Mapping the availability and accessibility of healthy food in rural and urban New Zealand : Te Wai o Rona : Diabetes Prevention Strategy

Objective Uptake of advice for lifestyle change for obesity and diabetes prevention requires access to affordable healthy foods (high in fibre/low in sugar and fat). The present study aimed to examine the availability and accessibility of healthy foods in rural and urban New Zealand. Design We identified and visited (mapped) 1230 food outlets (473 urban, 757 rural) across the Waikato/Lakes areas (162 census areas within twelve regions) in New Zealand, where the Te Wai O Rona: Diabetes Prevention Strategy was underway. At each site, we assessed the availability of healthy foods (e.g. wholemeal bread) and compared their cost with those of comparable regular foods (e.g. white bread).Results Healthy foods were generally more available in urban than rural areas. In both urban and rural areas, healthy foods were more expensive than regular foods after adjusting for the population and income level of each area. For instance, there was an increasing price difference across bread, meat, poultry, with the highest difference for sugar substitutes. The weekly family cost of a healthy food basket (without sugar) was 291 % more expensive than the regular basket ($NZ 17672 v. $NZ 13684). The difference between the healthy and regular basket was greater in urban ($NZ 4918) than rural areas ($NZ 3627) in adjusted analysis. Conclusions Healthy foods were more expensive than regular choices in both urban and rural areas. Although urban areas had higher availability of healthy foods, the cost of changing to a healthy diet in urban areas was also greater. Improvement in the food environment is needed to support people in adopting healthy food choices