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dc.contributor.authorConklin, Annalijn Ien
dc.contributor.authorForouhi, Nitaen
dc.contributor.authorSurtees, Paulen
dc.contributor.authorWareham, Nicholasen
dc.contributor.authorMonsivais, Pabloen
dc.date.accessioned2015-08-27T13:22:32Z
dc.date.available2015-08-27T13:22:32Z
dc.date.issued2015-07-22en
dc.identifier.citationConklin, A.I., Forouhi, N.G., Surtees, P., Wareham, N.J., Monsivais, P. (2015). "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 15(692). doi:10.1186/s12889-015-1895-yen
dc.identifier.issn1471-2458
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/250379
dc.description.abstractBackground: Multiple 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. Methods: Our 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. Results: Lower 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. Conclusion: A 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.
dc.description.sponsorshipThe work was undertaken by the Centre for Diet and Activity Research (CEDAR), a UKCRC Public Health Research of Excellence, funded by: the British Heart Foundation, Economic and Social Research Council, Medical Research Council, National Institute for Health Research and the Wellcome Trust, under the auspices of the UK Clinical Research Collaboration. EPIC-Norfolk is supported by programme grants from the Medical Research Council and Cancer Research UK. We further acknowledge core MRC Epidemiology Unit support through Programmes MC_UU_12015/1 and MC_UU_12015/5.
dc.languageEnglishen
dc.language.isoenen
dc.publisherBioMed Central
dc.rightsAttribution 2.0 UK: England & Wales
dc.rightsCreative Commons Attribution License 2.0 UK
dc.rights.urihttp://creativecommons.org/licenses/by/2.0/uk/
dc.subjectGenderen
dc.subjectFruit and vegetable intakeen
dc.subjectSocial relationshipsen
dc.subjectEconomic determinantsen
dc.subjectFinancial hardshipsen
dc.subjectDeprivation amplificationen
dc.subjectAgingen
dc.subjectEPIC cohorten
dc.titleGender and the double burden of economic and social disadvantages on healthy eating: Cross-sectional study of older adults in the EPIC-Norfolk cohorten
dc.typeArticle
dc.description.versionThis is the final version. It first appeared at http://dx.doi.org/10.1186/s12889-015-1895-y.en
prism.number692en
prism.publicationDate2015en
prism.publicationNameBMC Public Healthen
prism.volume15en
dc.rioxxterms.funderBHF
dc.rioxxterms.funderCRUK
dc.rioxxterms.funderESRC
dc.rioxxterms.funderMRC
dc.rioxxterms.funderNIHR
dc.rioxxterms.funderWellcome Trust
dcterms.dateAccepted2015-05-29en
rioxxterms.versionofrecord10.1186/s12889-015-1895-yen
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserveden
rioxxterms.licenseref.startdate2015-07-22en
dc.contributor.orcidForouhi, Nita [0000-0002-5041-248X]
dc.contributor.orcidWareham, Nicholas [0000-0003-1422-2993]
dc.contributor.orcidMonsivais, Pablo [0000-0002-7088-6674]
dc.identifier.eissn1471-2458
rioxxterms.typeJournal Article/Reviewen
pubs.funder-project-idMRC (MR/K023187/1)
pubs.funder-project-idMRC (MC_UU_12015/5)
pubs.funder-project-idMRC (MC_UU_12015/1)
pubs.funder-project-idESRC (ES/G007462/1)
pubs.funder-project-idWellcome Trust (087636/Z/08/Z)
pubs.funder-project-idMedical Research Council (MC_U106179471)


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Attribution 2.0 UK: England & Wales
Except where otherwise noted, this item's licence is described as Attribution 2.0 UK: England & Wales