Sue Booth

Hungry for change: the food banking industry in Australia

Purpose – Over the last 20 years, food banks in Australia have expanded nationwide and are a well-organised “industry” operating as a third tier of the emergency food relief system. The purpose of this paper is to overview the expansion and operation of food banks as an additional self-perpetuating “tier” in the response to hunger. Design/methodology/approach – This paper draws on secondary data sourced from the internet; as well as information provided by Foodbank Australia and Food Bank South Australia (known as Food Bank SA) to outline the history, development and operation of food banks. Food banking is then critically analysed by examining the nature and framing of the social problems and policies that food banking seeks to address. This critique challenges the dominant intellectual paradigm that focuses on solving problems; rather it questions how problem representation may imply certain understandings. Findings – The issue of food banks is framed as one of food re-distribution and feeding hungry pe...

Eating rough: food sources and acquisition practices of homeless young people in Adelaide, South Australia

OBJECTIVE The aim of this study was to determine the food sources and acquisition practices used by homeless youth in Adelaide. This work is part of a larger study that aimed to examine the extent and nature of food insecurity among homeless youth. DESIGN Cross-sectional design involving quantitative and qualitative methods. SETTING Four health and welfare inner-city agencies serving homeless youth in Adelaide, South Australia. SUBJECTS A sample of 150 homeless youth aged between 15 and 24 years recruited from these agencies. Fifteen were selected via snowball sampling for interview. RESULTS Use of welfare food sources was high (63%). Food from welfare agencies was supplemented by unorthodox food acquisition methods such as theft (65%), begging for money for food (61%), begging for food items (44%) and asking for help from friends and relatives (34%). Reasons given for non-usage of welfare food services included affordability, access, being too busy, shame or embarrassment. CONCLUSIONS Food insecurity is a salient issue for some homeless youth in Adelaide. Clarifying food acquisition practices of food-insecure homeless youth is essential for rational planning and improvement of food-related services to meet their needs. Such an understanding also underpins the development of broader public policy responses that improve individual and household skills and resources to acquire food and ensure food security. Nutrition professionals, welfare professionals and policy-makers need to work sensitively with welfare food agencies and others to improve food access and food security for homeless youth.

Cochrane update : Predicting sustainability of intervention effects in public health evidence: identifying key elements to provide guidance

Jillian Whelan1, Penelope Love1, Tahna Pettman1,2, Jodie Doyle2, Sue Booth1,3, Erin Smith1, Elizabeth Waters1,2 The CO-OPS Collaboration, WHO Collaborating Centre for Obesity Prevention, Population Health SRC, Deakin University, Geelong, Australia Cochrane Public Health Group, Jack Brockhoff Child Health and Wellbeing Program, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia Department of Public Health, Flinders University, Bedford Park, Australia Address correspondence to Jillian Whelan, E-mail: jill.whelan@deakin.edu.au

Improving access to community-based food systems: Comparing perspectives of low socioeconomic individuals and food system representatives

Evidence-based practice guidelines recommend routine malnutritionscreening of community living elderly, yet little is known about screen-ing practice. Therefore, the aim of this observational study was toinvestigate malnutrition screening practice of Australian dietitiansworking in community settings. A cross-sectional online survey withboth closed and open-ended questions was adapted to investigatecurrent practice, and barriers and enablers to malnutrition screening. Atotal of 133 dietitians completed the survey, with open-ended responsesreceived from 92 of those individuals. The majority of data were ana-lysed descriptively, with content analysis of open-ended responses toestablish the key barriers and enablers. Malnutrition screening occurswithin most organisations (77%) and was highest within governmentorganisations. The majority (75%) reported a malnutrition screeningtool was used; the most common was the Malnutrition Screening Tool (n= 52) followed by the Mini Nutritional Assessment short-form (n = 27).Efusal for nutritional assessment after positive screening was reportedby 66% of survey respondents. Dietitians identified policy and proce-dures related to screening and the provision of training and education tostaff as the strongest enablers. Insufficient time to screen and lack ofknowledge about malnutrition emerged as the strongest barriers.Overall screening practice is largely inconsistent and refusal for nutri-tional assessment after positive screening was common as reported by66% of survey respondents. This suggests a deeper understandingregarding malnutrition screening from the perspective of the elderly isneeded. Identifying and addressing disparities between practice andperception may ultimately reduce the prevalence of malnutrition riskamong community living elderly.

Improving Access to Community-Based Food Systems in Adelaide, South Australia: Strategies to Encourage Low-Socioeconomic Status Groups to Participate

The benefits of community-based food systems (CFSs) are well documented; however, evidence suggests limited access for socioeconomically disadvantaged people. Focus groups with low-socioeconomic status (SES) individuals explored enablers and barriers to using CFSs and potential modifications to enhance their participation. Participants believed that CFSs must improve their affordability and convenience and provide more information to enhance access by low-SES groups. Participant-generated strategies addressed each of these issues. CFSs will likely require a suite of strategies to attract low-SES patrons; however, these must be compatible with other goals integral to CFSs to ensure their sustainability.

Are low-to-middle-income households experiencing food insecurity in Victoria, Australia? An examination of the Victorian Population Health Survey, 2006?2009.

Food insecurity affects health and wellbeing. Little is known about the relationship between food insecurity across income levels. This study aims to investigate the prevalence and frequency of food insecurity in low-to-middle-income Victorian households over time and identify factors associated with food insecurity in these households. Prevalence and frequency of food insecurity was analysed across household income levels using data from the cross-sectional 2006-09 Victorian Population Health Surveys (VPHS). Respondents were categorised as food insecure, if in the last 12 months they had run out of food and were unable to afford to buy more. Multivariable logistic regression was used to describe factors associated with food insecurity in low-to-middle-income households (A

A snapshot of the scope of obesity prevention practice in Australia

40000-

Quantitative analysis of bariatric procedure trends 2001–13 in South Australia: implications for equity in access and public healthcare expenditure

80000 in 2008). Between 4.9 and 5.5% for total survey populations and 3.9-4.8% in low-to-middle-income respondents were food insecure. Food insecurity was associated with limited help from friends, home ownership status, inability to raise money in an emergency and cost of some foods. Food insecurity exists in households beyond those on a very low income. Understanding the extent and implications of household food insecurity across all income groups in Australia will inform effective and appropriate public health responses.

Bariatric surgery revisions and private health insurance

Community-based initiatives (CBIs) that build capacity and promote healthy environments hold promise for preventing obesity and non-communicable disease, however their characteristics remain poorly understood and lessons are learned in isolation. This limits understanding of likely effectiveness of CBIs; the potential for actively supporting practice; and the translation of community-based knowledge into policy. Building on an initial survey (2010), an online survey was launched (2013) with the aim to describe the reach and characteristics of Australian CBIs and identify and evaluate elements known to contribute to best practice, effectiveness and sustainability. Responses from 104 CBIs were received in 2013. Geographic location generally reflected population density in Australia. Duration of CBIs was short-term (median 3 years; range 0.2–21.0 years), delivered mostly by health departments and local governments. Median annual funding had more than doubled since the 2010 survey, but average staffing had not increased. CBIs used at least two strategy types, with a preference for individual behaviour change strategies. Targeting children was less common (31%) compared with the 2010 survey (57%). Logic models and theory were used in planning, but there was low use of research evidence and existing prevention frameworks. Nearly, all CBIs had an evaluation component (12% of budget), but dissemination was limited. This survey provides information on the scope and varied quality of the current obesity prevention investment in Australia. To boost the quality and effectiveness of CBIs, further support systems may be required to ensure that organizations adopt upstream, evidence-informed approaches; and integrate CBIs into systems, policies and environments.

‘Big Food’—The Industrial Food System

OBJECTIVES The aims of the present study were to: (1) identify trends in bariatric surgery in South Australia (SA) from 2001 to 2013; and (2) compare public and private hospitals, and so discuss the implications of these trends as they relate to equity in access to bariatric procedures and public system healthcare expenditure. METHODS An analysis of retrospective data of all bariatric procedures in public and private hospitals in SA was conducted using all SA public and private hospital administrative records between 2001 and 2013. RESULTS Of all procedures conducted in SA, 22.6% were revisions or reversals. The number of revisions or reversals conducted in SA has increased at a rate higher than weight loss procedures (6.4- vs 3.8-fold increase). An increasing proportion of public surgeries are revisions or reversals of weight loss procedures that occurred outside of the SA public system (interstate or in the private system). CONCLUSION Further investigation is necessary to identify the pathways patients navigate to access bariatric surgery, the utilisation of public services following private procedures and why rates of revisions or reversals of bariatric procedures are increasing in SA.