Why do women of low socioeconomic status have poorer dietary behaviours than women of higher socioeconomic status? A qualitative exploration

Abstract

In developed countries, persons of low socioeconomic status (SES) are generally less likely to consume diets consistent with dietary guidelines. Little is known about the mechanisms that underlie SES differences in eating behaviours. Since women are often responsible for dietary choices within households, this qualitative study investigated factors that may contribute to socioeconomic inequalities in dietary behaviour among women. Semi-structured interviews were conducted with 19 high-, 19 mid- and 18 low- SES women, recruited from Melbourne, Australia, using an area-level indicator of SES. An ecological framework, in which individual, social and environmental level influences on diet were considered, was used to guide the development of interview questions and interpretation of the data. Thematic analysis was undertaken to identify the main themes emerging from the data. Several key influences varied by SES. These included food-related values such as health consciousness, and a lack of time due to family commitments (more salient among higher SES women), as well as perceived high cost of healthy eating and lack of time due to work commitments (more important for low SES women). Reported availability of and access to good quality healthy foods did not differ strikingly across SES groups. Public health strategies aimed at reducing SES inequalities in diet might focus on promoting healthy diets that are low cost, as well as promoting time-efficient food preparation strategies for all women.

Perceived quality and availability of fruit and vegetables are associated with perceptions of fruit and vegetable affordability among socio-economically disadvantaged women

“…and (iii) 'ydiscourage you from eating unhealthy foods?' The five response categories were: never (1); rarely (2); a few times (3); often (4); and very often (5). Responses for these three items were summed to create a Family Social Support scale that had a range of 3 (i.e.…”

“…women with low education, low income and/or residing in disadvantaged neighbourhoods) consume diets that are less consistent with guidelines for health, including lower consumption of fruit and vegetables (1)(2)(3) . One explanation for this socio-economic gradient in fruit and vegetable consumption is that women of low SEP are more likely than their more advantaged counterparts to perceive fruit and vegetables as expensive (4)(5)(6)(7)(8)(9)(10) . Women's perceptions of fruit and vegetable affordability, rather than actual prices of fruit and vegetables, have been found to significantly mediate the relationship between SEP and fruit and vegetable consumption (11,12) .…”

The contribution of three components of nutrition knowledge to socio-economic differences in food purchasing choices

“…A lack of belief in or understanding of the relationship between diet and disease may result in a lack of motivation to apply other aspects of nutrition knowledge; for example, knowledge of the nutrient content of foods or knowledge of dietary guidelines. Socio-economic groups are found to have different priorities and perspectives in relation to food choice decision making (49,50) . Concerns regarding health and nutrition are often reported to be more salient in the food choices of those of high SEP compared with those who are disadvantaged (50)(51)(52) .…”

“…Socio-economic groups are found to have different priorities and perspectives in relation to food choice decision making (49,50) . Concerns regarding health and nutrition are often reported to be more salient in the food choices of those of high SEP compared with those who are disadvantaged (50)(51)(52) . Those of high SEP are also found to perceive greater levels of personal control over their health (53,54) , to be less likely to assume that they are at lower risk of negative health outcomes compared with the average person (optimistic bias) (49) and to have a greater sense of personal responsibility to engage in health-promoting behaviours (55) .…”

Is the perception of time pressure a barrier to healthy eating and physical activity among women?

“…This is often reported among women, with recent qualitative evidence suggesting Australian women's perception of time pressure was a fundamental barrier to their healthy eating and physical activity (9) . The concept of time constraint in relation to food is complex.…”