Introduction: There is increasing policy and academic interest in the role of the food environment in influencing rates of obesity, particularly in areas of deprivation. However although we have developed considerable insights into how to measure the healthiness of retail environments, and assess access and availability to healthy food, less is understood about how individuals and families experience and engage with their environments.
Methods: Focused ethnographic case studies were conducted in three locations in England: Great Yarmouth, Stoke-on-Trent, and the London Borough of Lewisham. Five qualitative methods were used, comprising engagement with community groups, semi-structured interviews, photo-elicitation, shop-along interviews, and participatory workshops. All participants across the case study sites (N=60) resided in neighbourhoods that scored 1 or 2 on the Standard Index of Multiple Deprivation and experienced rates of childhood obesity that were higher than the England average.
Results: Family life was described as both routinised and complex, and shaped how people engaged in the food environment. While most participants hoped to provide nutritious meals for their children, they identified numerous barriers which prevented them from achieving this in practice. Participants highlighted financial insecurity, challenges accessing supermarkets, deals for HFSS foods, the comparative expense of nutritious foods, the time required to prepare meals, and pressure from fussy children. Importantly, the food environment also served non-food needs. For example cheap HFSS foods offered a source of treats, while the presence of takeaways and fast-food outlets provided opportunities for meaningful shared family activities.
Conclusion: The food environment does not exist in isolation from the varying contexts of individuals lives. Therefore, efforts to address obesity through altering food environments must take peoples understandings and expectations into account. Policies and interventions may only be effective if they meet peoples broader, non-food needs, at the same time as increasing the physical, financial, and cultural accessibility of healthy foods.
Disclosures: There are no disclosures to report.
12 Sep 2019 - 13 Sep 2019