Food insecurity in three socially disadvantaged localities in Sydney, Australia.

ISSUE ADDRESSED Food insecurity, now listed among the social determinants of health, compromises the health and well-being of affected Australians. The objective of this study was to determine the prevalence of food insecurity within an urban population of social disadvantage in readiness for a local health promotion response. METHODS This was a cross-sectional survey conducted in three disadvantaged locations of south-western Sydney. Prevalence of food insecurity was assessed using both the 16-item US Household Food Security Survey Module and the single-item question previously used in national Australian health surveys. Bivariate and multiple logistic regression analyses were performed to determine associations between food insecurity and socio-demographic characteristics of the households. RESULTS The 16-item US tool yielded a significantly higher food insecurity prevalence (21.9%, 95% CI 20.0-23.8) than the single-item Australian tool (15.8%, 95% CI 14.1-17.5). Compared with the former, the single-item Australian tool has high specificity (96%) yet low sensitivity (56.9%). In our three sites, food insecurity was strongly and independently associated with household capacity to save money (AOR=5.05). Local fruit and vegetable production (83.8%), nutrition education (83.9%), transport to food outlets (81.5%) and better public transport overall (76.3%) were most highly rated by 'food insecure' households as useful future strategies. CONCLUSION The higher sensitivity of the US 16-item food security survey module relative to the single-item Australian tool indicates its potential for use in future Australian surveys of food insecurity.