Hostname: page-component-78c5997874-mlc7c Total loading time: 0 Render date: 2024-11-13T03:32:52.014Z Has data issue: false hasContentIssue false
  • English
  • Français

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

Published online by Cambridge University Press:  02 January 2007

Gavin Turrell ,
Belinda Hewitt ,
Carla Patterson  and
Brian Oldenburg
Gavin Turrell*
Affiliation:
Queensland University of Technology, School of Public Health, Victoria Park Road, Kelvin Grove, Brisbane, Queensland 4059, Australia
Belinda Hewitt
Affiliation:
Queensland University of Technology, School of Public Health, Victoria Park Road, Kelvin Grove, Brisbane, Queensland 4059, Australia
Carla Patterson
Affiliation:
Queensland University of Technology, School of Public Health, Victoria Park Road, Kelvin Grove, Brisbane, Queensland 4059, Australia
Brian Oldenburg
Affiliation:
Queensland University of Technology, School of Public Health, Victoria Park Road, Kelvin Grove, Brisbane, Queensland 4059, Australia
*
*Corresponding Author: Email g.turrell@qut.edu.au
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.
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

Keywords

Socio-economic positionMeasurementDiet
Type
Research Article
Information
Public Health Nutrition , Volume 6 , Issue 2 , April 2003 , pp. 191 - 200
Copyright
Copyright © CABI Publishing 2003

References

1Berkman, LF, Macintyre, S. The measurement of social class in health studies: old measures and new formulations. IARC Scientific Publications 1997; 138: 51–64.Google Scholar
2Liberatos, P, Link, BG, Kelsey, JL. The measurement of social class in epidemiology. Epidemiol. Rev. 1988; 10: 87–121.CrossRefGoogle ScholarPubMed
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.CrossRefGoogle ScholarPubMed
4Galobardes, B, Morabia, A, Bernstein, M. Diet and socioeconomic position: does the use of different indicators matter? Int. J. Epidemiol. 2001; 30: 334–40CrossRefGoogle ScholarPubMed
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.Google Scholar
6Bergstrom, E, Hernell, O, Persson, L. Cardiovascular risk indicators in girls from families of low socioeconomic status. Acta Paediatr. 1996; 85: 1083–90.CrossRefGoogle Scholar
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.CrossRefGoogle ScholarPubMed
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.CrossRefGoogle Scholar
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.CrossRefGoogle Scholar
10Turrell, G. Socioeconomic differences in food preference and their influence on healthy food purchasing choices. J. Hum. Nutr. Diet. 1998; 11: 135–49.CrossRefGoogle Scholar
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; 87–103.Google Scholar
12Lynch, J, Kaplan, G. Socioeconomic position. In: Berkman, LF, Kawachi, I, eds. Social Epidemiology. New York: Oxford University Press, 2000; 13–35.CrossRefGoogle Scholar
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.CrossRefGoogle ScholarPubMed
14Busselman, KM, Holcomb, CA. Reading skill and comprehension of Dietary Guidelines by WIC participants. J. Am. Diet. Assoc. 1994; 94: 622–5.CrossRefGoogle ScholarPubMed
15Robinson, N, Caraher, M, Lang, T. Access to shops: the views of low-income shoppers. Health Educ. J. 2000; 59: 121–36.CrossRefGoogle Scholar
16Barratt, J. The cost and availability of healthy food choices in southern Derbyshire. J. Hum. Nutr. Diet. 1997; 10: 63–9.CrossRefGoogle Scholar
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.Google Scholar
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: 31–41.CrossRefGoogle Scholar
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.CrossRefGoogle Scholar
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.CrossRefGoogle ScholarPubMed
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.CrossRefGoogle ScholarPubMed
22: Shi, L. Sociodemographic characteristics and individual health behaviours. S. Med. J. 1998; 91: 933–41.CrossRefGoogle Scholar
23Dobson, A, Porteous, J, McElduff, P, Alexander, H. Whose diet has changed? Aust. NZ J. Public Health 1997; 21: 147–54.CrossRefGoogle ScholarPubMed
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.CrossRefGoogle Scholar
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.CrossRefGoogle ScholarPubMed
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.CrossRefGoogle ScholarPubMed
27Evans, A, Booth, H, Cashel, K. Sociodemographic determinants of energy, fat and dietary fibre intake in Australian adults. Public Health Nutr. 2000; 3: 67–75.CrossRefGoogle ScholarPubMed
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: 179–187.CrossRefGoogle Scholar
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: 191–201.CrossRefGoogle Scholar
30Turrell, G. Determinants of gender differences in dietary behavior. Nutr. Res. 1997; 17: 1105–20.CrossRefGoogle Scholar
31Australian Bureau of Statistics. Australian Standard Classification of Occupations, 2nd ed. Catalogue No. 1220.0 Canberra: Australian Government Publishing Service, 1997.Google Scholar
32Turrell, G, Battistutta, D, McGuffog, I. Social determinants of smoking among parents with infants. Aust. NZ J. Public Health 2002; 26: 30–7.CrossRefGoogle ScholarPubMed
33Turrell, G. Income non-reporting: implications for health inequalities research. J. Epidemiol. Community Health 2000; 54: 166–72.CrossRefGoogle ScholarPubMed
34Australian Bureau of Statistics. Income Distribution 1999–2000. Catalogue No. 6523.0. Canberra: Australian Government Publishing Service, 2001.Google Scholar
35Turrell, G. Determinants of healthy food choice in a population-based sample. Am. J. Health Behav. 1998; 22: 342–57.Google Scholar
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.CrossRefGoogle Scholar
37Commonwealth Department of Health and Family Services. Australian Guide to Healthy Eating. Canberra: Australian Government Publishing Service, 1998.Google Scholar
38McLennan, W. National Nutrition Survey User's Guide. Canberra: Australian Government Publishing Service, 1998.Google Scholar
39Blalock, HM. Social Statistics. Tokyo: McGraw Hill, 1981; 462.Google Scholar
40SAS Institute, Inc. SAS/STAT Software: Changes and Enhancements through Release 6.12. Cary, NC: SAS Institute, Inc., 1997.Google Scholar
41Korn, EL, Graubard, BI. Analysis of large health surveys: accounting for the sampling design. J. Roy. Statist. Soc. 1995; 158: 263–95.CrossRefGoogle Scholar
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.CrossRefGoogle ScholarPubMed
43Research Triangle Institute. SUDAAN User's Manual, Release 8.0. Research Triangle Park, NC: Research Triangle Institute, 2001.Google Scholar
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.CrossRefGoogle ScholarPubMed
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.CrossRefGoogle ScholarPubMed
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.CrossRefGoogle ScholarPubMed
47Shaw, M, Dorling, D, Gordon, D, Smith, GD. The Widening Gap: Health Inequalities and Policy in Britain. Bristol: Policy Press, 1999.Google Scholar
48Tseng, M, DeVellis, RF. Fundamental dietary patterns and their correlates among US whites. J. Am. Diet. Assoc. 2001; 101: 929–32.CrossRefGoogle ScholarPubMed
49Kinsey, JD. Food and families' socioeconomic status. J. Nutr. 1994; 124: 1878S–85S.CrossRefGoogle ScholarPubMed
50Benzeval, M, Judge, K, Whitehead, M. Tackling Inequalities in Health: An Agenda for Action. London: King's Fund, 1995.Google Scholar
51Kawachi, I, Marmot, MG. What can we learn from studies of occupational class and cardiovascular disease? Am. J. Epidemiol. 1998; 148: 160–3.CrossRefGoogle ScholarPubMed
52Curtis, KA, McClellan, S. Falling through the safety net: poverty, food assistance and shopping constraints in an American city. Urban Anthropol. 1995; 24: 93–135.Google Scholar
53Ellaway, A, Macintyre, S. Shopping for food in socially contrasting localities. Br. Food J. 2000; 102: 52–9.CrossRefGoogle Scholar
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.CrossRefGoogle ScholarPubMed