Fat as Productive: Enactments of Fat in an Australian Suburb

Shape-shifting versions of class in Australia and the pursuit of equity in public health

The COVID-19 pandemic and current cost of living crisis have highlighted socioeconomically patterned health disparities, bringing renewed focus on equity in public health. Despite political rhetoric invoking cultural narratives of egalitarianism and opportunities for class mobility, social class remains a significant factor in health outcomes in the Australian context. For social scientists, class (despite robust critiques) is a key analytical concept that has been theoretically broadened to encompass social and cultural practices (habitus). In public health, however, concepts of social disadvantage have expanded toward frames such as health equity and socioeconomic status in ways that can obscure 'class' and habitus. Understandings and operationalization of concepts of class and equity not only impact collaborative and interdisciplinary relationships, but also the framing of public health problems and health promotion interventions and policies. In this article, we draw on our experiences as anthropologists conducting ethnography in and of Australian health promotion programs to map and re-evaluate the intersection of concepts of social class and equity. We trace how representations of class emerged in these programs, and the versions of class and equity that materialized across different public health contexts. We argue for a conceptual repositioning of class that recognizes its shape-shifting qualities and of its materializations in different politics, disciplines and everyday contexts. In doing so, we highlight 'class' as a salient dimension of the design, implementation and evaluation of health promotion programs.

Beyond individual responsibility towards healthy food choices: A qualitative study among Pakistani women in Hong Kong

While biomedical understandings of food and diet coupled with discourses on individual responsibility towards healthy food choices are nowadays prominent, other social and cultural meanings attached to food and diet are largely devalued. The limits of such a reductionist approach are more evident when related to the experiences of migrant and ethnic populations, whose alternative knowledge(s) and practices about food and health are especially neglected. A multicultural city with a public healthcare system inherited from the British colonial times and largely shaped by biomedical ideas of health, Hong Kong offers a lens into the limits of such a reductionist approach. Due to their vulnerability in the context of Hong Kong as shaped by intersecting social identities, 72 women from Pakistan were recruited to be our community partners in a community-based participatory action research project to investigate their health needs and concerns. 12 focus group discussions were conducted, exploring their experiences of "healthy" food and overweight especially related to their encounters with the Hong Kong public healthcare system, as these issues emerged as key health concerns within the community. Four major themes emerged: unmet expectations of care, health is beyond the individual, constraints to a healthy diet in the context of migration, and beyond health: food as care for diasporic women. This study highlights the limit of a reductionist approach to healthy food as merely based on nutrition and individual responsibility. It stresses the need of a counter-discourse in the field of public health, emphasizing not only alternative cultural ideas of health and food, but also enlarging the field of health in biomedical terms to embrace "care" and acknowledging the structural constraints shaping migrant and ethnic population's vulnerability in making "healthy" food choices.

The experience of living with obesity for adults in Asian countries: A scoping review of qualitative studies

Sociocultural and biological backgrounds significantly influence people's experience of obesity. Yet the experience within the Asian sociocultural context is underexplored. This scoping review aims to summarize the qualitative evidence that explores the lived experience of adults with obesity in Asian countries. Guided by the Joanna Briggs Institute (JBI) approach, we systematically searched five databases (MEDLINE, EMBASE, PsychINFO, CINAHL, and Scopus) for studies exploring the lived experience of adults with obesity in Asian countries. Eligible studies with English full text were screened by two reviewers and analyzed using a descriptive qualitative content analysis. Of the 16,764 articles retrieved, 11 were included. The qualitative data can be summarized into three categories: (1) cultural norms shaped the lived experience with obesity, (2) the influence of obesity on social relationships, and (3) coping with life challenges. Despite the small number of studies, a strong influence of the sociocultural environment on the lived experience of obesity was evident, particularly on social roles and expectations, social relationships, the stigma of obesity, and life challenges. The extent and significance of this sociocultural influence on the Asian population warrant further exploration. Future research should fully report the qualitative methods to provide contextual information about the study.

Childhood memories of food and eating in lower-income families in the United States: a qualitative study

Background

Childhood obesity prevention initiatives emphasize healthy eating within the family. However, family-focused initiatives may not benefit children whose families lack economic and/or social resources for home cooking and shared meals. The aim of this paper is to examine how adults talk about and make sense of childhood memories of food and eating, with particular attention to understandings of family life and socioeconomic conditions.

Methods

Semi-structured interviews with 49 adults in 16 families (22 parents and 27 grandparents of young children) were conducted in Oregon, United States. Most participants had experienced socioeconomically disadvantaged childhoods. The interviews were analyzed using thematic analysis, with a focus on the participants’ memories of food provision, preparation, and consumption in their childhood homes.

Results

Two main themes were developed: (1) “Food and cohesion”, with the subthemes “Care and nurturance” and “Virtue transmission through shared meals”, and (2) “Food and adversity”, with the subthemes “Lack and neglect” and “Restriction and dominance”. The first theme captures idealized notions of food in the family, with participants recounting memories of care, nurturance, and culinary pleasure. The second theme captures how participants’ recollections of neglectful or rigidly restrictive feeding, as well as food discipline tipping over into dominance, upend such idealized images. Notably, the participants alternately identified poverty as a source of lack and as an instigator of creative and caring, if not always nutritionally-ideal, feeding. Thus, they remembered food they deemed unhealthy as a symbol of both neglect and care, depending on the context in which it was provided.

Conclusions

Childhood memories of food and eating may express both family cohesion and family adversity, and are deeply affected by experiences of socioeconomic disadvantage. The connection between memories of food the participants deemed unhealthy and memories of care suggests that, in the context of socioeconomic disadvantage, unhealthy feeding and eating may become a form of caregiving, with nutrition considered only one aspect of well-being. This has implications for public health initiatives directed at lower-income families.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-10533-1.

Social Implications of Weight Bias Internalisation: Parents' Ultimate Responsibility as Consent, Social Division and Resistance

Responsibility is a moral quality of caring that is central to child health policies. In contemporary United Kingdom these policies are based on behavioural psychology and underpinned by individualism, an ideology central to neoliberal governance. Amid the complexities of “obesity” and inequalities, there is a multi-layered stigmatisation of parents as moral associates. Few studies consider the lived realities of food policy processes from the standpoint of class. This critical qualitative research draws on theorists who explain processes of power and class: Foucault, Gramsci, Bourdieu, and Marx. Its objectives are: (a) to understand the lived experience of parents as they interact with food policy; (b) to explore how parents resist stigmatisation; and (c) to reflect on implications for policy and practice.