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Measuring socio-economic position in dietary research: is choice of socio-economic indicator important?

  • Gavin Turrell (a1), Belinda Hewitt (a1), Carla Patterson (a1) and Brian Oldenburg (a1)

Abstract

Objectives:

To examine the association between socio-economic position (SEP) and diet, by assessing the unadjusted and simultaneously adjusted (independent) contributions of education, occupation and household income to food purchasing behaviour

Design:

The sample was randomly selected using a stratified two-stage cluster design, and the response rate was 66.4%. Data were collected by face-to-face interview. Food purchasing was examined on the basis of three composite indices that reflected a household's choice of grocery items (including meat and chicken), fruit and vegetables

Setting:

Brisbane City, Australia, 2000

Participants:

Non-institutionalised residents of private dwellings (n = 1003), located in 50 small areas (Census Collectors Districts)

Results:

When shopping, respondents in lower socio-economic groups were less likely to purchase grocery foods that were high in fibre and low in fat, salt and sugar. Disadvantaged groups purchased fewer types of fresh fruits and vegetables, and less often, than their counterparts from more advantaged backgrounds. When the relationship between SEP and food purchasing was examined using each indicator separately, education and household income made an unadjusted contribution to purchasing behaviour for all three food indices; however, occupation was significantly related only with the purchase of grocery foods. When education and occupation were simultaneously adjusted for each other, the socio-economic patterning with food purchase remained largely unchanged, although the strength of the associations was attenuated. When household income was introduced into the analysis, the association between education, occupation and food purchasing behaviour was diminished or became non-significant; income, however, showed a strong, graded association with food choice

Conclusions:

The food purchasing behaviours of socio-economically disadvantaged groups were least in accord with dietary guideline recommendations, and hence are more consistent with greater risk for the development of diet-related disease. The use of separate indicators for education, occupation and household income each adds something unique to our understanding of how socio-economic position is related to diet: each indicator reflects a different underlying social process and hence they are not interchangeable, and do not serve as adequate proxies for one another

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Copyright

Corresponding author

*Corresponding Author: Email g.turrell@qut.edu.au

References

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1Berkman, LF, Macintyre, S. The measurement of social class in health studies: old measures and new formulations. IARC Scientific Publications 1997; 138: 5164.
2Liberatos, P, Link, BG, Kelsey, JL. The measurement of social class in epidemiology. Epidemiol. Rev. 1988; 10: 87121.
3Krieger, N, Williams, DR, Moss, NE. Measuring social class in US public health research: concepts, methodologies and guidelines. Annu. Rev. Public Health 1997; 18: 341–78.
4Galobardes, B, Morabia, A, Bernstein, M. Diet and socioeconomic position: does the use of different indicators matter? Int. J. Epidemiol. 2001; 30: 334–40
5Milligan, RA, Burke, V, Beilin, LJ, Dunbar, DL, Spencer, MJ, Balde, E. Influence of gender and socioeconomic status on dietary patterns and nutrient intakes in 18 year old Australians. Aust. NZ J. Public Health 1998; 25: 389–95.
6Bergstrom, E, Hernell, O, Persson, L. Cardiovascular risk indicators in girls from families of low socioeconomic status. Acta Paediatr. 1996; 85: 1083–90.
7Billson, H, Pryer, JA, Nichols, R. Variation in fruit and vegetable consumption among adults in Britain: an analysis from the Dietary and Nutritional Survey of British Adults. Eur. J. Clin. Nutr. 1999; 53: 946–52.
8De Irala-Estevez, J, Groth, M, Johansson, L, Oltersdorf, U, Prattala, R, Martinez-Gonzalez, MA. A systematic review of socioeconomic differences in food habits in Europe: consumption of fruit and vegetables. Eur. J. Clin. Nutr. 2000; 54: 706–14.
9Rankin, JW, Winett, RA, Anderson, ES, Bickley, PG, Moore, JF, Leahy, M, et al. Food purchase patterns at the supermarket and their relationship to family characteristics. J. Nutr. Educ. 1998; 30: 81–8.
10Turrell, G. Socioeconomic differences in food preference and their influence on healthy food purchasing choices. J. Hum. Nutr. Diet. 1998; 11: 135–49.
11Turrell, G, Western, JS, Najman, JM. The measurement of social class in health research: problems and prospects. In: Waddell, C, Petersen, AR, eds. Just Health: Inequality in Illness, Care and Prevention. Melbourne: Churchill Livingstone, 1994; 87103.
12Lynch, J, Kaplan, G. Socioeconomic position. In: Berkman, LF, Kawachi, I, eds. Social Epidemiology. New York: Oxford University Press, 2000; 1335.
13Macario, E, Emmons, KM, Sorensen, G, Hunt, MK, Rudd, RE. Factors influencing nutrition education for patients with low literacy skills. J. Am. Diet. Assoc. 1998; 98: 559–64.
14Busselman, KM, Holcomb, CA. Reading skill and comprehension of Dietary Guidelines by WIC participants. J. Am. Diet. Assoc. 1994; 94: 622–5.
15Robinson, N, Caraher, M, Lang, T. Access to shops: the views of low-income shoppers. Health Educ. J. 2000; 59: 121–36.
16Barratt, J. The cost and availability of healthy food choices in southern Derbyshire. J. Hum. Nutr. Diet. 1997; 10: 63–9.
17Sooman, A, Macintyre, S, Anderson, A. Scotland's health – a more difficult challenge for some? The price and availability of healthy foods in socially contrasting localities in the West of Scotland. Health Bull. 1993; 51: 276–84.
18Najman, JM. The measurement of socioeconomic inequality and social class in Australia: a review of past practices and recent developments. Community Health Stud. 1988; 12: 3141.
19Winkelby, MA, Jatulis, DE, Frank, E, Fortmann, SP. Socioeconomic status and health: how education, income and occupation contribute to risk factors for cardiovascular disease. Am. J. Public Health 1992; 82: 816–20.
20Abramson, JH, Gofin, R, Habib, J, Pridan, H, Gofin, J. Indicators of social class: a comparative appraisal of measures for use in epidemiological studies. Soc. Sci. Med. 1982; 16: 1739–46.
21Auld, GW, Bruhn, CM, McNulty, J, Bock, MA, Gabel, K, Lauritzen, G, et al. Reported adoption of dietary fat and fiber recommendations among consumers. J. Am. Diet. Assoc. 2000; 100: 52–8.
22: Shi, L. Sociodemographic characteristics and individual health behaviours. S. Med. J. 1998; 91: 933–41.
23Dobson, A, Porteous, J, McElduff, P, Alexander, H. Whose diet has changed? Aust. NZ J. Public Health 1997; 21: 147–54.
24Thompson, B, Denmark-Wahnefried, W, Taylor, G, McClelland, JW, Stables, G, Havas, S, et al. Baseline fruit and vegetable intake among adults in seven 5 a day study centers located in diverse geographic areas. J. Am. Diet. Assoc. 1999; 99: 1241–48.
25Lindstrom, M, Hanson, BS, Wirfalt, E, Ostergren, PO. Socioeconomic differences in the consumption of vegetables, fruit and fruit juices: the influence of psychosocial factors. Eur. J. Public Health 2001; 11: 51–9.
26Bolton-Smith, C, Smith, WCS, Woodward, M, Tunstall-Pedoe, H. Nutrient intakes of different social-class groups: results from the Scottish Heart Health Study (SHHS). Br. J. Nutr. 1991; 65: 321–35.
27Evans, A, Booth, H, Cashel, K. Sociodemographic determinants of energy, fat and dietary fibre intake in Australian adults. Public Health Nutr. 2000; 3: 6775.
28Turrell, G, Patterson, C, Oldenburg, B, Gould, T, Roy, M-A. The socio-economic patterning of survey participation and non-response error in a multilevel study of food purchasing behaviour: area- and individual-level characteristics. Public Health Nutr. 2003; 6: 179187.
29Caraher, M, Dixon, P, Lang, T, Car-Hill, R. Access to healthy foods: part I. Barriers to accessing healthy foods: differentials by gender, social class, income and mode of transport. Health Educ. J. 1998; 57: 191201.
30Turrell, G. Determinants of gender differences in dietary behavior. Nutr. Res. 1997; 17: 1105–20.
31Australian Bureau of Statistics. Australian Standard Classification of Occupations, 2nd ed. Catalogue No. 1220.0 Canberra: Australian Government Publishing Service, 1997.
32Turrell, G, Battistutta, D, McGuffog, I. Social determinants of smoking among parents with infants. Aust. NZ J. Public Health 2002; 26: 30–7.
33Turrell, G. Income non-reporting: implications for health inequalities research. J. Epidemiol. Community Health 2000; 54: 166–72.
34Australian Bureau of Statistics. Income Distribution 1999–2000. Catalogue No. 6523.0. Canberra: Australian Government Publishing Service, 2001.
35Turrell, G. Determinants of healthy food choice in a population-based sample. Am. J. Health Behav. 1998; 22: 342–57.
36Turrell, G. Compliance with the Australian dietary guidelines in the early 1990's: have population-based health promotion programs been effective? Nutr. Health 1997; 11: 271–88.
37Commonwealth Department of Health and Family Services. Australian Guide to Healthy Eating. Canberra: Australian Government Publishing Service, 1998.
38McLennan, W. National Nutrition Survey User's Guide. Canberra: Australian Government Publishing Service, 1998.
39Blalock, HM. Social Statistics. Tokyo: McGraw Hill, 1981; 462.
40SAS Institute, Inc. SAS/STAT Software: Changes and Enhancements through Release 6.12. Cary, NC: SAS Institute, Inc., 1997.
41Korn, EL, Graubard, BI. Analysis of large health surveys: accounting for the sampling design. J. Roy. Statist. Soc. 1995; 158: 263–95.
42Carlin, JB, Hocking, J. Design of cross-sectional surveys using cluster sampling: an overview with Australian case studies. Aust. NZ J . Public Health 1999; 23: 546–51.
43Research Triangle Institute. SUDAAN User's Manual, Release 8.0. Research Triangle Park, NC: Research Triangle Institute, 2001.
44Shimakawa, T, Sorlie, P, Carpenter, MA, Dennis, B, Tell, GS, Watson, R, et al. Dietary intake patterns and sociodemographic factors in the Atherosclerosis Risk in Communities Study. Prev. Med. 1994; 23: 769–80.
45Roos, E, Lahelma, E, Virtanen, M, Prattala, R, Pietinen, P. Gender, socioeconomic status and family status as determinants of food behaviour. Soc. Sci. Med. 1998; 46: 1519–29.
46Smith, AM, Baghurst, KI. Public health implications of dietary differences between social status and occupational category groups. J. Epidemiol. Community Health 1992; 46: 409–16.
47Shaw, M, Dorling, D, Gordon, D, Smith, GD. The Widening Gap: Health Inequalities and Policy in Britain. Bristol: Policy Press, 1999.
48Tseng, M, DeVellis, RF. Fundamental dietary patterns and their correlates among US whites. J. Am. Diet. Assoc. 2001; 101: 929–32.
49Kinsey, JD. Food and families' socioeconomic status. J. Nutr. 1994; 124: 1878S–85S.
50Benzeval, M, Judge, K, Whitehead, M. Tackling Inequalities in Health: An Agenda for Action. London: King's Fund, 1995.
51Kawachi, I, Marmot, MG. What can we learn from studies of occupational class and cardiovascular disease? Am. J. Epidemiol. 1998; 148: 160–3.
52Curtis, KA, McClellan, S. Falling through the safety net: poverty, food assistance and shopping constraints in an American city. Urban Anthropol. 1995; 24: 93135.
53Ellaway, A, Macintyre, S. Shopping for food in socially contrasting localities. Br. Food J. 2000; 102: 52–9.
54Turrell, G, Najman, JM. Collecting food-related data from low socioeconomic groups: how adequate are our current research designs? Aust. J. Public Health 1995; 19: 410–6.

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