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Socio-economic inequalities in women's fruit and vegetable intakes: a multilevel study of individual, social and environmental mediators

  • Kylie Ball (a1), David Crawford (a1) and Gita Mishra (a2)
  • DOI: http://dx.doi.org/10.1079/PHN2005897
  • Published online: 01 January 2007
Abstract
AbstractObjective

This study employed a multilevel design to test the contribution of individual, social and environmental factors to mediating socio-economic status (SES) inequalities in fruit and vegetable consumption among women.

Design

A cross-sectional survey was linked with objective environmental data.

Setting

A community sample involving 45 neighbourhoods.

Subjects

In total, 1347 women from 45 neighbourhoods provided survey data on their SES (highest education level), nutrition knowledge, health considerations related to food purchasing, and social support for healthy eating. These data were linked with objective environmental data on the density of supermarkets and fruit and vegetable outlets in local neighbourhoods.

Results

Multilevel modelling showed that individual and social factors partly mediated, but did not completely explain, SES variations in fruit and vegetable consumption. Store density did not mediate the relationship of SES with fruit or vegetable consumption.

Conclusions

Nutrition promotion interventions should focus on enhancing nutrition knowledge and health considerations underlying food purchasing in order to promote healthy eating, particularly among those who are socio-economically disadvantaged. Further investigation is required to identify additional potential mediators of SES–diet relationships, particularly at the environmental level.

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*Corresponding author: Email kball@deakin.edu.au
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