DRAFT Australian Dietary Guidelines - Eat For Health

The economic, social and cultural factors that influence health inequities also influence the ability
of an individual to choose nutritious foods consistent with dietary guidelines [14]. The ability of
parents and carers to make nutritious food choices is likely to affect their family’s nutrition status
too.
Factors associated with complying with dietary guidelines include being female, older age, higher
socioeconomic status, with higher education and having nutrition knowledge [43, 138, 858, 995-
1011].
Conversely, lower socioeconomic status and lower educational attainment are barriers to
complying with dietary guidelines, and lower socioeconomic groups perceive cost as a barrier to
healthy food purchase [43, 138, 858, 995-1011].
In a Melbourne study it was found that areas of greater socio-economic advantage had closer
access to supermarkets, whereas areas of less socio-economic advantage had closer access to fast
food outlets [137].
A greater understanding of the barriers to consuming a nutritious diet will help ensure that
appropriate messages, education and public health strategies are developed for groups who
experience a greater burden of diet-related disease. It was essential that the social determinants of
health and nutrition status were considered in the Guidelines so as to reduce the risk of adding to
health inequities, for example, by promoting consumption of expensive or hard to access foods.
A7.2 Social distribution of diet-related health
outcomes
In 2002–06 the death rate for people between 15 and 64 years was 70% higher in the lowest SES
group than the highest SES group [26]. These rates reflect the higher prevalence of type 2 diabetes
and cardiovascular disease among people living in the lowest SES group [12, 26].
Gradients in risk factor prevalence are also apparent across quintiles of social disadvantage as
defined by socio-economic indexes for areas (SEIFA). The SEIFA assesses the relative social
disadvantage of respondents by the economic resources, education and occupation patterns of
their area of residence [26]. Overweight and obesity rates are also highest among the lower SES
areas, although there was not a clear gradation across SEIFA quintiles [26]. Some of the factors
that contribute to the development of overweight are also related to equity, particularly the social,
cultural and economic barriers and enablers to healthy food choices (see Chapter 2). There is also
a social gradient in physical activity levels; self-reported ‘sedentary’ behaviour rises from 25% of
people in the highest SES areas to 44% in the lowest SES areas [26].
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