ABSTRACT
We aimed to explore experiences of government-led actions on the social determinants of food insecurity during Australia's COVID-19 pandemic response (which included novel, yet temporary, social protection measures to support Australians facing hardship during state-wide lockdowns). During November-December 2020, we conducted in-depth interviews with 24 Victorians who received government income support (prior to COVID-19) and the temporary COVID-19 specific payments. Interviews were guided by a theoretical understanding of the social determinants of health and health inequities, which we aligned to the social policy context. Data were audio-recorded, transcribed, inductively coded, categorised and thematically analysed. Our sample included mostly women (n = 19) and single parents (n = 13). Interviews reflected four key themes. Firstly, participants described 'battles all around them' (i.e., competing financial, health and social stressors) that were not alleviated by temporary social policy changes and made healthy eating difficult to prioritise during the pandemic. Secondly, housing, income, job, and education priorities rendered food a lower and more flexible financial priority - even with 18 participants receiving temporary income increases from COVID-19 Supplements. Thirdly, given that food remained a lower and more flexible financial priority, families continued to purchase the cheapest and most affordable options (typically less healthful, more markedly price discounted). Finally, participants perceived the dominant public and policy rhetoric around income support policies and healthy eating to be inaccurate and shaming - often misrepresenting their lived experiences, both prior to and during COVID-19. Participants reported entrenched struggles with being able to afford basic living costs in a dignified manner during COVID-19, despite temporary social protection policy changes. To reduce inequities in population diets, a pre-requisite to health, all stakeholders must recognise an ongoing responsibility for adopting long-term food and social policies that genuinely improve lived experiences of food insecurity and poverty. Supplementary Information: The online version contains supplementary material available at 10.1007/s12571-022-01318-4.
ABSTRACT
BackgroundDespite being a public health priority in the UK for decades, rates of childhood obesity are continuing to rise along highly unequal lines. Investigating how families have engaged with food and food environments throughout the COVID-19 pandemic provides an opportunity to understand the conditions which shape peoples’ ability to consume nutritious diets.MethodsWe conducted a remote longitudinal qualitative study, engaging 62 parents of school or nursery age children across three case study sites in England;Bradford, Folkestone and London Borough of Brent. Participants were recruited purposively to represent the demographics of each study site and comprise a range of family structures. Methods informed by ethnographic and participatory approaches were adapted for a remote setting. These comprised: semi-structured interviews, photo-elicitation, participatory mapping, and oral diaries. Participants engaged with these methods three times at six-month intervals between October 2020 and December 2021. Data from each time point was analysed cross-sectionally and the whole data set longitudinally using trajectory analysis.ResultsCOVID-19 and its early impacts necessitated a reorganisation of daily routines and food practices, an adjustment of existing food practices, and/or an establishment of new ones. Some of these changes persisted beyond the context of lockdowns, such as households who had pivoted to alternative means of sourcing food (e.g. vegetable boxes) initially to avoid COVID-19 transmission maintaining this long-term due to perceived cost-saving and health benefits. Other changes were largely confined to the context of lockdown, such as the use of baking and cooking from scratch to provide entertainment in the absence of other opportunities for leisure. Households’ ability to enact and maintain practices beneficial for both nutrition and wellbeing was dictated by the availability of finances, time and social support systems. Changes to diet perceived as negative came about through financial insecurity, the gendered division of care work and mental health impacts associated with this burden.ConclusionCOVID-19 has revealed the multiple resources and systems of support that underpin families’ ability to eat well and, when disrupted, can limit capacity to procure and prepare nutritious foods. These contexts have the capacity to occur again both on a large scale in society (e.g. financial recessions and periods of food system disruption) and in the context of an individual’s lifetime (e.g. ill health, job loss or loss of social support networks). Policy now has a window of opportunity to implement learnings from this period and shape obesity prevention policy to be more effective and equitable.
ABSTRACT
Rates of childhood overweight and obesity continue to rise in England, along with a growing gap in obesity prevalence between children in the most and least deprived areas. To address child obesity, the UK government is increasingly considering how to intervene in the (food) environments that shape people's purchases, rather than focusing solely on individual health behaviors. With the COVID-19 pandemic and subsequent lockdowns having rapidly reconfigured life in the UK, it is important to understand how these changes may have impacted food practices and engagement with food environments. This remote, longitudinal qualitative study seeks to explore how the COVID-19 pandemic and its impacts are shaping families relationships with the food and the food environment. A sample of 60–80 parents/carers of school or nursery-aged children will be recruited from across three case study sites in England to take part in semi-structured interviews and set of flexible creative activities at three time points over the course of a year. Findings will provide practical policy insights for England's obesity prevention strategy as well as methodological insights in terms of conducting research into lived experience remotely. [ABSTRACT FROM AUTHOR] Copyright of International Journal of Qualitative Methods is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)