia’s first ‘whole of government’ food plan, intended to bring together all aspects of the federal government’s food-related policy. Its development was announced in 2010 by the Gillard Government and the Plan was released in May 2013. The aim was to ensure that “Australia will have built on its high level of food security by continuing to improve access to safe and nutritious food for those living in remote communities or struggling with disadvantage. The National Food Plan website was archived in July 2013; however, the discussion and consultation papers remain.

Victorian Policy Context

Public health

Despite many calls from public health advocates for the Victorian state government to adopt a state food plan or food policy or to focus specifically on food security issues and thus provide leadership and a policy framework for on-going work, this has not yet been achieved. There are however a number of plans and strategies that touch on aspects of the food security scenario, but the policy settings around food have never really been brought together. Food security is discussed largely in the context of food production; food safety as a health issue in food retail; healthy eating and physical activity as obesity and chronic disease prevention strategies, food waste as recycling, and urban development as about housing and transport infrastructure.

Victorian Public Health and Wellbeing Plan

For those working in the public health sector, Victoria’s strategic framework has been largely in the form of the Victorian Public Health and Wellbeing Act 2008 which requires the Minister for Health to prepare a State Public Health and Wellbeing Plan every four years. In September 2015 the Victorian Public Health and Wellbeing Plan 2015-2019 (VPHWP 2015-19) was released by the Minster for Health. This plan articulates the Government’s 6 priority areas to improve the health and wellbeing of all Victorians, the first priority being “healthier eating and active living”.

The plan is divided into 3 sections:

• Part A: Understanding Health and Wellbeing
• Part B: Strategic Direction
• Part C: Accountability

In Part A, it is stated: “Food security is likely to deteriorate for some, given the projected global population growth, existing and emerging food production constraints, changing consumption patterns, interruptions to sustainable agriculture production and water supplies and the anticipated impact of climate change.”(Page 21).

In Part B, two strategic directions relevant to healthier eating exist (Page 31):

• “Promote consumption of healthy, sustainable and safe food consistent with the Australian dietary guidelines.
• Support healthy food choices to be the easier choices for all Victorians by working across the entire food system.”

In October 2016 the Victorian Public Health and Wellbeing Outcomes Framework was produced. This was designed to support monitoring and reporting progress towards achieving the health and wellbeing outcomes and their determinants. The framework identifies 5 domains, a number of outcomes and a set of indicators. An accompanying document, The Data Dictionary, exists to provide the detailed technical specifications for the identified measures in the framework.

Since 2012, both community health and primary care partnerships have been required to develop strategic plans with reference to the Victorian public health priorities and on the same cycle as local government health and well-being plans.

Victorian governments have tended to invest in education and awareness raising programs around nutrition, healthy eating and physical activity. Until 2010 the government program was badged as Go-for your life and Kids Go for your life. A new program was devised after the change of government and the Victorian Healthy Eating Enterprise (VHEE) was launched in 2011. The website states this was designed as a “whole of community approach and focuses on workplaces, schools, early childhood services and health services”. The VHEE was a combination of statewide and local initiatives trialled in 12 local government areas as a part of the broader framework Healthy Together Victoria. Healthy Together Communities. A number of documents were launched as part of the VHEE including:

• The Healthy Food Charter: creating a vibrant healthy eating culture
• For hospitals (retail outlets and staff catering) and other workplaces: Healthy choices: food and drink guidelines for Victorian public hospitals
• For hospitals (inpatient menus) and residential aged care facilities: Department of Human Services Nutrition standards for menu items in Victorian hospitals and residential aged care facilities
• For licensed children’s services: Get up & grow: healthy eating and physical activity for early childhood
• For primary and secondary schools: Department of Education and Early Childhood Development School canteens and other school food services policy and food planner.

The state government established The Centre of Excellence in Intervention and Prevention Science (CEIPS) as a public health research organisation designed to strengthen the preventive health effort in Victoria. An evaluation of the Healthy Together Program was funded and implemented; however few results have been released to date.

Aboriginal Health

Koolin Balit is a statement of the Victorian Government's strategic directions for Aboriginal health to 2022 and was launched by the then Minister for Health in May 2012. Koolin Balit: Victorian Government Strategic Directions for Aboriginal Health 2012–2022 has the stated objectives of:

• closing the gap in life expectancy for Aboriginal people living in Victoria
• reducing the differences in infant mortality rates, morbidity and low birthweights between the general population and Aboriginal people
• improving access to services and outcomes for Aboriginal people.

Clearly food is an important component of the six key priorities of:

• a healthy start to life
• a healthy childhood
• a healthy transition to adulthood
• caring for older people
• addressing risk factors
• managing illness better with effective health services.

Urban planning

The Victorian Planning and Environment Act 1987 and Planning and Environment Amendment Act 2013 provide the framework for local government to deliver urban infrastructure and within which each LGA is required to develop a Municipal Strategic Statement (MSS). The role of the MSS is to provide a statement of the key strategic planning, land use and development objectives for the municipality and the strategies and actions for achieving them.

Plan Melbourne 2015-2050 was released in 2014 and is the Victorian Government’s long term integrated transport and planning strategy for metropolitan Melbourne until 2050. Plan Melbourne provides a long-term vision for land use, infrastructure and transport planning for the Victorian population, transport and housing needs in the future. It is an integrated land use and transport strategy providing spatial representation on the growth pressures of congestion, housing requirements, accessibility to jobs and services, mitigation of climate change by protecting natural assets and land encroachment of rural settlements.

Non-Government Policy & Innovation

The Food Alliance (now Sustain: The Australian Food Network) was founded in 2009 as a direct outcome of years of dedicated food security advocacy and research by community-based individuals and organisations, working in combination with the leadership and support of the Victorian Foundation for Health Promotion (VicHealth) and the findings of Food For All a food security program funded by VicHealth that noted that there were challenges at the local government level in tackling broad based state and national issues beyond the capacity of local government.

The Food Alliance was modelled on the Food Policy Council development in North America, which were created as multi-stakeholder ‘whole of food system’ governance bodies to address the food system as a whole. In other words, instead of many advocates working on the isolated symptoms of a failing food system, Food Policy councils aim to establish and implement platforms for coordinated and strategic actions and interventions.

In the first phase of its life (2009-2012) the Food Alliance worked within Deakin University primarily as a ‘food think tank’, conducting research into strategic issues such as planning and food access, and making submissions on food-related government policy development. With the awarding in 2013 of the Victorian Food Systems Network project, the Food Alliance entered a new phase, where it builds partnerships and relationships to identify strategic project opportunities for food system change. This is reflected through the creation of the Urban Agriculture and Healthy Food Systems Working Groups, an initiative to create for the first time an Urban Agriculture Charter and Network for Victoria, and practical interventions, such as Know Your Food Bowl and Farm-to-School.

The Australian Food Sovereignty Alliance was established in 2010 as an advocacy and social networking body seeking to influence the growth of a fair food system around Australia.

The Victorian Eco-Innovation Lab (VEIL) is a research/think tank sponsored by the Melbourne School of Design, the Faculty of Architecture, Building and Planning at the University of Melbourne that has played an important role in stimulating debate around sustainable agriculture and its role in supporting food security. VEIL’s work has included action research around the development of a regional ‘Food Hub’ on the peri-urban fringe of southeast Melbourne with the dual aims of providing better market access and fair returns to farmers, hence strengthening long-term local supply; and making fresh food accessible and affordable to local people.

VEIL has also made an input to the development of a Regional Food Plan for the Melbourne Regional Development Australia and has supported thinking around the development of a creative food economy in southern Melbourne. Of particular interest in the EMR is VEIL’s mapping of Melbourne’s peri-urban agricultural land capability. This work focuses on methods used to map and classify land within the peri-urban areas of: Nillumbik Shire, City of Casey, Mornington Peninsula Shire and parts of the Cardinia and Yarra Ranges Shires. The full report is yet to be published however the preliminary evaluation Mapping Melbourne for land capability is available.

The Victorian Health Promotion Foundation (VicHealth) has long been acting in the food security space with a specific focus on practical and policy action at the local government level. The first food security project was funded in the Cities of Yarra and Maribyrnong in 2000, followed by the five year VicHealth's Food For All program in nine municipalities from 2005-2010. A number of publications are available that document these initiatives and support local government to take action.

The National Heart Foundation (NHF) has worked with VEIL and VicHealth to create Food-sensitive planning and urban design: A conceptual framework for achieving a sustainable and healthy food system (FSPUD). FSPUD is an approach to planning and urban design that considers the intersection between public health, planning and urban design, and environmental sustainability. This approach is based on the belief that the way we design our environments either deters or supports people to meet their needs. FSPUD looks at how to create places that make it easy for people to access healthy and sustainable food in urban environments. FSPUD principles outline the approaches and interventions required to shift to a more sustainable and resilient food system and ensure people can meet their food needs into the future.

The Victorian Local Governance Association (VLGA) is a peak body in local government. It was also an active player in the food security space in the first 10 years of the century and was funded by VicHealth to be a clearing house for resources around food security during the Food For All years. Whilst the VLGA appears not to be as active currently there are still a number of useful publications available through their library, for example the 2009 work Integrating Land Use Planning and Community Food Security: A new agenda for government to deliver on sustainability, economic growth and social justice. This was a joint publication by the VLGA and the Community Planning and Development Program La Trobe University, Bendigo Campus.

Community Indicators Victoria (CIV) is a VicHealth funded project aimed at increasing the capacity of local government practitioners to make evidence informed decisions. It does this by providing a free online repository of community health and wellbeing indicators and advisory services on how to use evidence in community planning. This framework, initiated and peer reviewed in 2006 and again in 2012, adopts a social determinants of health approach and consists of five main policy domains which categorise more than eighty health and wellbeing indicators. These indicators serve as measures of progress and provide a method of tracking health and wellbeing issues over time. Another key objective is to provide evidence on how communities are faring at a local, regional and state level using data maps and customised Community Wellbeing profiles.

Local Policy Context

A number of mandatory plans at the local level (government, community health and primary care partnerships) have increasingly provided a framework within which policy and planning around food security, food access, healthy eating and closely related issues are articulated. Plans mandated by the state government include:

• Local government Council Plans (sometimes called City Plans), Municipal Strategic Statements and Municipal Public Health and Wellbeing Plans. All of these are required to be revised every 4 years in line with Council elections. The latest iteration is 2013- 2017 and these can be found on each Council’s website.
• Community Health strategic plans including the Integrated Health Promotion Plans: these too are revised every four years and on the same cycle as the above local government plans.
• Primary Care Partnership strategic plans are also in line with the four year local government cycle.

Local government also develops a range of other non-mandated plans, policies, strategies and guidelines which may have relevance to or make mention of food related issues. These vary widely and include:

• Food policy or food security policies/plans for example:
• City of Casey: Food Security Policy
• City of Darebin: Food Security Policy
• Hobsons Bay City Council: Improving Access to Food in Hobson Bay (Food Security) Policy Statement
• City of Maribyrnong: Food Security Policy
• City of Melbourne: Food Policy.

• Background papers, (research, discussion, community consultations and issues papers) around food security and food access have also been done by a number of other municipalities for example Banyule, Ballarat, Frankston, Greater Bendigo, Greater Geelong, Hobsons Bay, Moreland, Mornington Peninsular and Wodonga. These can all be found on the relevant council websites.
• Plans and guidelines affecting the use of open space such as urban agriculture or urban food production strategies, nature strip planting guidelines, community garden guidelines, (Darebin, Moreland, Yarra etc).
• Sustainability or environment plans.
• Plans with a focus on specific population groups such as Indigenous Australians, people living with a disability, older people, youth and family services, children, people from culturally and linguistically diverse backgrounds.
• Business or economic development plans, structure plans for the planning of specific areas.

Impacts & Outcomes

The experience of food insecurity has a high cost to individuals, families and to the community as a whole in terms of reduced physical, mental and social health and wellbeing and the cumulative effect of such inequality and disadvantage. Overall food insecurity has been linked both as cause and effect in relation to low social capital in terms of the individuals and the communities within which they live.

Impact on Physical Health

Access to sufficient quality and quantities of food is essential for healthy eating, which in turn is a key building block to good health. Burden of disease data show that preventable diseases which can be affected by diet such as heart disease, stroke, type 2 diabetes and cancer rank within the top ten causes of death in Knox, Maroondah and Yarra Ranges. Paradoxically, food insecurity is also associated with higher rates of overweight and obesity. If the food supply is unpredictable, inaccessible and/or of poor quality, people tend to over-consume cheap or free foods when available, thus increasing the risk of obesity.

Impact on Mental Health & Wellbeing

Short term and chronic long term food insecurity can also have an impact on people’s mental health and wellbeing. One of the immediate issues arising from poor food access is anxiety about not having enough food to feed themselves or their family, and depression at not being able to afford a healthy diet for family and children. Inability to feed oneself and one’s family can also contribute to a sense of powerlessness that not only affects mental wellbeing, but also affects the capacity of a person to change their circumstances, to take more control of their own health and welfare, and to adopt new skills.

Understanding is growing of the negative effects of the absence of a varied diet including fresh fruit and vegetables on behaviour, concentration and demeanour in children and young adults and mental impairment in older people. For example children from low income families receiving regular breakfast at school are reported as presenting fewer behavioural challenges in the class room, having greater capacity to concentrate as well as improved school attendance (Byrne & Anderson 2014).

Impact on Social Inclusion & Life Chances

Healthy eating is more than just eating nutritious food. It is also about the cultural and social significance of sharing food where for many food is a focus for social interactions with family and friends. Research shows that people who experience food insecurity are more likely to feel excluded from society, powerless and socially isolated (McGlone et al, 1999). In addition, evidence is mounting of the impact of food insecurity in children. The provision of breakfast program to students in disadvantaged schools is reported to have a positive impact not only on behaviour, but also on school attendance, punctuality and on educational achievement.

Impact on the Environment

What we eat not only affects our health and wellbeing, but also has major environmental implications with how it is produced, distributed, processed, sold, prepared and disposed of. In a report by Watermark Australia (2007), it was found that our food choices could make a bigger difference to household sustainability than direct water and energy use with 50% of Australian urban household’s water use being estimated to be through their food compared to 11% directly in showers, gardening and cleaning.

In Victoria, 47% of municipal waste sent to landfill is food and green waste (EcoRecycle 2005). This has immediate environmental impacts (release of methane as it decomposes). It is also a wasted resource. Overall, 23% of Australian emissions come from the food system (Garnaut 2007). In addition, greenhouse gas emissions from car-based shopping can be greater than the transport emissions from production and distribution phases. Ideally, there is a need to encourage change in how people access food (i.e. through walking and public transport) to ensure that increased local food purchase does not require extra car trips (Foster, C. et al. Environmental impacts of food production and consumption: A report to the department for environment, food and rural affairs, Manchester Business School, DEFRA, London, 2006).

Impact on the Urban Form

Again the question of chicken or egg arises in terms of whether food insecurity is affected by or affects the urban form. Research consistently shows that residential areas termed “food deserts” (i.e. more than a certain distance from fresh food outlets) tend to have poorer public transport, lower per capita income, and more convenience or fast food outlets. All the aspects of limited urban infrastructure seem to cluster in areas where people are food insecure.

Prevalence

Food Security in Australia

In Australia, data on food security have generally been collected via the question “In the last 12 months, were there any times that you ran out of food and you couldn’t afford to buy more?” This question was first asked in the last (1995) National Nutrition Survey of adults 16 years of age and over and at that time the estimated national food insecurity frequency was reported as 5% of adults across Australia. This rose to 8.9% of adults in the areas of most disadvantage (Wood et al 2000a), 12.8% of adults living on a low income and reporting fair or poor health, and 16.5% of persons on a low income who were aged 16-24 years (Wood et al 2000b).

The latest national data come from the Australian Bureau of Statistics (ABS) Australian Healthy Survey 2011-12. This Survey reports that nationally in 20011/12, 4.0% of people lived in a household that, in the previous 12 months, had run out of food and could not afford to buy more, and that 1.5% of all Australians live in a household where someone went without food when they couldn't afford to buy any more. It is also reported that nationally, more than one in five (22%) Aboriginal and Torres Strait Islander people are living in a household where someone went without food when the household ran out of food compared with less than one in twenty (3.7%) in the non-Indigenous population. Aboriginal and Torres Strait Islander people living in remote areas are more likely than those in non-remote areas to be living in a household that had run out of food and couldn’t afford to buy more (31% compared with 20%).

Food Security in Victoria

This same Australian Health Survey reports that in 2011/12 around 3.7% of people in Victoria were living in a household that, in the previous 12 months, had run out of food and had not been able to afford to buy more and 1% went without food when they couldn’t afford to buy any more.

The Victorian Population Health Survey (VPHS) first incorporated the food security question in 2008 and again in 2011 and reports slightly higher levels of food insecurity. In 2008, the VPHS noted that 5.6% of Victoria’s population reported running out of food in the previous 12 months and not being able to afford to buy more. The 2011 survey figure was lower at 4.6% of Victorian adults. Over the two surveys, women consistently reported a higher incidence of food insecurity compared to men, and younger people as compared to older people.

Table 1: Ran out of food in the previous 12 months, Victoria, 2008-09 and 2011–12 by gender and age

Sources: VPHS 2008-9 page 339 VPHS 2011-2012 page 515

Determinants & Risk Factors

Determinants of Food Security

The determinants of food insecurity are the broader societal factors which shape the way in which risk factors interact to result in community, household and individual food insecurity. In a wealthy developed country like Australia these determinants reside in three environments; the economic, the physical and the socio-cultural. In a developing country we could probably include the natural environment as a determinant where severe climatic conditions such as drought, soil degradation or desertification become important factors in food insecurity.

• The economic determinant: the unequal distribution of income and resources that results in significant numbers of people living in poverty with insufficient income and resources to cover their day to day expenses including housing, utilities, transport and the purchase of appropriate food.

• The physical determinant: the planning and development of our towns and cities (and rural and remote areas) that result in the growth of suburbs or communities which have unequal access to appropriate infrastructure such as fresh food outlets, affordable housing, and public transport.

• The social-cultural determinant: the social, economic and physical disadvantages that people experience when they are frail and elderly, or culturally different, or physically or mentally unwell and the way these disadvantages intersect to impair their capacity to access and afford culturally appropriate and nutritionally adequate food.

• The natural environment determinant: the alienation and degradation of food producing land as a result of urban growth and climate change. The growth of cities and towns combined with the impact of higher temperatures and lower rainfall can result in the reduction of food producing areas close to major population centres, and numerous challenges for those involved in the production and distribution of food, (higher costs, lower productivity, diminished returns, longer supply networks etc) and also those at the end of the food supply chain who then have to absorb the additional costs.

These determinants can be described as structural or societal factors that underpin the existence of food insecurity in Australia i.e. they are fundamental aspects of our society that are generally not within the capacity of the individual to modify or even of local level agencies; they require system or structural change.

Risk Factors for Food Security

Within this framework, each of these determinants can be described as intersecting with a number of associated risk (and protective) factors that enhance (or diminish) the likely impact of the determinants. These risk factors can be described as “modifiable” and their impact can potentially be tackled at the community, household and individual level.

The risk factors are closely related to one another and can also be considered within the economic, physical and socio-cultural framework.

Economic risk factors include:

• Low income due to reliance on social security, low wage and /or insecure jobs and high levels of unemployment.

• High living expenses for example, food prices, rents and housing affordability, petrol costs, mortgage rates, utility bills and other fixed costs making a demand on income.

• Living in single income and sole person or sole parent headed households especially as a woman. These household structures are associated with living on a low income, finding secure accommodation difficult to afford and challenges in making a limited budget stretch to cover all necessary expenses.

• Limited financial skills combined with low income.

Physical environment risk factors include:

• Living with housing stress; this includes living in insecure, unstable housing, or housing that is unaffordable for the individual or family or living rough or in temporary housing such as boarding houses, crisis accommodation services, refuges etc.

• Living in areas where there are few local fresh food outlets and limited public transport.

• Living in households or housing types which have limited facilities for cooking, refrigeration, storage etc.

• Lack of personal transport and low levels of car ownership.

Socio–cultural risk factors include:

• Low proficiency in English, particularly among newly arrived migrants and refugees.

• Cultural requirements (for specific food items, financial obligations to others).

• Living with a chronic disease or disability, or an alcohol or drug dependency, or mental illness.

• Lack of knowledge and skills in relation to nutrition, food shopping, meal planning, food preparation and cooking and for recent arrivals lack of knowledge of Australian food and how to prepare it. The umbrella term “food literacy” is sometimes used to cover these factors.

• Low levels of education and potentially low levels of literacy and numeracy.

• Isolation and lack of social networks.

Natural risk factors can include:

• Lack of capacity to produce food locally.

Paper continues in Part B