Project

FOODPATH

Systemic drivers of (un)healthy diets among
people living in socioeconomic insecurity

FOODPATH - Work package 1

Why is healthy eating not self-evident for everyone? And what measures can be taken to facilitate healthier eating among individuals living on a low income? In this study, residents who have experience living on a limited income and professionals jointly explored these questions. The research adopts a systems perspective on the dietary behaviors of people with constrained financial means and provides recommendations for systemic change.

Socioeconomic inequalities in health and diet can be observed in many European countries [1,2]. Overall, less healthy dietary intakes among lower socioeconomic groups (e.g., lower fruit and vegetable consumption, higher intake of energy-dense foods), contribute to higher prevalence rates of overweight, obesity and diet-related NCDs among lower than higher socioeconomic groups [2,3].

Unhealthy eating behavior and socioeconomic inequalities in diets are the result of a complex system in which various factors and processes interact and reinforce each other [4,5]. However, there is still insufficient understanding of which specific factors and interactions play a role in this system.

Especially, to achieve dietary and health equity in the long term, there is a need to engage with disadvantaged communities and key stakeholders, as this can provide more insights into the main drivers and underlying mechanisms for food-related inequalities and identify leverage points for change [4].

FOODPATH will expand the theoretical basis on the systemic barriers to change through innovative methods with citizens, stakeholders and researchers co-creating systems maps through Group Model Building to identify policy leverage points with the potential to improve food environments and reduce food-related inequalities. The research questions that were addressed are:

  • What are the systemic drivers and barriers of (healthy) dietary behaviours among disadvantaged communities in European cities?
  • What are systemic leverage points and policy actions to improve food environments and reduce food-related inequalities from a citizen and food environment/social domain perspective in European cities?

Group Model Building sessions have taken place in the Netherlands,
Ireland, Belgium and Poland.

Group Model Building sessions in the Netherlands

The research sessions resulted in a system map that provides insight into the complexity of the underlying mechanisms influencing dietary behavior of people living on a low income. The system map illustrates that the interaction between experiencing scarcity, an unhealthy food environment, reduced physical and mental well-being, and social influences contributes to the maintenance and reinforcement of unhealthy dietary behavior among people who have to make ends meet on a low income.

The findings also show that there is no simple solution for making healthy eating easier for people living on a low income. The current situation calls for an integrated plan in which themes such as the food environment and mental health care are brought together. Thirty actions have been recommended by residents and professionals, to which various stakeholders, such as governments, the food industry, food providers, and social organizations, can contribute.

More results will be added soon.

References

  1. Giskes K, Avendano M, Brug J, Kunst AE. A systematic review of studies on socioeconomic inequalities in dietary intakes associated with weight gain and overweight/obesity conducted among European adults. Obes Rev. 2010 Jun;11(6):413–29.
  2. WHO European Regional Obesity: Report 2022. Copenhagen: World Health Organization, Regional Office for Europe; 2022.
  3. Fanzo J, Davis C. Can Diets Be Healthy, Sustainable, and Equitable? Curr Obes Rep [Internet]. 2019 Dec 1 [cited 2023 Mar 8];8(4):495–503. Available from: https://doi.org/10.1007/s13679-019-00362-0
  4. Swinburn, B. A., et al. (2019). The global syndemic of obesity, undernutrition, and climate change: The Lancet Commission report. The Lancet, 393(10173), 791-846. https://doi.org/10.1016/S0140-6736(18)32822-8
  5. Nisbett, N., et al. (2022). Holding no-one back: The nutrition equity framework in theory and practice. Global Food Security, 32, 100580. https://doi.org/10.1016/j.gfs.2022.100580

FOODPATH: FOOD systems and policy PATHways for equal population nutrition in Europe