Introduction
The right to food is an international human right recognised by the UN(1). Everyone deserves an active and healthy life free from hunger(1,2) . The pursuit, of which, is recognised as an international priority in the UN Sustainable Development Goal 2 (Zero Hunger)(3). However, not everyone has the same opportunity to exercise their human right to food(4). One in eight Australian households experience food insecurity(5). The consequences, of which, reinforce and entrench inequity.
Across different community groups, the definition of food security varies. As a construct, food security is conceptualised differently across sectors. For almost 30 years, however, food security has been predominantly understood through the following well-accepted international definition, ‘Food security exists when all people, at all times, have physical and economic access to sufficient safe and nutritious food that meets their dietary needs and food preferences for an active and healthy life (2)’. For food security to be realised, four conditions must be met:
-
• Healthy food and drinks must be available – there is enough food and drinks available to feed the population (for example, stock levels, net trade and food production) and it is of adequate quality and nutrition(2).
-
• Healthy food and drinks must be accessible – there is sufficient physical and economic access to a healthy diet (for example, transport options to food/drink outlets and food affordability)(2).
-
• Healthy food and drinks must be appropriately utilised – communities and households possess the infrastructure, knowledge, skills and behaviours required to safely prepare, store and consume a healthy diet(2).
-
• Healthy food and drink access, availability and utilisation are stable – a healthy diet must be reliably available and resilient to adverse weather conditions, economic factors, political stability and other destabilising influences(2).
Increasingly, agency and sustainability are being recognised as additional food security dimensions(Reference Clapp, Moseley and Burlingame6). Sustainability refers to the harmonisation between food system practices, ecosystems, livelihoods, society and the political economy(Reference Clapp, Moseley and Burlingame6). By recognising the connection between food and the environment, the sustainability dimension acknowledges the importance of safeguarding the food security of future generations by supporting food system longevity(Reference Clapp, Moseley and Burlingame6). The extent to which food system consumers have control and influence over their circumstances is described by the agency dimension(Reference Clapp, Moseley and Burlingame6). Agency is aligned with concepts of food sovereignty and self-determination and calls for a redistribution of power within food systems to enable meaningful food system participation by individuals and communities(Reference Clapp, Moseley and Burlingame6).
Food insecurity occurs when one or more of the above conditions are not met. Its impacts are pervasive and stretch across the lifespan. Research has demonstrated a clear association between household food insecurity and poorer social, emotional, behavioural and academic outcomes in children from infancy to adolescence(Reference Clapp, Moseley and Burlingame6,Reference Shankar, Chung and Frank7) . Women experiencing food insecurity face an increased risk of violence(Reference Maynard, Andrade and Packull-McCormick8), and parents/caregivers (especially women and mothers) are likely to skip meals so that their children can consume a full meal(Reference McIntyre, Glanville and Raine9,Reference Bowden10) . Food insecurity is often accompanied with worry and stress and can negatively influence mental health and wellbeing(11). Evidence linking food insecurity with mental illness has found associations with suicidal behaviour and depression(11,Reference Kent, Gebremariam and Visentin12) .
While the food insecurity impacts are wide ranging, amongst the most concerning are nutrition and health consequences. Food security is fundamental to good health. Without it, families tend to rely on convenience products that are energy-dense and nutrient-poor(Reference Bowden10,Reference Lee and Ride13) . These options are often chosen out of necessity because they are shelf‑stable and/or ready-to-eat without the household infrastructure required to cook, store and consume a healthy meal. For example, a working refrigerator and cooktop, reliable electricity, water security, utensils/cookware and expensive ingredients like oil(Reference Lee and Ride13). As a result, families experiencing food insecurity consume a fewer fruits and vegetables, have lower protein, fibre and healthy fat intake and consume more carbohydrates and sugar(Reference Lindberg, McNaughton and Abbott14). Over the long term, dietary patterns such as these can manifest in chronic disease such as type 2 diabetes, CVD, iron deficiency anaemia, obesity and other chronic conditions(Reference Tafuri and Latino15–Reference Leung, Kullgren and Malani18). Concerningly, most Australian households experiencing food insecurity experienced moderate or severe food insecurity(5), meaning household nutrition and health are compromised(Reference Bowden10).
Food insecurity disproportionately impacts Australians at the intersection of inequity. Amongst those experiencing food insecurity, low-income earners, culturally and linguistically diverse groups and people living in remote areas are over-represented(5). Those living in larger group households (which make up a greater proportion of remote Aboriginal and Torres Strait Islander households) are amongst the least food secure in Australia (27.8%)(5,19) .
Food security barriers in Queensland
The prevalence of food insecurity in Australia is unacceptable. Multiple public inquiries and policies related to food insecurity indicate appetite for change nationwide(20–22). Such inquiries, amongst other research, have clearly articulated the drivers of food insecurity, particularly in remote communities.
The determinants of food insecurity are complex, varied and rooted in structural inequity. The Gather + Grow Queensland Remote Food Security Framework (The framework, Fig. 1) highlights that food security is deeply embedded within all layers of society and extends beyond the remit of the health sector(23). Remote communities in Queensland face structural barriers to accessing healthy food including geographic isolation, long and fragile supply chains, variable food pricing, housing insecurity and constrained economic opportunities(23). These factors combine to limit the availability, affordability and quality of nutritious foods, ultimately contributing to persistent health inequities(23).
A framework for food security in remote Aboriginal and Torres Strait Islander communities in Queensland(23).

The framework (Fig. 1) was developed in consultation with community stakeholders and emphasises that food security is not simply a function of individual choice, behaviour or education(23). It is shaped by systemic conditions including logistics, market competition, infrastructure, regulation and policy(23). For example, training and education programmes are less accessible in remote communities as tertiary education is usually centralised in major towns and cities(Reference Holden and Zhang24). Related to reduced education opportunities, people living in remote communities experience less access to employment(Reference Holden and Zhang24,Reference Anthony and Keating25) . By extension, this can weaken the local economy and have significant flow on effects at the community level(26). For example, a higher proportion of people living in remote communities are low-income earners(27) and therefore less likely to be able to afford the necessities of healthy living. Further, reduced training and education opportunities in remote communities can mean localised skilled workforce shortages. As a result, the development and maintenance of critical infrastructure (such as transport and housing) relies on a fly-in, fly-out workforce(28,Reference Langdon, Biggs and Rowland29) , which can be costly and time-consuming. These challenges impact all infrastructure, from the wharves that receive food deliveries, to cooktops and refrigerators in family homes. Ultimately, impacting community food security. This is merely one example of how the determinants of food security extend across multiple sectors and cumulate to impact daily life, health and wellbeing(23).
Building collective leadership and action
Since many food security determinants are beyond the remit of the health sector, a multi-sectoral, systems–oriented response is required(23). Addressing food insecurity requires coordinated action across government (at all levels), community, industry, non-government organisations, universities and research agencies(23,30) . Health promotion and related stakeholders play a critical role, but in isolation, their capacity to achieve outcomes is limited. Establishing and maintaining food security requires a multi-strategic effort centred in equity and focused on structural drivers. In practice, this approach demands collective leadership, community-centred decision-making and action that align cultural priorities and equity-centred goals.
In Queensland, interest and support around food security has been growing. Led by Health and Wellbeing Queensland (HWQld, the state’s prevention agency), Gather + Grow is Queensland’s strategic response to food insecurity in remote Aboriginal and Torres Strait Islander communities(31,32) . Gather + Grow focuses on improving access to healthy, affordable food through locally driven and cross-sector action(31,32) . To demonstrate the mechanisms for building collective action for food security, this review will draw on the example of Gather + Grow and reflect the authors’ experiences of its development and implementation.
Aligning priorities and establishing shared language
One of the most important steps towards building momentum around any agenda is establishing a shared governance, language and vision. To do this, engaging with cross-sector stakeholders to understand the lens through which they view food security is critical. In the introduction of this paper, an international definition of food security was referenced as ‘well accepted’ amongst many sectors. However, food security is conceptualised differently across various population groups and sectors(Reference Gibson33). For example, some sectors refer to food security as the ratio between national food import and export(34). Some community groups may view food security as a connection to Country, with a focus on harmonious relationships, sharing and safeguarding natural and cultural capital for future generations(35). Some sectors do not see themselves as having a role in food security at all. It is through engaging with different viewpoints that areas of alignment and divergence can be identified. Once they are surfaced, the process of aligning priorities can commence. From which, shared governance and language to articulate these priorities through a common framing is established. The lens through which the problem is framed plays an important role and can influence cross-sector collaboration.
The Queensland and Australian Governments are committed to the National Agreement on Closing the Gap(36). In 2023, the Australian Government identified remote food security as a cross-cutting issue for Closing the Gap and committed to a National Remote First Nations Food Security Strategy(37). Noting that improvement in food security could benefit all Closing the Gap outcomes(37). Aligning Queensland’s food security efforts with these national policy levers has enabled HWQld to demonstrate mutual benefit with national actors. Through Closing the Gap, HWQld has found effective, shared framing for food security action in Queensland. The commitments of the Australian government to food security (in alignment with Closing the Gap) have given licence to Queensland government actors (who also have responsibilities under Closing the Gap) to engage in food security matters and strengthened the appetite for cross-action in Queensland. This is one example of how Gather + Grow has established a collective vision and goal for food security in Queensland by highlighting strategic alignment and activating policy levers. HWQld has solidified this shared accountability by establishing cross-sector governance with relevant actors (including those at the national level) to progress aligned priorities.
Building collective leadership requires understanding the perspectives of cross-sector stakeholders and establishing common ground. Effective framing is critical to gaining support and momentum and should be responsive to the policy context. This reflects existing frameworks that emphasise the importance of shared language and common goals in public health advocacy(Reference Day, Shickle and Smith38). However, without governance structures that bring people together to drive these mutual priorities, it is difficult to establish and maintain strong alignment.
Establishing mutual benefit
Through consultation on the development of Gather + Grow, several food security priorities emerged (these are discussed later in this article: Activating Food Security). Many of these priorities are shared by HWQld and cross-sector actors – they are not wholly the responsibility of health actors. As such, food security became another framing through which cross-sector actors could demonstrate the benefits of their respective agenda. This helped to secure and sustain the cross-sector collaboration required to progress whole-of-system priorities. For example, food supply chains and logistics were identified as a food security priority. In discussion with transport and logistics stakeholders, HWQld highlighted the role of supply chains in food security and overall community health. Thus, giving these stakeholders an additional lens through which they could describe the benefits of their existing work. Simultaneously, this increased stakeholder commitment and willingness to collaborate on Gather + Grow as they understood the benefits for their own priorities. Establishing mutual benefits has become an important mechanism through which HWQld has progressed the food security agenda whilst complementing the priorities of other agencies.
Centralised coordination
It is well established that food security is a systemic issue requiring multi-sectoral support. This can be viewed as both an opportunity and a risk. Agencies working together towards a common objective are significantly more effective than fragmented, siloed efforts. System actors are stronger through collective influence, and shared resources/networks are necessary for sustainable change(Reference Brady39,Reference Stonehan, Videler and Edmunds40) . At the same time, sharing responsibility across sectors brings with it the considerable task of coordination(Reference Brady39) and runs the risk of diluted, duplicative or disjointed efforts(Reference Peters41). HWQld has managed these risks through taking leadership as a centralised coordinating agency for Gather + Grow. As the coordinating agency, HWQld aims to:
-
• Ensuring that cross-sector implementation efforts are harmonious and maximise results(Reference Peters41).
-
• Working with sectors to continuously refine Gather + Grow in accordance with stakeholder and community feedback(Reference Peters41).
-
• Connecting stakeholders across sectors who are engaging in similar work, or whose work could be strengthened by one another, to reduce duplication and build network capacity(Reference Peters41).
-
• Embedding a highly consultative approach that establishes and maintains partnerships and strong communication channels(Reference Peters41).
These coordination functions have strengthened the food security agenda in Queensland by supporting the development and implementation of Gather + Grow. Further, they align with the remit of HWQld as an agency focused on reducing inequity and tackling the social determinants of health. This coordination is particularly important in the context of the Australian food system, which stakeholders have described as fragmented, hindered by competing priorities and restricted when it comes to co-operation(42).
Community voice
The evidence is clear: engaging with communities (particularly Aboriginal and Torres Strait Islander communities) to share leadership over programme and policy development, implementation and evaluation is critical(Reference Fono, Parter and Chapman43–Reference Zorbas, Jeyapalan and Nunez45). The benefits include feasible, fit-for-purpose solutions that meet the needs of local people and are community-owned(Reference Fono, Parter and Chapman43,Reference Gerrard, Godwin and Whiteley44) . Food security is no exception to this. Food security action should centre the voices of people with lived experience by establishing genuine community partnerships and trust. In some ways, however, current systems are not conducive to this. Community voices are at risk of being overshadowed due to the concentration of power in institutions such as governments and universities(Reference Zorbas, Jeyapalan and Nunez45,Reference Silver, Weitzman and Brecher46) . For these reasons, professionals engaging in food security must also engage with power dynamics and aim to actively create opportunities for communities to be heard and listened to. Community voice has, therefore, been a guiding consideration in the development of Gather + Grow(31,32) .
To ensure community priorities were reflected in Gather + Grow, HWQld led several co–design forums in partnership with regional community organisations, such as Aboriginal and Torres Strait Islander council alliances(31,32) . For example, in October 2023, HWQld, the Torres and Cape Indigenous Council Alliance and the Local Government Association of Queensland teamed up to deliver a series of food security roundtables drawing 125 cross-sector stakeholders(30). These roundtable discussions surfaced system barriers and locally endorsed solutions, which were synthesised into themes that guided subsequent Gather + Grow planning(30–32). HWQld complemented these forums with several place-based engagements across remote Far North Queensland and the Lower Gulf, including commissioning local food security action plans (developed by community-controlled organisations) and supply chain mapping(47). This was coupled with statewide public consultation on draft plans, with respondents affirming alignment with community needs and highlighting the need for clear monitoring, accountability and governance mechanisms. This feedback informed revisions of Gather + Grow, its governance processes and a measuring change framework(31,32) . Multiple opportunities and mechanisms for community participation were offered, including in-person community visits, online survey forms and workshop-style discussions. Collectively, these activities enabled Gather + Grow to embed community leadership and accountability into its design(Reference Butler, Gall and Garvey48).
Through the consultation process, stakeholders raised food insecurity as a systemic issue and identified related issues that are not directly influenced by, but interact with, food security. For example, digital connectivity, water security and cost of living(Reference Wahbeh, Anastasiadis and Sundarakani49–Reference Stone, Brown and Douglas51). Some of these issues were integrated within Gather + Grow(31,32) . Others, however, were noted as aligned issues outside the scope of Gather + Grow(31,32) . For these aligned (but separate) issues, Gather + Grow mapped existing policy opportunities and key actors and committed to supporting and advocating for their improvement(31,32) . This highlights the importance of policy scope. It is unrealistic to expect that one policy would address every issue of importance. Particularly when these issues are complex, interconnected and wicked(Reference Donner, Mamès and de Vries52,Reference Head and Alford53) . In some cases, it is more effective to identify and elevate the alignment between separate policy agendas rather than attempting to address them all under one umbrella. For Gather + Grow, scope was decided through an iterative process of engagement with community and other stakeholders. In this way, communities and their leaders actively defined and refined the scope of a food security agenda that was built with and for them.
Consultation about Gather + Grow was a dedicated, region-wide effort, in which, arguably, every sector related to food security (from energy providers to community food relief volunteers) was invited to have their say. The key learnings, from authors involved in this process, are summarised below:
-
• Instead of creating new community governance groups, find and tap into existing ones. There are many dimensions of Aboriginal and Torres Strait Islander health – all of which should be centred in community leadership and shared decision-making. One mechanism that is often utilised to achieve this is a community governance/advisory group. An unintended consequence of this well-meaning approach is the over-population of such groups, which can burden communities with over-consultation and cumbersome governance processes(Reference Hunt54,Reference McGuffog, Chamberlain and Hughes55) . It is often the same organisations and community leaders who are asked to participate in these groups, which, collectively, can place unrealistic expectations on their time/resources. While community decision-making is important and needs to be embedded in the ways we work, establishing new community governance groups (for every issue) is not always the most effective approach. In many instances, stakeholders outside the community suggested HWQld establish a community governance group for food security. When proposing this to community stakeholders, however, we were encouraged to avoid setting up (yet another) governance group and instead leverage existing community engagement forums and mechanisms. As such, our consultation approach included mapping, identifying and partnering with existing community groups related to community advocacy, health and regional governance. This required finding the right groups, with the right representation, who understand the issues at hand and are willing to provide advice. To achieve this, aligning priorities at the local level was key.
-
• Minimise consultation burden through coordinated engagement. Aboriginal and Torres Strait Islander communities are over-researched, with little reciprocal benefit for communities(Reference McGuffog, Chamberlain and Hughes55). Avoid fragmented, duplicative engagement and the associated fatigue this imposes on communities by working with other agencies to coordinate streamlined consultation efforts. For example, where another agency or partner is planning a consultation event, understand the alignment between the respective consultation priorities to determine if the opportunity exists to work together on a multi-purpose event. During the development of Gather + Grow, Hospital and Health Services across Queensland were consulting on the development of Making Tracks for Health Equity Strategies(56). HWQld engaged with Queensland Health to understand the nature of their consultation and findings and used this information to complement consultation efforts, rather than duplicating them. This approach respects communities’ time, consolidates effort and can yield more coherent, community-led priorities(57,58) . However, it also requires awareness of other consultation and community engagement efforts occurring across sectors, which relies on strong relationships and strategic engagement.
-
• Build on, rather than duplicating, previous consultation. Take care to identify, review and learn from previous related consultation efforts. Often, there is no need to start from scratch. Avoid asking communities the same questions twice and aim to build on previous engagement, rather than repeating it. For example, instead of revisiting problem definition, take what you have learned from previous consultation events and move the conversation forward to solution development(57,58) .
Activating food security in Queensland
The development of a Gather + Grow Strategic Framework (Fig. 2) has supported growing momentum around food security in remote Queensland, resulting in an action plan endorsed by government agencies across all tiers(31,32) . Consultation findings were synthesised into a shared vision, target outcomes, priority areas and principles for food security action(31,32) . This strategic framework reflects the priorities of communities and is a platform for food security action and advocacy in remote Queensland.
Balancing long-term change with immediate action
Gather + Grow is intentionally designed as a decade-long, whole-of-system strategy, acknowledging that transforming systems requires long-term, considered and sequenced action(31,32) . Systems change takes time, but this must be balanced with immediate action that respects and supports communities currently experiencing food insecurity(31,32,Reference Rutter, Savona and Glonti59) . The strategy, therefore, utilises a three-phase action planning cycle designed to build momentum, readiness, evidence, leadership and action over time(31,32) :
-
• Phase 1 – Plant: Establishes the foundations for systems change by strengthening governance, consolidating cross-sector leadership and deepening cross-sector understanding of food security barriers. This phase focuses on piloting place-based change where there is readiness whilst setting the foundation for broader systems impact in future phases.
-
• Phase 2 – Nurture: Builds on Phase 1 by testing, trialling and evaluating place-based solutions. This phase aims to deepen collective action, refine initiatives and support communities to embed practices that have demonstrated potential, ensuring solutions are tailored, culturally safe and locally owned.
-
• Phase 3 – Grow: Focuses on scaling and sustaining the most effective solutions for systems-wide change. This includes embedding successful models into ongoing processes and policies so that food security gains are maintained beyond the strategy’s 10-year horizon.
Integrated priority areas to strengthen remote food security
Through consultation, four discrete but interdependent priority action areas were identified for the advancement of food security: Logistics and Supply Chain, Local Food Production, Healthy Communities, Healthy Homes and Enabling Actions(31,32) . The priority areas were designed to be implemented collectively, rather than as isolated silos(31,32) . Together, the priority areas set the foundation for a holistic response across all domains of food security (which are the target outcomes of Gather + Grow). Leadership of priority areas is distributed across state government actors with HWQld coordinating whole-of-system alignment and accountability.
Priority area 1: logistics and supply chain
Supply chains are a critical determinant of food security in remote communities. They are one important factor shaping food and drink availability, affordability, quality and stability within the food environment. In the context of today’s contemporary food system, food security in remote Queensland relies on the external supply of food, drinks and other essential items. This occurs via supply chains which operate under challenging circumstances. Characterised by long distances, multiple complex touchpoints, seasonal weather disruptions and limited freight options, supply chains to remote communities are often disrupted or delayed(31,32) . As a result, the availability, quality and affordability of healthy food in remote communities is compromised. Some supply chains to remote communities are up to 8 d long (and traverse the entire length of Australia)(47). Food/drink products that journey along these supply chains can, therefore, arrive in poor quality, with reduced shelf life, and a higher price tag, if they arrive at all(31,32) . The estimated cost of freight towards food in remote communities is 20%(Reference Lovell60), and approximately 12% of the basic grocery items required for a healthy diet are missing from remote stores(Reference Lee, Darcy and Leonard61). These pressures are amplified by low purchasing power in remote regions (where the population is small and dispersed), climate change and rising operating expenses such as fuel(47). Moreover, because no single actor has end-to-end visibility of the supply chain, coordination is challenging and constrains timely resolutions when disruptions occur(47). These challenges can manifest as food security issues that erode diet quality and exacerbate chronic disease risk(47,Reference Lovell60) .
The Gather + Grow logistics and supply chain priority area aims to optimise the performance, resilience and efficiency of remote food supply chains with the view to support availability, accessibility and quality of healthy food year-round(31,32) . Key actors include the Department of Transport and Main Roads, Department of Primary Industries (DPI), Queensland Health and partner entities across freight, retail and supply chain sectors(31,32) . Together, these agencies are tackling supply chain challenges through cross-government governance and actions that prioritise coordinated supply chain analysis and evidence-informed decision-making(31,32) .
Priority area 2: local food production
When discussing food security, community stakeholders consistently highlighted their aspirations to grow food closer to where they live(Reference Emmanuel, Read and Grande62–Reference Davies, Gwynn and Flood64). Localised food production was seen, by community, as a mechanism to reduce reliance on long, complex and sometimes disrupted supply chains and exercise self-determination over their local food system. This aligns with Aboriginal and Torres Strait Islander definitions of food security and food sovereignty through emphasising community autonomy and control(Reference Emmanuel, Read and Grande62). While local food production initiatives offer a variety of benefits (health, wellbeing, employment and community cohesion, amongst others)(Reference Tracey, Gray and Manohar65), evidence has shown that such projects are often prone to challenge(Reference Hunter, Onnie and Pritchard66). Common constraints include workforce capacity and skills gaps, climate and environmental stressors, inadequate infrastructure, short-term funding and land/water access issues(Reference Hunter, Onnie and Pritchard66). These factors can combine to make local food production unreliable and difficult to sustain. Hence, it is important that this priority area is pursued in conjunction with a focus on logistics and supply chains (Priority Area 1) so that strong supply chains address gaps in local food production capabilities.
The Gather + Grow strategy recognises both community aspirations and historical lessons related to local food production by focusing on creating supportive settings for sustainable, place-based local food production(31,32) . This priority area emphasises careful planning, evidence-informed design and strong partnerships(31,32) . Key actions include feasibility assessments and business planning, facilitating access to technical experts, infrastructure and equipment planning and establishing robust governance arrangements(31,32) . Key actors include HWQld and the DPI, who are working alongside multi-sector stakeholders to understand the critical success factors for local food production in remote communities(31,32) . The aim is not merely to start gardens, but to build sustainable, community-owned production systems that maximise benefits over the long-term(31,32) .
Priority area 3: healthy communities
Even with reliable supply chains and sustainable local production, food security will not be realised if households cannot utilise the foods available to them. For example, if communities lack the knowledge, skills and supportive environments required to select, store, prepare and consume a nutritious diet. The healthy communities priority area is closely tied to the utilisation domain of food security(31,32) . Food literacy is a condition of food security. However, health promotion and nutrition resources/programmes are often developed with limited input from remote contexts and, therefore, can lack relevance and feasibility in this setting(Reference McDonald, Bailie and Grace67,Reference Colles, Belton and Brimblecombe68) . These conditions, along with social and cultural norms around dietary practice, can emphasise issues of low food literacy and impinge upon nutrition and food security(Reference McDonald, Bailie and Grace67,Reference Colles, Belton and Brimblecombe68) . Over the long term, contributing to obesity, diabetes and CVD. The Gather + Grow healthy communities priority seeks to empower communities to choose and prepare healthy foods by building nutrition capability, reshaping food environments and embedding culturally safe health promotion(31,32) . It focuses on building nutrition capability and shaping local food environments so that healthier choices become the norm, feel familiar and are preferred(31,32) .
HWQld and partners such as remote retailers and community organisations, are working together to shift communities towards healthy eating(31,32) . Through a series of actions, Gather + Grow is promoting nutrition education, healthy retail environment changes (that nudge towards healthier purchasing) and nutrition workforce development(31,32) .
Priority area 4: healthy homes
Having a home that supports healthy living practices and good nutrition is the final line of defence for food security. Even if food is available, accessible and affordable, and families are empowered to choose a healthy diet, food insecurity will persist if the family home is not adequately equipped for healthy food preparation, storage and consumption. Healthy homes are the point at which community food security translates to nutrition benefits at the household level(Reference Lee, Zhao and Reesor-Oyer69–71). The benefits of investments in all other priority areas will not be realised without fit-for-purpose, reliable health hardware in homes. Without working fridges, cooktops, sinks, reliable water and electricity and pest-safe storage, nutritious foods cannot be used as intended, leading to spoilage, food safety risks and reduced intake of healthy food(Reference Lee, Zhao and Reesor-Oyer69–71). As a result, families experiencing housing insecurity or issues with household cooking infrastructure might rely on shelf stable, convenience and ready-made ultra-processed products which have negative health consequences(Reference Lane, Gamage and Du72). This is the reality for the 50% of very remote Aboriginal and Torres Strait Islander households who live in a home with major structural issues(73).
For these reasons, healthy housing is a prerequisite for food security. The Gather + Grow healthy homes priority area, therefore, focuses on enabling households to store, prepare and eat a healthy diet with the required household infrastructure(31,32) . Early actions include aligning housing programmes with nutrition objectives, working with stores to promote health hardware and supporting household gardening(31,32) . This work is pursued by HWQld in partnership with Queensland Health and the Department of Housing(31,32) . When implemented alongside improvements in other priority areas, healthy homes help translate system change into tangible gains.
Enabling action
Each of the four priority areas are underpinned by a series of system enablers that, if achieved will lay the foundation for effective implementation. Without the following enablers, progress towards food security will be compromised by system barriers. The strategy explicitly acknowledges that enablers are not automatic, and dedicated action is required to create the conditions for meaningful impact over time(31,32) .
As previously established, collective leadership is essential to food security action(31,32) . This is because the social, commercial and cultural drivers of food insecurity are influenced by a variety of agencies and sectors(Reference Oñederra-Aramendi, Begiristain-Zubillaga and Cuellar-Padilla74). Working together to address them is critical(Reference Donner, Mamès and de Vries52,Reference Oñederra-Aramendi, Begiristain-Zubillaga and Cuellar-Padilla74) . In Gather + Grow, collective leadership is positioned as a core enabler for systems change and operationalised through(31,32) :
-
• An action plan supported by the collective commitment of 17 government agencies,
-
• Cross-government governance groups aimed at supporting coordinated and accountable implementation and
-
• Multi-agency project partnerships.
Knowledge translation is the dynamic and collaborative process of moving information, data and evidence into practical real-world action(Reference Armstrong, Waters and Roberts75). This is a core enabler for Gather + Grow, intended to align policy intent and community benefit(31,32) . An active focus on knowledge translation ensures that Gather + Grow moves beyond knowledge gathering and towards solution generation(31,32,Reference Armstrong, Waters and Roberts75) . This enabler recognises the need to consider different types of knowledge when translating evidence to practice, including integrating technical expertise with lived experience and cultural knowledge to blend information and establish shared solutions(31,32) . HWQld has elevated the importance of knowledge translation through committing to the following actions(31,32) :
-
• Identify critical relevant data sets to enable informed decision-making and investment in food security (Enabler Action 1).
-
• Strengthen and drive policies and networks that address food security barriers in remote community settings across sectors, including at the national level (Enabler Action 2).
-
• Embed Aboriginal and Torres Strait Islander paradigms and data sovereignty across food security priorities, with an initial focus on research and evaluation (Enabler Action 5).
Progressing food security priorities requires long-term solution-driven investment (31,32,Reference Wahbeh, Anastasiadis and Sundarakani49,Reference Donner, Mamès and de Vries52) . Traditional funding structures that are short-term and project-oriented are not aligned with the system changes required to improve food security(31,32) . Funding that supports consistent and sustained effort is required(31,32) . Flexible and future-focused funding models should prioritise implementation, evaluation and evidence-based scale-up to support the Gather + Grow priority areas(31,32) .
Research, evidence and community voices have consistently highlighted the importance of a strengths-based approach when it comes to public health promotion(Reference Askew, Brady and Mukandi76,Reference Wilson, Wilson and Delbridge77) . A strengths-based approach amplifies and bolsters community assets, leadership and knowledge. Gather + Grow is taking a strengths-based approach by learning from and highlighting community successes and building solutions with the input of community champions and local knowledge(31,32) .
The compass: ways of working
Together, the priority areas are designed to shift systems towards food security in remote Queensland. They outline the action areas for implementation as described by community and cross-sector stakeholders. Equally as important, however, is a framework to describe how these priority areas will be achieved. Effective implementation requires a set of guiding principles that shape how actions are delivered and define ways of working. These principles provide the foundations that support implementation to be community-led, equity-driven, systems-oriented and sustainable(31,32) .
A community-centred, place-based approach is central to ensuring that implementation is directly informed by the lived experience, cultural knowledge and priorities of Aboriginal and Torres Strait Islander communities(Reference Wilson, Wilson and Delbridge77). Gather + Grow emphasises that meaningful food security outcomes can only be achieved through leadership with, and guidance from, the communities most affected, acknowledging history, strengths and self-determination(31,32) . Operationalising this principle involves co-design processes and locally tailored actions that reflect community-identified needs(31,32) . By placing communities at the centre of decision-making, implementation is supported to be culturally grounded, feasible and effective, enhancing the potential for lasting and meaningful change(Reference Wilson, Wilson and Delbridge77).
Gather + Grow is directed to support remote Aboriginal and Torres Strait Islander communities that experience the most significant barriers to food security. Since food insecurity is shaped by structural inequities and the ongoing impacts of colonisation, an equity-based approach to implementation is critical(31,32) . An equity lens supports targeted action and directs resources towards activities that address disparities in food access and availability(Reference Weiler, Hergesheimer and Brisbois78). By taking an equity focus, Gather + Grow aligns with broader commitments to health equity(56) and Closing the Gap(36). To operationalise an equity-based approach, Gather + Grow was developed in alignment with the HWQld Equity Framework, which helped to elucidate the different influences on food equity, the potential intervention points and how to work across the system to create structural change(79).
Systems thinking is a foundational principle recognising food security as a systems issue(31,32,Reference Bustamante, Vidueira and Baker80) . Gather + Grow explicitly calls for cross-sector collaboration and collective problem solving to address entrenched and structural food security barriers(31,32) . In practice, enacting systems thinking involves understanding and highlighting interdependencies and designing interventions that operate across multiple levels simultaneously. This approach supports an integrated implementation approach that is cognisant of, and actively avoids, negative unintended consequences.
The goal of Gather + Grow is to create enduring benefits for communities now and into the future. Through including sustainability as a key principle, Gather + Grow articulates a long-term vision for food security emphasising the need for sustained investment, capability-building and continuous learning. In practice, enacting this principle requires(31,32) :
-
• Designing interventions that strengthen local capacity,
-
• Monitoring and evaluating initiatives to support adaptation and growth and
-
• Aligning efforts with enduring national and international priorities.
Respect is the ethical underpinning of Gather + Grow, influencing every engagement, decision and action(31,32) . To uphold the principle of respect, including respect for Aboriginal and Torres Strait Islander peoples and their history, Gather + Grow highlights community strengths(31,32) . Gather + Grow recognises traditional Aboriginal and Torres Strait Islander food systems as secure, acknowledges the impacts of colonisation and emphasises the importance of self-determination(31,32) . In implementation, this principle aims to be enacted through community partnership, protection of intellectual and cultural property rights and efforts towards data sovereignty and culturally affirming governance(31,32) . The respect principle also encourages culturally appropriate communication, acknowledgement of historical and contemporary injustices and deep listening throughout all phases of programme design and delivery(31,32) .
Conclusion
This review has outlined the case for food security action, highlighting connections to Human Rights, international priorities and powerful national policy levers. Through exploring the impacts of food insecurity and its drivers, the need for collective action and shared leadership remains well established. Analysing and reflecting on Gather + Grow, Queensland’s strategic response to food insecurity in remote Aboriginal and Torres Strait Islander communities, has surfaced the success factors, opportunities and strategic framework for food security action. Gather + Grow is an example of how a prevention agency has built momentum and commitment around food security. It is not just a programmatic response and demonstrates systems thinking in action. The strategic framework, consultation process and collaboration approach taken by Gather + Grow has potential to be adapted in other states/territories in which food security is a priority. Learnings, guiding principles and enabling actions discussed in this review could be applied to a variety of public health challenges across Australia.
Acknowledgements
The authors would like to acknowledge all colleagues, communities and advocates that have contributed to Gather + Grow.
Author contributions
All authors contributed to the concepts, key themes and scope of this review article. RE drafted the manuscript with input and critical review by RL and SN.
Financial support
The authors have no financial support to disclose.
Competing interests
The authors have no conflicts of interest to disclose.
