Gender and the double burden of economic and social disadvantages on healthy eating: cross-sectional study of older adults in the EPIC-Norfolk cohort

BMC Public Health

Research Article

Nita G. Forouhi¹  Paul Surtees²  Pablo Monsivais³  Annalijn I. Conklin³  Nicholas J. Wareham⁴ 

[1] Medical Research Council Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK;Strangeways Research Laboratory and Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK;UK Clinical Research Collaboration Centre for Diet and Activity Research (CEDAR), MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, UK;UK Clinical Research Collaboration Centre for Diet and Activity Research (CEDAR), MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, UK;Medical Research Council Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK;

关键词: Gender;    Fruit and vegetable intake;    Social relationships;    Economic determinants;    Financial hardships;    Deprivation amplification;    Aging;    EPIC cohort;   

DOI  :  10.1186/s12889-015-1895-y

 received in 2014-11-25, accepted in 2015-05-29,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundMultiple economic factors and social relationships determine dietary behaviours, but the inter-relations between determinants is unknown. Whether women and men differ in the vulnerability to, and impact of, combined disadvantages is also unclear. We examined associations between diverse combinations of economic resources and social relationships, and healthy eating in British older women and men.MethodsOur sample comprised 9,580 over-50s (47 % of over-50 respondents) in the EPIC-Norfolk cohort study. We examined six economic factors (education, social class, home-ownership, money for needs, frequency of insufficient money for food/clothing, paying bills) and three social relationships (marital status, living arrangement and friend contact), independently and in combination, in relation to fruit variety and vegetable variety. We analysed gender-specific associations using multivariable linear regression with interaction terms.ResultsLower social class, lower education, and difficulty paying bills were associated with lower fruit and vegetable variety in both genders, independent of social relationships. All social relationships were independently associated with fruit variety in men and with vegetable variety in both genders. Substantially lower variety was found for all combinations of low economic resources and lack of social relationship than for either measure alone, with men faring worse in the majority of combined disadvantages. For example, the difference in vegetable variety for men reporting low social class and non-married was much greater (β -4.1, [-4.8, -3.4]), than the independent association of low social class (β -1.5, [-1.8,–1.2]), or non-married (β -1.8, [-2.3,–1.3]). Variety was also lower among men with high economic resources but non-married or lone-living.ConclusionA double burden of low economic resources and lack of social relationships suggested they are unique joint determinants, particularly in older men, and that public health efforts to improve healthy eating would offer most benefit to older adults with intersecting economic and social disadvantages.

【 授权许可】

Unknown   
© Conklin et al. 2015. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.