TY - JOUR
T1 - The role of material and psychosocial resources in explaining socioeconomic inequalities in diet
T2 - A structural equation modelling approach
AU - Hoenink, Jody C.
AU - Waterlander, Wilma
AU - Beulens, Joline W. J.
AU - Mackenbach, Joreintje D.
N1 - Funding Information: The ‘Eet & Leef’ study, and the work of JDM, is funded by an NWO VENI grant on “Making the healthy choice easier – role of the local food environment” (grant number 451-17-032 ). JCH and JDM are further funded by the Netherlands Heart Foundation (Hartstichting) and the Netherlands Organisation for Health Research and Development (ZonMw) through the Supreme Nudge ( CVON2016–04 ) project. Publisher Copyright: © 2022 The Authors
PY - 2022/3/1
Y1 - 2022/3/1
N2 - We examined whether material and psychosocial resources may explain socioeconomic differences in diet quality. Cross-sectional survey data from 1461 Dutch adults (42.5 (SD 13.7) years on average and 64% female) on socio-demographics, diet quality, psychosocial factors and perceptions of and objective healthiness of the food environment were used in a structural equation model to examine mediating pathways. Indicators for socioeconomic position (SEP) were income, educational, and occupational level and the 2015 Dutch Healthy Diet (DHD15) index assessed diet quality. Material resources included food expenditure, perceptions of healthy food accessibility and healthfulness of the food retail environment. Psychosocial resources were cooking skills, resilience to unhealthy food environments, insensitivity to food cues and healthy eating habits. Higher SEP was associated with better diet quality; Beducation 8.5 (95%CI 6.7; 10.3), Bincome 5.8 (95%CI 3.7; 7.8) and Boccupation 7.5 (95%CI 5.5; 9.4). Material resources did not mediate the association between SEP and diet quality and neither did the psychosocial resources insensitivity to food cues and eating habits. Cooking skills mediated between 13.3% and 19.0% and resilience to unhealthy food environments mediated between 5.9% and 8.6% of the relation between SEP and the DHD15-index. Individual-level factors such as cooking skills can only explain a small proportion of the SEP differences in diet quality. On top of other psychosocial and material resources not included in this study, it is likely that structural factors outside the individual, such as financial, work and living circumstances also play an important role.
AB - We examined whether material and psychosocial resources may explain socioeconomic differences in diet quality. Cross-sectional survey data from 1461 Dutch adults (42.5 (SD 13.7) years on average and 64% female) on socio-demographics, diet quality, psychosocial factors and perceptions of and objective healthiness of the food environment were used in a structural equation model to examine mediating pathways. Indicators for socioeconomic position (SEP) were income, educational, and occupational level and the 2015 Dutch Healthy Diet (DHD15) index assessed diet quality. Material resources included food expenditure, perceptions of healthy food accessibility and healthfulness of the food retail environment. Psychosocial resources were cooking skills, resilience to unhealthy food environments, insensitivity to food cues and healthy eating habits. Higher SEP was associated with better diet quality; Beducation 8.5 (95%CI 6.7; 10.3), Bincome 5.8 (95%CI 3.7; 7.8) and Boccupation 7.5 (95%CI 5.5; 9.4). Material resources did not mediate the association between SEP and diet quality and neither did the psychosocial resources insensitivity to food cues and eating habits. Cooking skills mediated between 13.3% and 19.0% and resilience to unhealthy food environments mediated between 5.9% and 8.6% of the relation between SEP and the DHD15-index. Individual-level factors such as cooking skills can only explain a small proportion of the SEP differences in diet quality. On top of other psychosocial and material resources not included in this study, it is likely that structural factors outside the individual, such as financial, work and living circumstances also play an important role.
KW - Adults
KW - Diet
KW - Explanatory factors
KW - Inequity
KW - SES
KW - Socioeconomic differences
UR - http://www.scopus.com/inward/record.url?scp=85122779863&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.ssmph.2022.101025
DO - https://doi.org/10.1016/j.ssmph.2022.101025
M3 - Article
C2 - 35097184
SN - 2352-8273
VL - 17
JO - SSM - Population Health
JF - SSM - Population Health
M1 - 101025
ER -