Objective: To present disparities in consumption of vegetables and fruits in Europe and to discuss how educational level, region and level of consumption influence the variation. Design: A review of selected studies from 1985 to 1997. Setting/subjects: 33 studies (13 dietary surveys, nine household budget surveys and 11 health behaviour surveys) representing 15 European countries were selected based on criteria developed as part of the study. Association between educational level and consumption of vegetables and fruits was registered for each study and common conclusions were identified. Results: In the majority of the studies, with the exception of a few in southern and eastern Europe, consumption of vegetables and fruits was more common among those with higher education. The results suggest that in regions where consumption of vegetables and fruits is more common, the lower social classes tend to consume more of these than the higher social classes. Conclusions: The differences in the patterns of disparities in vegetable and fruit consumption between regions, as well as within populations, need to be considered when efforts to improve nutrition and health are planned.
The consistent association of gender and food and the similarity of gender patterning in population subgroups point to the stability of masculine versus feminine food habits. The similarity suggests that food habits contribute equally to the gender gap in health in the Baltic countries as they do in Finland.
Community empowerment approaches have been proven to be powerful tools for solving local health problems. However, the methods for measuring empowerment in the community remain unclear and open to dispute. This study aims to describe how a context-specific community empowerment measurement tool was developed and changes made to three health promotion programs in Rapla, Estonia. An empowerment expansion model was compiled and applied to three existing programs: Safe Community, Drug/HIV Prevention and Elderly Quality of Life. The consensus workshop method was used to create the measurement tool and collect data on the Organizational Domains of Community Empowerment (ODCE). The study demonstrated considerable increases in the ODCE among the community workgroup, which was initiated by community members and the municipality’s decision-makers. The increase was within the workgroup, which had strong political and financial support on a national level but was not the community’s priority. The program was initiated and implemented by the local community members, and continuous development still occurred, though at a reduced pace. The use of the empowerment expansion model has proven to be an applicable, relevant, simple and inexpensive tool for the evaluation of community empowerment.
The level of nonresponse and missing information was comparable in different countries, not information on health behaviour. Therefore special efforts are needed to design a questionnaire form which appears equally relevant to all respondent groups. The follow-up mailings were an effective way to increase the total response rate, but it was unlikely that they provided an effective way to reach the 'hard core' nonrespondents.
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