Australia is generally considered a food secure nation. The current COVID-19 pandemic has highlighted that national food consumption needs are more than amply supplied through domestic agriculture production with Australia exporting far more food (70%) than it needs. Despite an apparent abundance of food production within Australia, there are still segments within the community who struggle to consistently access safe, affordable and nutritious food.
A recent study into rural health equity in the small remote district of The Gemfields revealed that food insecurity was commonplace for many residents. The Gemfields is a small geographically remote community in Central Queensland located approximately 350 km west of Rockhampton. The resident population is predominantly white, older Australians (50+) with complex health needs, the majority of whom experience age-related decline or live with a disability.
The researcher conducted 45 face-to-face interviews with local residents, health workers and outreach service providers to explore their views about health equity issues in The Gemfields. This research identified five key factors that contributed to food insecurity for people living in this remote community – limited transport, geographic isolation, lack of refrigeration, poor knowledge about nutrition, and cost.
A lack of transport options was a persistent barrier for people to access food in the study area. The study identified that there was no public transport in The Gemfields and a large cohort of residents (21%) either had no motor vehicle or struggled to pay for fuel if they did have access to a car. As one research participant noted, “for a lot of people getting food without a car is problematic; they don't have transport so they can only carry the food that's in the bag that they get from the shop”.
Another interviewee reported community members using the high school bus to travel to Emerald, the nearest regional centre 50 km away, to do their shopping but then they have to stay in town all day until they can catch the bus back when school finishes. “They can't buy like frozen food because it's thawed out by the time they get back home at half past four in the afternoon,” another study participant said.
Safe food storage was also problematic in the Gemfields and was a contributing factor of poor food security. Many residents live in temporary or makeshift dwellings such as caravans, tin shacks, decommissioned buses or humpies and are not connected to the main power grid. Study participants said residents used solar power but they did not have a fridge and could not freeze anything. Consequently, a diet comprising mainly of tinned food was a common phenomenon.
The study found there was a lack of awareness about the importance of eating a nutritious balanced diet and the need to buy fresh fruit and vegetables. One health worker reported visiting a client who did not cook, had no fridge and was living on chips and dips. Another study participant anecdotally recounted that “half the people out here wouldn't know what an orange was”. Further compounding a general lack of knowledge about nutrition was economic disadvantage - buying fresh, nutritious food was viewed as expensive and a luxury.
The real-life consequence of food insecurity in the remote study area was malnutrition and poor health outcomes. In the ominous words of one health worker, “I have to say, the most disturbing thing I’ve seen was an elderly gentleman who was so malnourished, filthy dirty and dying in front of us”.
The study concluded that greater action at the local community level was required to tackle the identified socio-economic determinants of health that impede food security in rural and remote communities.
Lisa Caffery is a rural health PhD candidate based in Emerald, Central Queensland. Under the supervision of Olav Muurlink and Andrew Taylor-Robinson (Central Queensland University), Lisa’s research focus is on health equality in the remote Central Queensland district known as The Gemfields. Her research interests are driven by innate curiosity and by the ambition to make a connection between research and practice. She is particularly interested in understanding what the trade-offs are between living in a rural and remote community and having limited access to local health care services. The results from Lisa’s PhD research intend to inform the development of a new health equity assessment tool for small rural towns. With a professional background in community engagement and social impact, Lisa also holds several company director roles and is currently a board member on the Central Queensland Hospital and Health Service. When not researching, you’ll most likely find Lisa at home with her two boys and husband or outside enjoying the Queensland sunshine on her mountain bike.