The role of socio-cultural factors in the obesity epidemic

Obesity is socio-culturally distributed; that is the prevalence of obesity is known to vary according to socio-cultural factors, including socio-economic position, social roles and circumstance, and cultural factors. Further, these socio-cultural patterns are complex and specific to sex, age, and sometimes racial groups, as well as type of society, with patterns of relationships observed in developed countries sometimes reversed in developing countries. As described in Chapter 4, there is little doubt of the importance of the changing physical environment to the increases in obesity observed over the past several decades. However, far less attention has been paid to investigating the potential contribution of socio-cultural factors and to changes in the socio-cultural environment over time to the current obesity pandemic. The mechanisms through which socio-cultural factors may influence body weight and risk for obesity are also not well understood. In discussing socio-cultural influences we refer to systems of social relations (roles and relationships that define class, gender, ethnicity, and other social factors) and the meanings attached to these (1). For the purposes of this chapter, we focus on the impact of social, economic, and value systems on individuals' obesity-related behaviors (particularly, certain eating patterns and physical inactivity). In particular, we examine socio-cultural categories (socio-economic status, ethnicity, marital/family roles) for which evidence exists that rates of obesity are differentially distributed. We have not focused on the role of physical environmental factors, which is covered in Chapter 4, and we have largely restricted our focus to developed countries, from where the majority of the evidence for socio-cultural influences on obesity is derived. Issues relating to influences on obesity in developing countries are covered in detail in Chapter 5. This chapter provides an overview of the impact of socio-cultural influences on obesity in developed countries, and considers the potential pathways through which these influences may operate. The chapter concludes by speculating about the potential impact of societal trends on future rates and patterns of obesity in developed countries.

Fat, rich and beautiful: changing socio-cultural paradigms associated with obesity risk, nutritional status and refugee children from sub-Saharan Africa

There has been an increase in Australia's intake of refugees and migrants from sub-Saharan Africa over the last two decades. These refugees have been exposed to nutritional risks prior to migration, which, together with changes associated with acculturation, impact on their health and nutritional status post-migration. However, there is a paucity of data in Australia that has examined the health and nutritional status of this ethnic minority in Australia. Despite basic research assessing the nutritional status of children, none have specifically concentrated on the health and nutritional situation of sub-Saharan refugee children. In the absence of such studies, this paper explores issues relating to obesity in sub-Saharan African refugee children within a cultural and public health framework. We begin by outlining the history of obesity and its cultural meaning. We then move to a consideration of predisposing factors for obesity and how these factors translate into obesity risk contexts of sub-Saharan refugees post-migration. We argue there are a number of key challenges related to culture and the relationship between socio-economic factors post-migration that require addressing by health professionals, dieticians and health educators to ensure the delivery of successful health outcomes.

Economic growth and sustainability - an empirical study of the Thai development experience

Increasing economic growth has long been the dominant position within the public policies of all South East Asian countries. More recently, a new issue, sustainability, has emerged within development economic literature, which has significant implications for the continual pursuit of economic growth. Sustainability is concerned with ensuring the current generation meets their present needs without threatening future generations' ability to do likewise. This ability is dependent on a healthy and functioning socio-economic environmental (SEE) system. Economic growth can damage the SEE-system, though, through resource degradation, over-harvesting and pollution. Therefore, achieving economic growth and sustainability simultaneously may not be possible. This paper discusses these tensions between economic growth and sustainability by undertaking a number of SEE-based adjustments to GDP in order to measure sustainability. Thailand is used as a case study for a 25 year period, 1975-1999. The adjustments include the environmental costs caused by economic growth such as noise pollution, water pollution, the depletion of non-renewable resources, and deforestation. The results show a stark difference in terms of GDP per capita and the SEE-adjusted GDP per capita figure. The paper concludes that with increasing environmental costs of economic growth, pursuing high growth objectives without considerations to the environment threatens sustainability

Socio-demographic inequalities in the diets of mid-aged Australian women

Objectives: This study reports on the distributions of food and nutrient intakes by socio-demographic factors for a large population sample of mid-aged Australian women participating in the Australian Longitudinal Study on Women's Health.
Design: This cross-sectional population-based study used the Cancer Council of Victoria food frequency questionnaires to derive estimates of food and nutrient intakes.
Setting: Nationwide community-based survey.
Subjects: A total of 10561 women aged 50-55 y, at the time of the survey in 2001.
Results: Analysis showed favourable patterns of food intake, with frequent consumption of many foods that are promoted as components of a healthy diet (eg, fresh fruit, leafy green and other vegetables, bread, cereals, milk and meat). Intakes of both foods and nutrients varied significantly across socio-demographic groups, with unmarried women, and women in 'labouring' occupations (eg, cleaner, factory worker, kitchenhand) having poorer nutrient intake.
Conclusions: Although many mid-aged women in this sample had generally healthful diets, women in certain socio-demographic groups (particularly unmarried women and those in labouring occupations) had nutrient intakes of concern. As well as helping to address the dearth of current data on dietary intakes in the Australian population, the results highlight the need for continued targeted public health strategies aimed at improving diet of women from the various socio-economic backgrounds.

Adolescence and abuse : trauma and the socio-sexual abject in John Duigans lawn dogs

The article analyzes the presentation of youth in the film "Lawn Dogs," directed by John Duigan. In the film, the child as victim is defined by socio-economic contexts. The author explores the discursive moves by which means the film witnesses or occludes the traumatic experiences suffered by the child and adolescent characters, and how far it articulates a satiric revision of social hierarchies that construct generational identities of gender and class.

Economic transition and commercial property cycles in China

Drawn from a recently completed study, this paper aims at a better understanding of commercial property cycles in the transitional economy of China. It examines the behaviour of the property submarket system in China and considers structural changes in the socio-economic system as a primary factor in addressing the research problem. The study suggests that the underlying social and economic structure has greatly determined market behaviour. It finds that radical changes can alter the formal structure (the designed structure) of the market system, including the property market structure, but cannot alter the informal structure (i.e. the emergent structure) at the similar rate. As the study shows, cycles in the commercial property market in the economic transition is largely a key resulting feature of the continuous structural change both at formal and informal levels in a way that is often imbalanced and not always consistently changing together. The same situation also applies to the transformation of inner-city built form, which is featured by a delayed change of physical building stock against the space demand trend that is underpinned by the socio-economic transition. Put simply, there is a supply lag, mainly in the form of changing land use and building stock replacement, against economic change (the business cycle). This affects the level of effective demand for office space and hence becomes a major force in shaping current office cycles.

Meta-regression analysis as the socio-economics of economics research

Meta-regression analysis (MRA) provides an empirical framework through which to integrate disparate economics research results, filter out likely publication selection bias, and explain their wide variation using socio-economic and econometric explanatory variables. In dozens of applications, MRA has found excess variation among reported research findings, some of which is explained by socio-economic variables (e.g., researchers’ gender). MRA can empirically model and test socio-economic theories about economics research. Here, we make two strong claims: socio-economic MRAs, broadly conceived, explain much of the excess variation routinely found in empirical economics research; whereas, any other type of literature review (or summary) is biased.

Personal, social and environmental correlates of resilience to physical inactivity among women from socio-economically disadvantaged backgrounds

While sex and socio-economic disparities in physical activity have been well documented, not all disadvantaged women are inactive. This study aimed to examine correlates of achieving recommended levels of physical activity among women of low socio-economic position. In 2005, a population-based sample of 291 women with low educational attainment provided survey data on leisure time physical activity (LTPA). Participants reported potential personal (enjoyment and self-efficacy; barriers; intentions; guilt and priorities; routines and scheduling; occupational physical activity; television viewing), social (support from family/friends; social participation; sport/recreation club membership; dog ownership) and environmental (aesthetics; safety; local access; footpaths; interesting walks; busy roads to cross; heavy traffic) correlates of physical activity. Nearly 40% of participants achieved recommended LTPA (150 min week–1). Multivariable analyses revealed that higher levels of self-efficacy for walking [prevalence ratio (PR) 2.05, 95% confidence interval (CI) 1.19–3.53], higher enjoyment of walking (PR 1.48, 95% CI 1.04–2.12), greater intentions to be active (PR 1.97, 95% CI 1.12–3.45) and having set routines for physical activity (PR 1.91, 95% CI 1.18–3.09) were significantly associated with achieving recommended LTPA. Personal factors were the characteristics most strongly associated with achieving recommended levels of LTPA among women from socio-economically disadvantaged backgrounds.

Sociodemographic factors associated with healthy eating and food security in socio-economically disadvantaged groups in the UK and Victoria, Australia

Objective
To investigate the associations between sociodemographic factors and both diet indicators and food security among socio-economically disadvantaged populations in two different (national) contextual settings.

Design
Logistic regression was used to determine cross-sectional associations between nationality, marital status, presence of children in the household, education, employment status and household income (four low income categories) with daily fruit and vegetable consumption, low-fat milk consumption and food security.

Setting
Socio-economically disadvantaged neighbourhoods in the UK and Australia.

Subjects
Two samples of low-income women from disadvantaged neighbourhoods: (i) in the UK, the 2003–05 Low Income Diet and Nutrition Survey (LIDNS; n 643); and (ii) in Australia, the 2007–08 Resilience for Eating and Activity Despite Inequality (READI; n 1340).

Results
The influence of nationality, marital status and children in the household on the dietary outcomes varied between the two nations. Obtaining greater education qualifications was the most telling factor associated with healthier dietary behaviours. Being employed was positively associated with low-fat milk consumption in both nations and with fruit consumption in the UK, while income was not associated with dietary behaviours in either nation. In Australia, the likelihood of being food secure was higher among those who were born outside Australia, married, employed or had a greater income, while higher income was the only significant factor in the UK.

Conclusions
The identification of factors that differently influence dietary behaviours and food security in socio-economically disadvantaged populations in the UK and Australia suggests continued efforts need to be made to ensure that interventions and policy responses are informed by the best available local evidence.

Longitudinal predictors of frequent vegetable and fruit consumption among socio-economically disadvantaged Australian adolescents

Adequate vegetable and fruit consumption is necessary for preventing nutrition-related diseases. Socio-economically disadvantaged adolescents tend to consume relatively few vegetables and fruits. However, despite nutritional challenges associated with socio-economic disadvantage, a minority of adolescents manage to eat vegetables and fruit in quantities that are more in line with dietary recommendations. This investigation aimed to identify predictors of more frequent intakes of fruits and vegetables among adolescents over a 2-year follow-up period. Data were drawn from 521 socio-economically disadvantaged (maternal education ≤Year 10 of secondary school) Australian adolescents aged 12–15 years. Participants were recruited from 37 secondary schools and were asked to complete online surveys in 2004/2005 (baseline) and 2006/2007 (follow-up). Surveys comprised a 38-item FFQ and questions based on Social Ecological models examining intrapersonal, social and environmental influences on diet. At baseline and follow-up, respectively, 29% and 24% of adolescents frequently consumed vegetables (≥2 times/day); 33% and 36% frequently consumed fruit (≥1 time/day). In multivariable logistic regressions, baseline consumption strongly predicted consumption at follow-up. Frequently being served vegetables at dinner predicted frequent vegetable consumption. Female sex, rarely purchasing food or drink from school vending machines, and usually being expected to eat all foods served predicted frequent fruit consumption. Findings suggest nutrition promotion initiatives aimed at improving eating behaviours among this at-risk population and should focus on younger adolescents, particularly boys; improving adolescent eating behaviours at school; and encouraging families to increase home availability of healthy foods and to implement meal time rules.

Gambling participation and problem gambling severity in a stratified random survey : Findings from the second social and economic impact study of gambling in Tasmania

Demographic characteristics associated with gambling participation and problem gambling severity were investigated in a stratified random survey in Tasmania, Australia. Computer-assisted telephone interviews were conducted in March 2011 resulting in a representative sample of 4,303 Tasmanian residents aged 18 years or older. Overall, 64.8 % of Tasmanian adults reported participating in some form of gambling in the previous 12 months. The most common forms of gambling were lotteries (46.5 %), keno (24.3 %), instant scratch tickets (24.3 %), and electronic gaming machines (20.5 %). Gambling severity rates were estimated at non-gambling (34.8 %), non-problem gambling (57.4 %), low risk gambling (5.3 %), moderate risk (1.8 %), and problem gambling (.7 %). Compared to Tasmanian gamblers as a whole significantly higher annual participation rates were reported by couples with no children, those in full time paid employment, and people who did not complete secondary school. Compared to Tasmanian gamblers as a whole significantly higher gambling frequencies were reported by males, people aged 65 or older, and people who were on pensions or were unable to work. Compared to Tasmanian gamblers as a whole significantly higher gambling expenditure was reported by males. The highest average expenditure was for horse and greyhound racing ($AUD 1,556), double the next highest gambling activity electronic gaming machines ($AUD 767). Compared to Tasmanian gamblers as a whole problem gamblers were significantly younger, in paid employment, reported lower incomes, and were born in Australia. Although gambling participation rates appear to be falling, problem gambling severity rates remain stable. These changes appear to reflect a maturing gambling market and the need for population specific harm minimisation strategies. © 2014 Springer Science+Business Media New York.

Subjective wellbeing among adults with diabetes : results from Diabetes MILES—Australia

This study examines the subjective wellbeing of Australian adults with diabetes who completed the Diabetes MILES—Australia survey, investigating by diabetes type and treatment, and by comparing with the subjective wellbeing of the general Australian adult population. In addition, the extent to which depression and socio-demographic factors account for subjective wellbeing is investigated. People with type 1 or type 2 diabetes have significantly lower subjective wellbeing compared to the general population, even after controlling for covariates (demographic and socio-economic status, diabetes duration, body mass index, number of diabetes-related complications, and depression). Furthermore, adults with type 2 diabetes using insulin to manage their condition report the lowest levels of subjective wellbeing, and are also most likely to report dissatisfaction with their current health. These findings suggest that living with diabetes, and in particular, living with type 2 diabetes and using insulin, strongly challenges the maintenance of subjective wellbeing.

Economic and social opportunity: the changing lives of Aboriginal Victorians

 This study examined Aboriginal advantage in Victoria, demonstrating that relatively rapid change is occurring on a number of socio-economic indicators. This research, including interviews with Aboriginal participants, highlighted the interdependence of Aboriginal agency and responsive societal structures as significant enablers of Indigenous progress and advancement.