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Addressing embodied inequities in health: how do we enable improvement in women’s diet in pregnancy?

Published online by Cambridge University Press:  06 July 2020

L McKerracher
Affiliation:
Department of Biochemistry and Biomedical Sciences, McMaster University, Hamilton, ON, Canada Department of Anthropology, McMaster University, Hamilton, ON, Canada
S Oresnik
Affiliation:
Department of Anthropology, McMaster University, Hamilton, ON, Canada
T Moffat
Affiliation:
Department of Anthropology, McMaster University, Hamilton, ON, Canada
B Murray-Davis
Affiliation:
Department of Midwifery, McMaster University, Hamilton, ON, Canada
J Vickers-Manzin
Affiliation:
Public Health Services, Healthy Families Division, Hamilton, ON, Canada
L Zalot
Affiliation:
Public Health Services, Healthy Families Division, Hamilton, ON, Canada
D Williams
Affiliation:
Department of Anthropology, McMaster University, Hamilton, ON, Canada
DM Sloboda
Affiliation:
Department of Biochemistry and Biomedical Sciences, McMaster University, Hamilton, ON, Canada Department of Obstetrics and Gynecology, McMaster University, Hamilton, ON, Canada Department of Pediatrics, McMaster University, Hamilton, ON, Canada Farncombe Institute of Digestive Health, McMaster University, Hamilton, ON, Canada
ME Barker
Affiliation:
Medical Research Council Lifecourse Epidemiology Unit, Southampton University, Southampton, United Kingdom of Great Britain and Northern Ireland
Corresponding

Abstract

Objective:

To disrupt cycles of health inequity, traceable to dietary inequities in the earliest stages of life, public health interventions should target improving nutritional wellbeing in preconception/pregnancy environments. This requires a deep engagement with pregnant/postpartum people (PPP) and their communities (including their health and social care providers, HSCP). We sought to understand the factors that influence diet during pregnancy from the perspectives of PPP and HSCP, and to outline intervention priorities.

Design:

We carried out thematic network analyses of transcripts from ten focus group discussions (FGD) and one stakeholder engagement meeting with PPP and HSCP in a Canadian city. Identified themes were developed into conceptual maps, highlighting local priorities for pregnancy nutrition and intervention development.

Setting:

FGD and the stakeholder meeting were run in predominantly lower socioeconomic position (SEP) neighbourhoods in the sociodemographically diverse city of Hamilton, Canada.

Participants:

All local, comprising twenty-two lower SEP PPP and forty-three HSCP.

Results:

Salient themes were resilience, resources, relationships and the embodied experience of pregnancy. Both PPP and HSCP underscored that socioeconomic-political forces operating at multiple levels largely determined the availability of individual and relational resources constraining diet during pregnancy. Intervention proposals focused on cultivating individual and community resilience to improve early-life nutritional environments. Participants called for better-integrated services, greater income supports and strengthened support programmes.

Conclusions:

Hamilton stakeholders foregrounded social determinants of inequity as main factors influencing pregnancy diet. They further indicated a need to develop interventions that build resilience and redistribute resources at multiple levels, from the household to the state.

Type
Research paper
Copyright
© McMaster University and The Author(s), 2020

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Footnotes

These authors share senior/principal investigator authorship status.

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