Title: Nutritional, socio-economic and health status

Key words: Acheson Report, health inequalities, polyunsaturated fat, saturated fat, antioxidants, heart disease, gender differences, intelligence, education

Date: March 2001

Category: Food and the environment

Type: Article

Author: Kate Neil (NS³)

Nutritional, socio-economic and health status

The Acheson Report in 1998 highlighted inequalities in health in England and identified priority areas for the development of policies to reduce them.

Health inequalities have been rising when the richest and poorest groups have been compared e.g. in the 1970’s the difference in mortality rate between men in class V was twice that in class 1. In 1980, the Black Report indicated that ill health was more prevalent among people with low incomes and that they were more likely to die prematurely.

The Acheson Report considered it crucial to target the health of families with children, provide measures to reduce income inequalities, and improve the living standards of poor households. The Report identified other target groups including: pregnant women, young people, adults of working age, older people, ethnic and gender inequalities.

It is now accepted that members of lower income households have poorer health experiences including:

• Higher rates of heart disease
• Higher blood pressure
• Obesity, particularly women
• Higher incidence of death from stomach and oesophageal cancer
• Respiratory and digestive system disorders
• Dental caries in children

Identifiable patterns include:

• Less varied diet
• Lower consumption of wholegrains, fruit and vegetables and antioxidants
• Higher incidence of smoking and physical inactivity
• High in calories, low nutrient-dense foods

The National Food Survey and the National Diet and Nutrition Surveys provide the best data. Surveys find with lower socio-economic status:

• Lower intakes of total sugars and higher intakes of starch, lower intakes of most minerals and many vitamins in pre-school children
• Less breast-feeding
• High fat and sugar intake, lower in iron, and possibly folate in school-age children. Lower calcium in older girls.
• Reduced intakes of sugars, fibre, calcium, total carotene, vitamin C
• Lower polyunsaturated:saturate ratio in adults.
• Poorer intakes of folate and antioxidant nutrients
• A range of nutrients affected in older people

Surveys also indicate geographical differences:

• Higher incidence of heart disease due to considerably lower intake of fresh green vegetable and fruit in Scotland
• Lower polyunsaturated:saturated fat ratios, vitamins C, E and beta-carotene, sugars, fibre and calcium
• Northern men have a higher intake of iron and consume more overall energy and sodium
• Saturated fat intake has declined in all income groups and regions in Great Britain
• Pre-school Scottish children have lower intakes of vitamin C and beta-carotene than elsewhere, while sodium intake is higher
• Higher incidence of dental caries in the North

Lower socio-economic households tend to:

• Purchase foods that provide bulk, energy and do not easily spoil
• Have less space for food storage, preparation facilities
• Reduced transport facilities to access low cost nutritious foods

Education, combined with a commitment to provide practical strategies for improving conditions for socio-economically deprived groups is vital if this trend is to be reversed. Reduced intelligence associated with iron deficiency and poor polyunsaturated:saturated fat ratios, combined with the concept of the Barker hypothesis make it virtually impossible for the lower socio-economic groups to transcend their position.

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