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


METHODS
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.


METHODS
Brisbane City, Australia, 2000.


METHODS
: Non-institutionalised residents of private dwellings 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.
Turrell
Gavin
G
Queensland University of Technology, School of Public Health, Victoria Park Road, Kelvin Grove, Brisbane, 4059. g.turrell@qut.edu.au
Hewitt
Belinda
B
Patterson
Carla
C
Oldenburg
Brian
B
D001519:Behavior; D002755:Choice Behavior; D016000:Cluster Analysis; D004034:Diet Surveys; D004041:Dietary Fats / Q000032:analysis; D004043:Dietary Fiber / Q000032:analysis; D004522:Educational Status; D005247:Feeding Behavior; D005260:Female; D005502:Food / Q000191:economics / Q000592:standards; D005518:Food Preferences / Q000523:psychology; D005638:Fruit; D006801:Humans; D007182:Income; D008297:Male; D009790:Occupations; D011793:Queensland; D012106:Research; D012923:Social Class; D014675:Vegetables
D004041:Dietary Fats; D004043:Dietary Fiber