Disparities in fruit and vegetable intakeat the intersection of gender and educationin northern Sweden : a cross‑sectional study

• Published in: BMC Nutrition
• Main Authors: Vogt, Thomas, Gustafsson, Per E
• Format: Article in Journal/Newspaper
• Language: English
• Published: Umeå universitet, Institutionen för epidemiologi och global hälsa 2022
• Subjects: Intersectionality; Joint disparity; Referent disparities; Excess intersectional disparity; Discriminatory accuracy; Fruits; Vegetables; Gender; Education; Sweden; Public Health; Global Health; Social Medicine and Epidemiology; Folkhälsovetenskap; global hälsa; socialmedicin och epidemiologi; Northern Sweden
• Online Access: http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-201405; https://doi.org/10.1186/s40795-022-00641-5

Background: Even though the existence of inequalities in fruit and vegetable consumption has been well established, it is not clear how it is patterned across intersections of multiple social positions and identities. This study aims to investigate disparities in fruit and vegetable intake between groups at the intersection of education and gender in northern Sweden, and to estimate the discriminatory accuracy of the intersectional groups. Methods: Cross-sectional data from the 2018 Health on Equal Terms survey conducted in four regions in northern Sweden was used (N = 21,853). Four intersectional groups were created: high and low educated men, and high and low educated women. Prevalence differences corresponding to joint, referent, and excess intersectional inequalities, were estimated for three outcomes: inadequate fruit and vegetable intake combined, inadequate fruit intake, and inadequate vegetable intake. The discriminatory accuracy of the intersectional groups was estimated by the area under the receiver operating characteristic curve. Results: Low educated men had the highest prevalence of inadequate intake of fruits and vegetables combined (81.4%), fruits (83.4%), and vegetables (84.9%), while high educated women had the lowest (47.7, 60.2, and 51.8%, respectively). The joint disparities between high educated women and low educated men were both significant and substantial for all outcomes (34.6 percentage points (pp.), 25.2 pp., and 31.2 pp., adjusted), although differences in magnitude were noted between fruit and vegetable intake. The joint disparities were mostly explained by the two referent disparities for gender and education. The excess intersectional disparity - the part of the joint disparity not explained by either referent disparity – was negative for all three outcomes (-5.5 pp., − 4.2 pp., and − 4.6 pp. respectively, adjusted). The discriminatory accuracy of the intersectional groups was moderate (0.67, 0.65, and 0.68 respectively). Conclusions: An intersectional approach can provide a more ...