title: Exploring health inequalities through the lens of an ethnographic study of healthy eating provision in the early years sector.
abstract: The social determinants of health are increasingly receiving international attention since the publication of the World Health Organization's Commission on the Social Determinants of Health in 2008. How different determinants affect health is much debated. Contrasting suggestions include, for example, a major link with socio-economic inequalities, lack of social status and psychosocial stress or the extent of the welfare state. Others emphasise the need to understand the socio-cultural contexts of specific situations. Diet-related health is a good example of the relationship between poor health outcomes and deprivation. The aim of this paper is to explore the specific conditions and contexts that might reduce or exacerbate the provision of a healthy diet to children under 5 years in a range of nurseries supported by the Sure Start Local Programmes initiative in Liverpool. An ethnographic approach was taken to gather data from six nurseries, combining observation at the nurseries with interviews with owners and or managers (10), cooks (6), staff (12) and parents (2). The findings reveal the complex way different issues work together to support or hinder a nursery to develop a healthy eating culture and how relative inequalities, in general, are outworked. While recognising the importance of social status leading to poor health due to psychosocial stress, the findings tend to emphasise the importance of a strong welfare state and taking an early years of life-course approach in reducing health inequalities.
authors: Institute of Psychology, Health and Society, University of Liverpool, Liverpool, UK National Heart Forum, London, UK. k.s.bristow@liverpool.ac.uk
authors: Katie
authors: K
authors: Bristow
authors: Susan
authors: S
authors: Povall
authors: Simon
authors: S
authors: Capewell
authors: Modi
authors: M
authors: Motswama
authors: Ffion
authors: F
authors: Lloyd-Williams
mesh_terms: D000884:Anthropology, Cultural / Q000379:methods*; D002664:Child Nutritional Physiological Phenomena; D002675:Child, Preschool; D004032:Diet; D005247:Feeding Behavior; D005260:Female; D063427:Food Quality; D007722:Health Knowledge, Attitudes, Practice; D054624:Health Status Disparities; D006801:Humans; D007223:Infant; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires