Title: Socio-Economic Status and Nutrition

Key words: National food data, nutritional status, socio-economic factors, north-south divide, pre-school children

Date: July 2000

Category: 5. Nutrition and the Environment

Type: Article

Author: Dr van Rhijn

Socio-Economic Status and Nutrition

Health, socio-economic status and geographical factors in the UK

Introduction

National food surveys and independent enquiries have repeatedly confirmed a correlation between health status, socio-economic status and geographical region. Inequalities in dietary patterns may be a major contributory factor.

Socio-economic Status

There are great differences in food intake patterns between members of social class I & II and members of social class IV & V. The latter have a lower consumption of total energy (despite higher alcohol intake), fat, whole grain products, non-starch polysaccharides (NSP = fibre), fruits, vegetables, vitamins, minerals and antioxidants. The diet also lacked variety and nutrient density.

Children from non-manual home backgrounds were more likely to have eaten protein, rice, wholemeal bread, whole grain and high-fibre breakfast cereals, buns, cakes, pastries and fruit juices than were children from a manual home background. In contrast, the latter consumed more fat, sugar, starch, white bread and non-whole grain breakfast cereals, tea and their diets contains less vitamins (A, B-group, C, E, Folic acid ).

Geographical Region

The north-south divide also shows a different nutrient pattern and on average, the population in the north (especially Scotland) consumes less fat, vitamin C & E, beta-carotene, fresh vegetables & fruit, minerals and soluble vitamins. They also consume more sugars, fibre, calcium, iron (men) and sodium compared to the population of the south.

The National Diet and Nutritional Survey of pre-school children (1.5-4.5 year olds) show that children in the northern region were more likely to consume salt, meat products (beef & pies), baked beans and potatoes (chips, mashed & jacket), starch, canned fruit in syrup, soft drinks and coffee. They also tend to have lower intakes of folate, vitamin C, minerals and total energy compared to the south. In contrast, children in the south were more likely to be eating rice, coated chicken, cheese, non-starch polysaccharides (NSP), raw and salad vegetables as well as fruit juices. Tooth decay was more prevalent in Scotland (50%) and northern England (43%) compared with the rest of England and Wales (less than 25%).

Disease Rates

Members of low income households (social class IV & V) have poorer health experiences, with higher rates of coronary heart disease, hypertension, strokes, obesity (higher MBI), cancers, respiratory and digestive system disorders compared to members of social class I & II for men and women. This group also has a higher prevalence of smoking and physical inactivity.

Conclusion

At face value, there seems to be a relationship between nutritional and health status for different socio-demographic variables. Interpreting the results needs to be done cautiously, due to numerous potential sources of bias (lifestyles, stress & depression) in making causal associations. The results do, however, contribute to nutritional intervention policies. More importantly, they help refine hypotheses about the role of certain nutrients in the thus far poorly understood genesis of certain diseases.

 

References

James et al. Contribution of nutrition in the distribution of Health. BMJ. 1997; Vol: 314: 1545

National Diet and Nutritional Survey: Children aged 1 to 4: Summary.

The Dietary and Nutritional Survey of British Adults: Introduction.

National Diet and Nutritional Survey: People aged 65 years and over.

The National Heart Forum: 1997; At Least Five a day. Strategies to increase vegetables and fruit consumption. The Stationery Office. London.

Trends in Patterns of Disease and diet: Fact File No 10: 1993; National Dairy Council. London.

Macintyre & Anderson. Socio-demographic and Psycho-social variables. Chapter 9 pp 273-288. In: Margetts B. & Nelson M. 1998; Design Concepts in Nutritional Epidemiology. Second Edition. Oxford University Press. New York.