Examining the relationship between socioeconomic status and obesity. A case study of Khayelitsha in the Western Cape province of South Africa
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Date
2019
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Publisher
University of the Western Cape
Abstract
Background: Obesity in South Africa is a critical public health issue. Previously considered a
problem of the affluent, obesity is now reported among all populations in South Africa regardless
of age, race, gender or geographical location. Although a body of literature suggests that
sociocultural, environmental and behavioural factors are likely to explain the increasing levels of
obesity in South Africa, few studies have examined the relationship between socioeconomic
status and obesity. As such, there is dearth of evidence showing how socioeconomic status
influences obesity in the country. Given the multiplicity of challenges associated with controlling
obesity, understanding the link between socioeconomic status and obesity is critical for informing
and developing effective prevention programmes. This study therefore examines the nexus
between socioeconomic status and obesity by using Khayelitsha as a case study area.
Goal and objectives: Guided by the conceptual framework of the Theory of Planned Behaviour,
the overall goal of this study is to determine how education status and income level influence
dietary and weight control behaviours in relation to obesity. The objectives are to 1) examine the
role of social factors on food consumption behaviour; 2) investigate the influence of income
levels on food consumption; 3) explore the relationship between education levels and food
choices and 4) provide recommendations for policy review.
Methods: This research is embedded within a larger study conducted by researchers from the
Institute for Social Development on factors that influence food choices and eating habits of
residents in Khayelitsha and Mitchells Plain. The epistemological position forming the basis of
this research was guided by the concepts of positivist and interpretivist paradigms, as both
perspectives were deemed relevant for achieving the study objectives. Moreover, the study
combined both qualitative and quantitative research methodologies to analyze the gathered
data.
Results: The study identified cereals, bread, pasta, milk products, processed meat, fried chicken,
fish and oil fat, soft drinks, fruit and vegetables as the main kinds of food consumed by residents
in Khayelitsha. However, among these food groups, fruit and vegetables consumption was found
to be low. In general, cost was identified as the main barrier for the frequent consumption of
fruit and vegetables. The study also discovered a positive relationship between education and
eating habits, with most educated individuals’ demonstrating high intentions to consume healthy
foods compared to people with lower education. However, in contrast to the hypothesis of this
study, the impact of education on dietary behaviour was found to be insignificant. Similarly, the
impact of education on weight control behaviour was found to be insignificant although the
relationship between these two variables was equally found to be positive. With regards to the
association between income and food choices the study discovered an overall positive
relationship between the two variables. However, the general effect of income on food choice
was not statistically significant. Cost of food and low family income were found to be key barriers
to the purchase and consumption of healthy foods.
Conclusion and recommendations: This study has demonstrated that education and income
status correlate positively with dietary lifestyle as well as weight management practices.
However, contrary to the hypotheses outlined in this study, neither education nor income status
was found to significantly impact on dietary and weight control behaviours. In general, other
factors such as culture, price of foods, television advertisement and perception of weight status
were found to also contribute to respondent’s dietary lifestyle and weight management
practices. Given these findings, a multidisciplinary approach involving the promotion of proper
dietary patterns as well as physical activity are recommended. Specifically, the strategies should
focus on 1) the development of policy measures that regulate the high cost of healthy foods, 2)
the roll-out of food voucher interventions that promote frequent consumption of fruit and
vegetables and 3) the promotion of physical exercises in religious and health centers.
Description
Master of Public Health - MPH
Keywords
South Africa, Western Cape, Cape Town, Khayelitsha, Obesity, Public health, Theory of Planned Behaviour, Mitchells Plain