Drivers of food cost in outer regional, remote, and very remote Australia: a systematic scoping review

A key determinant of diet quality in outer regional to very remote areas is the higher cost of food. This systematic scoping review aims to identify evidence gaps on drivers of the cost of food, to guide future research and policy development to improve food security across outer regional to very remote areas of Australia. The Joanna Briggs Institute three step literature search was utilised and the review was conducted in accordance with PRISMA guidelines. Five electronic databases (Ovid MEDLINE, CINAHL, Informit, Embase, Scopus) were systematically searched in September 2024. Peer-reviewed literature set in outer regional to very remote regions of Australia were included if they were on the topic of food and food price and the drivers influencing these. Title and abstract screening were performed by two authors, as well as double screening of full texts by two authors. Data were extracted from included articles regarding remoteness category, aims, sampling, methodology, drivers influencing food price, outcomes and implications on policy, as well as author commentary on the drivers of food price. The CREATE tool for research involving Aboriginal and Torres Strait Islander communities was completed by two authors, with guidance from two First Nations authors and the senior author. Twenty articles published between 1987 to 2022 met the inclusion criteria. Most studies reported on remoteness itself as the determinant of high food price. Other drivers of food price included freight, high operating costs of smaller stores and weather events. Those living in outer regional to very remote Australia pay more for food, however there is a lack of empirical detailed evidence on the drivers of higher food price. To effectively address the higher cost of food in outer regional, rural, and remote Australia and promote food security in these areas, empirical evidence on system determinants could complement existing expert evidence for targeted policy and government support.