Healthy eating strategies for socioeconomically disadvantaged populations: a meta-ethnography

Abstract

Purpose: In developed countries, diet-related health inequalities between people with different levels of socioeconomic advantage persist. However, there is limited qualitative evidence to inform the design of effective healthy eating (HE) strategies in socioeconomically disadvantaged populations (SDPs). The purpose of this review was to explore the characteristics influencing HE strategies for SDPs and develop a new understanding of how and why they influence their success. Methods: A qualitative evidence synthesis using a systematic meta-ethnographic approach. The twelve studies included were conducted in the USA, Canada, Australia, and UK. Results: The studies described a range of HE strategies, including nutrition education programs, food vouchers, and community gardens. Personal values and sense of pride and autonomy were found to have an influence on participants' attitudes towards HE strategies. Similarly, social characteristics such as level of social support and opportunities for shared benefits influenced participants' engagement. Structural characteristics such as the affordability and accessibility of healthy foods determined strategy acceptability and success. Finally, organizational characteristics such as flexibility influenced how well strategies supported the circumstances of participants. Conclusions: These overlapping characteristics may be used to inform the development, implementation, and evaluation of strategies to improve healthy eating in SDPs.

Cross-sectional survey of attitudes and beliefs towards dementia risk reduction among Australian older adults

“…Individuals who engage in more health-promoting behaviours (e.g., participate in exercise, attend social and cultural events, engage in continuous learning) have better physical and psychological health despite their socioeconomic status [ 74 ]. Indeed, enabling individuals by incorporating elements of social cohesion for engagement, provision of affordable, accessible information and tailored advice from credible sources (e.g., GPs), and constant external monitoring due to a lack of self-mobilisation have been critical to the successful implementation of grass-root lifestyle interventions in lower socioeconomic areas [ 75 , 76 ].…”

Do food-related capabilities, opportunities and motivations of adolescents mediate the association between socioeconomic position in adolescence and diet quality in early adulthood?

“…This is particularly relevant for food insecure households, [ 52 ] who have been disproportionately affected as a result of the COVID-19 pandemic [ 53 ]. In addition, broader social and structural-level factors that influence the home availability of fruits and vegetables should also be addressed, such as ensuring food outlets stock fruit and vegetable varieties that are aligned with cultural beliefs and norms of the communities they serve, increasing the affordability of fruits and vegetables, subsidizing their costs and prioritizing food assistance programs and fiscal incentives for the consumer, food industry and organizations [ 54 – 56 ]. Notably, availability of a large variety of fresh fruit and vegetables in the neighborhood, a further structural-level factor, was excluded from the analyses to optimize model fit.…”

Engaging with ‘less affluent’ communities for food system transformation: a community food researcher model (FoodSEqual project)

“…Socially and economically disadvantaged communities can be defined as 'individuals and families at risk of food and housing insecurity, often culturally diverse, who can experience multiple challenges; financial, mental health and physical health' (1) . Such communities are particularly at risk of food insecurity due to their inability to afford healthier foods (43,44) . Food access, quality and quantity are significant social determinants of health, and there remains a lack of understanding about what underpins food choices (or lack of choices) in such communities (45)(46)(47) .…”