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Research article
Flora Douglas
Robert Gordon University
Corresponding Author
ORCiD: https://orcid.org/0000-0002-0333-6605
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Public Health.
Background: As more people are living with one or more chronic health conditions, supporting patients to become activated, self-managers of their conditions has become a key health policy focus both in the UK and internationally. There is also growing evidence in the UK that those with long term health conditions have an increased risk of being food insecure. While international evidence indicates that food insecurity adversely affects individual’s health condition management capability, little is known about how those so affected manage their condition(s) in this context. An investigation of lived experience of health condition management was undertaken with food insecure people living in north east Scotland. The study aimed to explore the challenges facing food insecure people in terms of, i. their self-care condition management practices, and ii. disclosing and discussing the experience of managing their condition with a health care professional, and iii. notions of the support they might wish to receive from them.
Methods : Twenty in-depth interviews were conducted with individuals attending a food bank and food pantry in north east Scotland. Interview audio recordings were fully transcribed and thematically analysed.
Results : Individuals reporting multiple physical and mental health conditions, took part in the study. Four main themes were identified i.e.: 1. food practices, trade-offs and compromises, that relate to economic constraints and lack of choice; 2. illness experiences and food as they relate to physical and mental ill-health; 3. (in)visibility of participants’ economic vulnerability within health care consultations; and 4. perceptions and expectations of the health care system.
Conclusions : This study, the first of its kind in the UK, indicated that participants’ health condition management aspirations were undermined by the experience of food insecurity, and that their health care consultations in were, on the whole, devoid of discussions of those challenges. As such, the study indicated practical and ethical implications for health care policy, practice and research associated with the risk of intervention-generated health inequalities that were suggested by this study. Better understanding is needed about the impact of household food insecurity on existing ill health, wellbeing and health care use across the UK.
Keywords
Household food insecurity, food poverty, chronic health conditions, long-term health conditions, self-management, self-care, support for self-care, lived experiences, qualitative research
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CURRENT STATUS: Published
Version 3
Posted 30 Jul, 2020
Published
On 28 Aug, 2020
No community comments so far
Submission checks complete
On 24 Jul, 2020
Editorial decision: Accept
On 24 Jul, 2020
No comments provided
Editorial decision: Minor revision
On 15 Jul, 2020
Review #2 received
Received 07 Jul, 2020
Reviewer #2 agreed
On 02 Jul, 2020
Review #1 received
Received 21 Jun, 2020
Reviewer #1 agreed
On 27 May, 2020
Editor assigned
On 22 May, 2020
Reviewers invited
Invitations sent on 22 May, 2020
Submission checks complete
On 21 May, 2020
Editor invited
On 21 May, 2020
No comments provided
Editorial decision: Major revision
On 23 Apr, 2020
Review #2 received
Received 22 Apr, 2020
Review #1 received
Received 12 Apr, 2020
Reviewer #2 agreed
On 26 Mar, 2020
Reviewer #1 agreed
On 24 Mar, 2020
Reviewers invited
Invitations sent on 23 Mar, 2020
Editor assigned
On 06 Mar, 2020
Submission checks complete
On 05 Mar, 2020
Editor invited
On 05 Mar, 2020
First submitted
On 04 Mar, 2020
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This preprint is under consideration at BMC Public Health. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Flora Douglas
Robert Gordon University
Corresponding Author
ORCiD: https://orcid.org/0000-0002-0333-6605
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
Version 3
Posted 30 Jul, 2020
Published
On 28 Aug, 2020
No community comments so far
Submission checks complete
On 24 Jul, 2020
Editorial decision: Accept
On 24 Jul, 2020
No comments provided
Editorial decision: Minor revision
On 15 Jul, 2020
Review #2 received
Received 07 Jul, 2020
Reviewer #2 agreed
On 02 Jul, 2020
Review #1 received
Received 21 Jun, 2020
Reviewer #1 agreed
On 27 May, 2020
Editor assigned
On 22 May, 2020
Reviewers invited
Invitations sent on 22 May, 2020
Submission checks complete
On 21 May, 2020
Editor invited
On 21 May, 2020
No comments provided
Editorial decision: Major revision
On 23 Apr, 2020
Review #2 received
Received 22 Apr, 2020
Review #1 received
Received 12 Apr, 2020
Reviewer #2 agreed
On 26 Mar, 2020
Reviewer #1 agreed
On 24 Mar, 2020
Reviewers invited
Invitations sent on 23 Mar, 2020
Editor assigned
On 06 Mar, 2020
Submission checks complete
On 05 Mar, 2020
Editor invited
On 05 Mar, 2020
First submitted
On 04 Mar, 2020
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Public Health.
Background: As more people are living with one or more chronic health conditions, supporting patients to become activated, self-managers of their conditions has become a key health policy focus both in the UK and internationally. There is also growing evidence in the UK that those with long term health conditions have an increased risk of being food insecure. While international evidence indicates that food insecurity adversely affects individual’s health condition management capability, little is known about how those so affected manage their condition(s) in this context. An investigation of lived experience of health condition management was undertaken with food insecure people living in north east Scotland. The study aimed to explore the challenges facing food insecure people in terms of, i. their self-care condition management practices, and ii. disclosing and discussing the experience of managing their condition with a health care professional, and iii. notions of the support they might wish to receive from them.
Methods : Twenty in-depth interviews were conducted with individuals attending a food bank and food pantry in north east Scotland. Interview audio recordings were fully transcribed and thematically analysed.
Results : Individuals reporting multiple physical and mental health conditions, took part in the study. Four main themes were identified i.e.: 1. food practices, trade-offs and compromises, that relate to economic constraints and lack of choice; 2. illness experiences and food as they relate to physical and mental ill-health; 3. (in)visibility of participants’ economic vulnerability within health care consultations; and 4. perceptions and expectations of the health care system.
Conclusions : This study, the first of its kind in the UK, indicated that participants’ health condition management aspirations were undermined by the experience of food insecurity, and that their health care consultations in were, on the whole, devoid of discussions of those challenges. As such, the study indicated practical and ethical implications for health care policy, practice and research associated with the risk of intervention-generated health inequalities that were suggested by this study. Better understanding is needed about the impact of household food insecurity on existing ill health, wellbeing and health care use across the UK.
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