Equity

In general, many food environments are significantly less healthy in areas of greater socio-economic deprivation, and this is a likely contributor to creating and exacerbating social and health inequities.

Indicator	Result	What was measured?	Source
Food Promotion
Density of junk food advertisements around low vs. high decile** schools	9.6 ads per km2 vs. 7.2 per km2	Content of outdoor advertisements within a 500m radius of a sample of 950 NZ schools.	Vandevijvere et al. (2018)
Proportion of junk food advertisements around low vs. high decile** schools	50.7% vs 37.4%	Content of outdoor advertisements within a 500m radius of a sample of 950 NZ schools.	Vandevijvere et al. (2018)
Food in schools
Proportion of most deprived** schools selling sugar-sweetened beverages, compared with least deprived schools	33.9% vs 44.3%	Types of beverages for sale at 434 primary and 143 secondary schools across NZ that sold food and/or beverages, in 2016.	How healthy are New Zealand’s food environments? (2018)
Proportion of foods offered for sale that are ‘occasional’ items in most deprived** compared to least deprived schools. Primary schools Secondary schools	54.8% vs 56.6% 59.5% vs 53.6%	Types of beverages for sale at 434 primary and 143 secondary schools across NZ that sold food and/or beverages, in 2016.	How healthy are New Zealand’s food environments? (2018)
In-store environments
Average proportion of aisle end-caps / island bins within each supermarket that are junk food free Most deprived neighbourhoods^ Least deprived neighbourhoods^	46% / 42% 44% / 40%	Comparison of in-store environments between 23 supermarkets in most deprived neighbourhoods and 13 supermarkets in least deprived neighbourhoods in 2020.	How healthy are Aotearoa New Zealand’s food environments? (2021)
Proportion of supermarkets with at least one checkout free of junk food Most deprived neighbourhoods^ Least deprived neighbourhoods^	57% 77%	Comparison of in-store environments between 23 supermarkets in most deprived neighbourhoods and 13 supermarkets in least deprived neighbourhoods in 2020.	How healthy are Aotearoa New Zealand’s food environments? (2021)
Food retail
Density of unhealthy outlets^^ around most vs least deprived** urban schools	2.4 per km2 vs 1.8 per km2	Density of fast-food, takeaway and convenience stores within 500m of all (2,473) schools in New Zealand in 2014.	Vandevijvere et al. (2016)
Availability of fast-food and takeaway outlets in most vs least deprived areas	73% higher availability	Spatial analysis of 9674 food outlets across NZ in 2014	Sushil et al. (2017)
Availability of convenience stores in most vs least deprived areas	64% higher availability	Spatial analysis of 9674 food outlets across NZ in 2014	Sushil et al. (2017)
Availability of supermarkets and fruit and vegetable stores in most vs least deprived areas	66% higher availability	Spatial analysis of 9674 food outlets across NZ in 2014	Sushil et al. (2017)
Food prices and affordability
Cost of a healthy diet as a proportion of income for: Median-income groups Low-income groups Groups receiving income support	18.7% 32.8% 51.0%	Cost of the recommended healthy diet as a proportion of income in three population groups by income scenario (2016).	Mackay et al. (2018)

*Assessment not relevant or applicable in this domain.

** Most deprived refers to decile 1-3 schools, least deprived refers to decile 8-10 schools.

^The most deprived areas were supermarkets in NZ Deprivation Index 9 & 10. The least deprived were 2 & 3 (there were no supermarkets in area 1). Deprivation indices were taken from the NZDep2018.

^^ Unhealthy outlets refer to fast-food, takeaway and convenience stores.

Key Findings

Schools with higher deprivation (lower decile) are surrounded by more junk food ads, and a higher proportion of junk food ads, than schools with lower deprivation (higher decile).

Neighbourhoods of higher deprivation tend to have more unhealthy food outlets, as well as more healthy food outlets, than neighbourhoods of lower deprivation.

Supermarkets in higher deprivation neighbourhoods tend to have fewer checkouts that are junk-food free, and a higher proportion of ads at store entrance are for junk food.

The cost of a healthy diet as a proportion of income is higher for low income groups (above the threshold considered to be unhealthy), and especially high for groups receiving income support.

Key Recommendations

In order to consume a healthy diet, policies are required to lower the cost of healthy food or ensure that households have sufficient income after fixed expenses to purchase nutritious, acceptable and safe food.

Retail outlets and food and beverage companies must be held accountable for apparent targeting of higher deprivation neighbourhoods and schools with their promotional strategies.

For more information

Reports

How healthy are New Zealand food environments? 2018 full report

How healthy are Aotearoa New Zealand’s food environments? 2021 Full Report

Articles

Mackay S, Buch T, Vandevijvere S, Goodwin R, Korohina E, Funaki-Tahifote M, et al. Cost and affordability of diets modelled on current eating patterns and on dietary guidelines, for New Zealand total population, Maori and Pacific Households. Int J Environ Res Public Heal. 2018 Jun 13;15(6):1255. doi: 10.3390/ijerph15061255.

Sushil Z, Vandevijvere S, Exeter DJ, Swinburn B. Food swamps by area socioeconomic deprivation in New Zealand: a national study. Int J Public Health 2017; 62(8): 869-877

Vandevijvere S, Molloy J, Hassen de Medeiros N, Swinburn B. Unhealthy food marketing around New Zealand schools: a national study. Int J Public Health. 2018;63(9):1099– 107.

Vandevijvere S, Sushil Z, Exeter Dj, Swinburn B. Obesogenic retail food environments around New Zealand schools: A national study. Am J Prev Med 2016; 51(3): 57-66.

Indicator Assessment Criteria
Metric
Price of recommended (healthy) diet as a proportion of disposable household income*	< 25%	25-29%	≥ 30%