“Ready-made” assumptions: Situating convenience as care in the Australian obesity debate

Shape-shifting versions of class in Australia and the pursuit of equity in public health

The COVID-19 pandemic and current cost of living crisis have highlighted socioeconomically patterned health disparities, bringing renewed focus on equity in public health. Despite political rhetoric invoking cultural narratives of egalitarianism and opportunities for class mobility, social class remains a significant factor in health outcomes in the Australian context. For social scientists, class (despite robust critiques) is a key analytical concept that has been theoretically broadened to encompass social and cultural practices (habitus). In public health, however, concepts of social disadvantage have expanded toward frames such as health equity and socioeconomic status in ways that can obscure 'class' and habitus. Understandings and operationalization of concepts of class and equity not only impact collaborative and interdisciplinary relationships, but also the framing of public health problems and health promotion interventions and policies. In this article, we draw on our experiences as anthropologists conducting ethnography in and of Australian health promotion programs to map and re-evaluate the intersection of concepts of social class and equity. We trace how representations of class emerged in these programs, and the versions of class and equity that materialized across different public health contexts. We argue for a conceptual repositioning of class that recognizes its shape-shifting qualities and of its materializations in different politics, disciplines and everyday contexts. In doing so, we highlight 'class' as a salient dimension of the design, implementation and evaluation of health promotion programs.

Convenience as a dimension of food environments: A systematic scoping review of its definition and measurement

Convenience is a major driver of food choice throughout the world, yet it is often inconsistently conceptualised, defined and measured. This limits the scope for food systems policy and interventions to leverage convenience to improve diet and nutrition outcomes. We conducted a systematic literature review to determine how convenience is both defined and measured in food environment and nutrition research. Six databases were systematically searched and studies were screened by two independent reviewers based on pre-defined eligibility criteria, yielding 243 studies for inclusion in the final review. 77% of studies did not explicitly define convenience. Among those that did, the dimensions and components within definitions varied. 83% of studies used perceived measures of convenience rather than objective measures. Convenience was most commonly measured in high income countries (64%) and in relation to the home food environment (53%), followed by formal retail (40%). Very few studies measured convenience in relation to the informal retail or cultivated food environments, and no studies considered convenience in relation to wild food environments. The vast majority of studies did not consider the validity or reliability of the measures of convenience. Based on our findings we propose a definition of convenience as a characteristic that results in reduced requirement for resources including time, physical effort, mental effort and skills by the consumer in relation to the planning, acquisition, preparation, storage, transport, consumption or clean-up of food. This definition can be used to help guide the development of measurement tools that can be used to assess convenience across different dimensions and contexts in a more comprehensive way. We also propose a framework for considering convenience as an entry point in food systems to improve diets and nutrition outcomes.

Use of Online Food Delivery Services to Order Food Prepared Away-From-Home and Associated Sociodemographic Characteristics: A Cross-Sectional, Multi-Country Analysis

Online food delivery services like Just Eat and Grubhub facilitate online ordering and home delivery of food prepared away-from-home. It is poorly understood how these services are used and by whom. This study investigated the prevalence of online food delivery service use and sociodemographic characteristics of customers, in and across Australia, Canada, Mexico, the UK, and the USA. We analyzed online survey data (n = 19,378) from the International Food Policy Study, conducted in 2018. We identified respondents who reported any online food delivery service use in the past 7 days and calculated the frequency of use and number of meals ordered. We investigated whether odds of any online food delivery service use in the past 7 days differed by sociodemographic characteristics using adjusted logistic regression. Overall, 15% of respondents (n = 2929) reported online food delivery service use, with the greatest prevalence amongst respondents in Mexico (n = 839 (26%)). Online food delivery services had most frequently been used once and the median number of meals purchased through this mode of order was two. Odds of any online food delivery service use were lower per additional year of age (OR: 0.95; 95% CI: 0.94, 0.95) and greater for respondents who were male (OR: 1.50; 95% CI: 1.35, 1.66), that identified with an ethnic minority (OR: 1.57; 95% CI: 1.38, 1.78), were highly educated (OR: 1.66; 95% CI: 1.46, 1.90), or living with children (OR: 2.71; 95% CI: 2.44, 3.01). Further research is required to explore how online food delivery services may influence diet and health.