Food Retail Environments in Greater Melbourne 2008–2016: Longitudinal Analysis of Intra-City Variation in Density and Healthiness of Food Outlets

Obesity prevalence is inequitably distributed across geographic areas. Food environments may contribute to health disparities, yet little is known about how food environments are evolving over time and how this may influence dietary intake and weight. This study aimed to analyse intra-city variation in density and healthiness of food outlets between 2008 and 2016 in Melbourne, Australia. Food outlet data were classified by location, type and healthiness. Local government areas (LGAs) were classified into four groups representing distance from the central business district. Residential population estimates for each LGA were used to calculate the density of food outlets per 10,000 residents. Linear mixed models were fitted to estimate the mean density and ratio of ‘healthy’ to ‘unhealthy’ food outlets and food outlet ‘types’ by LGA group over time. The number of food outlets increased at a faster rate than the residential population, driven by an increasing density of both ‘unhealthy’ and ‘healthy’ outlets. Across all years, ratios of ‘unhealthy’ to ‘healthy’ outlets were highest in LGAs located in designated Growth Areas. Melbourne’s metropolitan food environment is saturated by ‘unhealthy’ and ‘less healthy’ food outlets, relative to ‘healthy’ ones. Melbourne’s urban growth areas had the least healthy food environments.


Supplementary
Mainly engaged in the sale of fresh fruit and vegetables; including wholesale stores with direct to public sales 10 Fish shop Mainly engaged in the sale of fresh seafood; including wholesale stores with direct to public sales and takeaway stores also providing a range of fresh seafood.

9
Poultry shop Mainly engaged in the sale of fresh poultry; including wholesale stores and with direct to public sales. 9 Butchery Mainly engaged in the sale of fresh meat; including wholesale stores with direct to public sales. 9 Major Supermarket Mainly engaged in the sale of groceries (fresh foods, canned and packaged foods, dry goods) of non-specialised (conventional) food lines. May contain a butcher or baker. Usually have 5 or more checkouts and a floor area over 1000 square meters. I.e. Woolworths, Coles, BI-LO, Franklins (no frills), ALDI 5 Minor Supermarket Mainly engaged in the sale of groceries (fresh foods, canned and packaged food, dry goods) of non-specialised (conventional) food lines. Usually have 4 or fewer checkouts and a floor area under 1000 square meters. E.g. Independent grocer or supermarket.

5
Specialty food stores -core foods Mainly engaged in the sale of a limited line of specialised food such as a particular gourmet food that can be defined under core food.

5
Restaurant/café -franchise E.g. franchise restaurants and cafes; mainly engaged in the preparation and sale of meals/snacks for consumption on the premises; table service provided; may sell alcohol with food; may provide takeaway services.

0
Restaurant/café -local independent e.g. restaurant in a golf club, culture-based restaurant/café which is not a take-away such as Mexican, Thai, Chinese etc. ; mainly engaged in the preparation and sale of meals/snacks for consumption on the premises; table service provided; may also sell alcohol with food, may provide takeaway services.
0 Sandwich shop Mainly engaged in the preparation of filled bread products like sandwiches or rolls. 5 Salad/sushi bar Mainly engaged in the preparation of salads and sushi. 5 Delicatessen Mainly engaged in the sale of specialty packaged or fresh products such as cured meats and sausage, pickled vegetables, dips, bread and olives; may also provide dine in meals.

Bakery
Mainly oriented towards bread, biscuits, pastries or other flour products with or without packaging. 0 General store Mainly engaged in the sale of a limited line of groceries generally includes milk, bread and canned and packaged foods.
-5 Specialty food store -extra foods Mainly engaged in the sale of foods such as ice-creams, donuts, waffles, cakes etc. than can be defined under extra food. -8 Pub e.g. pub within a bowing park, pub inside a private gambling club; food primarily engaged in selling alcoholic beverages where consumers can order and consume the alcoholic drinks in premises; can also be part of park or private club. -5 Take-away local independent E.g. kebab, fish & chips, burger, chicken shops, local pizza, mainly engaged in the preparation and sale of meals/snacks that are ready for immediate consumption; table service not provided; meals can be eaten on site; taken away or delivered; shop is not a franchise. -8 Take-away franchise store E.g. McDonalds, KFC, Subway; mainly engaged in the preparation and sale of meals (excludes donuts, drinks, ice-cream etc.)/snacks that area ready for immediate consumption; table service not provided; meal can be eaten on site, taken away or delivered; the food shop is a franchise/chain store with food being sold in specialised packaging.