How are inequalities generated in the management and consequences of gastrointestinal infections in the UK? An ethnographic study

2021
Gastrointestinal infections are an important global public health issue. In the UK, one in four people experience a gastrointestinal infection each year and epidemiological research highlights inequalities in the burden of disease. Specifically, poorer children are at greater risk of infection and the consequences of illness, such as symptom severity and time off work/school, are greater for less privileged groups of all ages. Gastrointestinal infections are, however, largely 'hidden' within the home and little is known about the lived experience and practices surrounding these illnesses, how they vary across contrasting socioeconomic contexts, or how inequalities in the disease burden across socioeconomic groups might come about. This paper presents data from an ethnographic study which illuminate how socioeconomic inequalities in the physical and material management and consequences of gastrointestinal infections are generated in families with young children. The study shows how the 'work' needed to manage gastrointestinal infections is more laborious for people living in more 'disadvantaged' conditions, exacerbated by: more overcrowded homes with fewer washing and toilet facilities; inflexible employment; low household incomes; and higher likelihood of co-morbidities which can be made worse by having a gastrointestinal infection. Our findings call into question the current approach to prevention of gastrointestinal infections which tend to focus almost exclusively on individual behaviours, which are not adapted to reflect differences in socioeconomic context. Public health agencies should also consider how wider social, economic and policy contexts shape inequalities in the management and consequences of illness. Our findings are also pertinent to the COVID-19 pandemic response in the UK. They highlight how research and policy approaches to acute infectious diseases need to take into consideration the differing lived experiences of contrasting households if they wish to address (and avoid exacerbating) inequalities in the future.
SOCIAL SCIENCE & MEDICINE
卷号:282
ISSN:0277-9536
收录类型
SSCI
发表日期
2021
学科领域
循证公共卫生
国家
英国
语种
英语
DOI
10.1016/j.socscimed.2021.114131
其他关键词
HEALTH; DISEASE
EISSN
1873-5347
资助机构
National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Gastrointestinal Infections at University of Liverpool; Public Health England (PHE); University of East Anglia; University of Oxford; Quadram InstituteUK Research & Innovation (UKRI)Biotechnology and Biological Sciences Research Council (BBSRC) [HPRU201210038]
资助信息
The authors would like to thank the participants, the community organisations who allowed fieldwork observations, and the local public health team for their help in choosing the socioeconomically contrasting areas. We also acknowledge and thank wider members of the People Theme of the NIHR HPRU in Gastrointestinal Infections; Dr Jeremy Hawker, Dr Sarah McGarrol, Dr Alex Kaley, Dr Rachael Eastham and Dr Mark Limmer. Thanks are also extended to the two reviewers for their helpful comments. The research was funded by the National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Gastrointestinal Infections at University of Liverpool in partnership with Public Health England (PHE) , in collaboration with University of East Anglia, University of Oxford and the Quadram Institute (grant reference code HPRU201210038) . Suzanne Rotheram is based at the University of Liverpool. The views expressed are those of the authors and not necessarily those of the NIHR, Public Health England or the Department of Health and Social Care.
被引频次(WOS)
0
被引更新日期
2022-01
来源机构
University of Liverpool University of Liverpool City University London
关键词
Gastrointestinal infection Health inequalities Behavioural interventions Ethnography COVID-19