Socio-economic inequalities in women's fruit and vegetable intakes: a multilevel study of individual, social and environmental mediators.
OBJECTIVE
This study employed a multilevel design to test the contribution of individual, social and environmental factors to mediating socio-economic status (SES) inequalities in fruit and vegetable consumption among women.


METHODS
A cross-sectional survey was linked with objective environmental data.


METHODS
A community sample involving 45 neighbourhoods.


METHODS
In total, 1347 women from 45 neighbourhoods provided survey data on their SES (highest education level), nutrition knowledge, health considerations related to food purchasing, and social support for healthy eating. These data were linked with objective environmental data on the density of supermarkets and fruit and vegetable outlets in local neighbourhoods.


RESULTS
Multilevel modelling showed that individual and social factors partly mediated, but did not completely explain, SES variations in fruit and vegetable consumption. Store density did not mediate the relationship of SES with fruit or vegetable consumption.


CONCLUSIONS
Nutrition promotion interventions should focus on enhancing nutrition knowledge and health considerations underlying food purchasing in order to promote healthy eating, particularly among those who are socio-economically disadvantaged. Further investigation is required to identify additional potential mediators of SES-diet relationships, particularly at the environmental level.
Ball
Kylie
K
Centre for Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Highway, Burwood, Victoria 3125, Australia. kball@deakin.edu.au
Crawford
David
D
Mishra
Gita
G
D000293:Adolescent; D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D004032:Diet / Q000191:economics* / Q000523:psychology*; D004034:Diet Surveys; D004522:Educational Status; D004777:Environment; D005260:Female; D005638:Fruit; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008875:Middle Aged; D009747:Nutritional Physiological Phenomena; D012923:Social Class; D012959:Socioeconomic Factors; D014675:Vegetables