How do supermarkets shape the experience of vulnerable people in Australia's food system? A scoping review

AIMS: The aim of this scoping review was to synthesise how supermarkets shape health behaviours and nutrition-related outcomes of vulnerable populations in Australia. METHODS: Five databases were searched and studies were included if they discussed Australia's major supermarket chains, their relationship with vulnerable populations, and outcomes linked to nutrition behaviour or health. Findings were synthesised narratively and reported using the food systems approach interdisciplinary conceptual framework. RESULTS: Twenty-eight studies met the inclusion criteria. Twenty-seven studies investigated food access, six studies examined health behaviours, and four studies focused on nutrition-related health outcomes. Socioeconomic disadvantage was the only vulnerability explored across all studies. Large supermarket chains provided greater access and availability to foods of higher nutritional quality at lower prices than other types of stores; however, areas of lower socio-economic status experienced poorer proximity to supermarkets. Supermarket food prices were less affordable for low-income households in all locations. Individuals living in lower socio-economic areas had a higher risk of greater body size. CONCLUSION: Supermarkets play a structural role in the health of socioeconomically vulnerable populations in Australia. Supermarkets are important for the provision of higher nutritional quality foods but can also have negative effects through the stocking and marketing of discretionary foods. Future research is required to understand the relationship between supermarkets and other populations experiencing disadvantage and/or vulnerability, such as those with physical disabilities, older adults, youth, and other cultural backgrounds. The extent of alternative food systems and community-based initiatives that provide food for these groups requires further investigation.