Improving economic access to healthy diets in first nations communities in high-income, colonised countries: a systematic scoping review

• Published in: Nutrition Journal
• Main Authors: Lee, Amanda J., Herron, Lisa-Maree, Rainow, Stephan, Wells, Lisa, Kenny, Ingrid, Kenny, Leon, Wells, Imogen, Kavanagh, Margaret, Bryce, Suzanne, Balmer, Liza
• Format: Text
• Language: English
• Published: BioMed Central 2024
• Subjects: Review; Canada; New Zealand; First Nations
• Online Access: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10790425/; http://www.ncbi.nlm.nih.gov/pubmed/38225569; https://doi.org/10.1186/s12937-023-00895-0

BACKGROUND: Affordability of healthy food is a key determinant of the diet-related health of First Nations Peoples. This systematic scoping review was commissioned by the Ngaanyatjarra Pitjantjatjara Yankunytjatjara Women’s Council (NPYWC) in Central Australia to identify interventions to improve economic access to healthy food in First Nations communities in selected high-income, colonised countries. METHODS: Eight databases and 22 websites were searched to identify studies of interventions and policies to improve economic access to healthy food in First Nations communities in Australia, Canada, the United States or New Zealand from 1996 to May 2022. Data from full text of articles meeting inclusion criteria were extracted to a spreadsheet. Results were collated by descriptive synthesis. Findings were examined with members of the NPYWC Anangu research team at a co-design workshop. RESULTS: Thirty-five publications met criteria for inclusion, mostly set in Australia (37%) or the US (31%). Interventions (n = 21) were broadly categorised as price discounts on healthy food sold in communities (n = 7); direct subsidies to retail stores, suppliers and producers (n = 2); free healthy food and/or food vouchers provided to community members (n = 7); increased financial support to community members (n = 1); and other government strategies (n = 4). Promising initiatives were: providing a box of food and vouchers for fresh produce; prescriptions for fresh produce; provision/promotion of subsidised healthy meals and snacks in community stores; direct funds transfer for food for children; offering discounted healthy foods from a mobile van; and programs increasing access to traditional foods. Providing subsidies directly to retail stores, suppliers and producers was least effective. Identified enablers of effective programs included community co-design and empowerment; optimal promotion of the program; and targeting a wide range of healthy foods, particularly traditional foods where possible. Common barriers in the least ...