When we think of the relationship between hunger and poverty we often conjure in our mind images from famine and overseas aid campaigns. If we are asked to think of a picture of a child who is hungry, that child would more than likely appear as thin. This child we imagine as having ‘not enough’ food. Childhood obesity, on the other hand, (indeed obesity in general) is commonly presented as being a case of ‘too much’. Too much ‘junk food’, too many calories, too many fizzy drinks. However, our recent research with children, carried out in Adelaide and funded by a Channel 7 Children’s Research Foundation grant, has prompted us to think about:
- the ‘unspoken’ possibility of being both hungry and obese,
- how this impacts on children’s lives, and
- what implications this might have for public health interventions.
Children from low socio-economic backgrounds have been made a significant priority in Australian government obesity interventions. Such programmes tend to focus on promoting change in food and exercise practices. In our research we carried out qualitative, ethnographic research with children aged 10-14 to explore their understanding of obesity in relation to a large government-funded obesity prevention programme in South Australia. We found that central to children’s experiences of food, particularly in low socio-economic settings, is how they cope with hunger, both practically and more conceptually.
Our two key findings were:
- Short term management of hunger is more important for children and their carers than long term health agendas.
- Hunger is stigmatised, therefore children who are obese are at risk of being doubly marginalised in their day-to-day lives.
Children living in low socio-economic settings experience ‘food insecurity’ where food supplies and availability are precarious and unpredictable. In our research we found that the financial vulnerability of families (for example, through unemployment, low income, or sudden changes in circumstance) meant that children experienced significant fluctuations in both their ability to access food and, therefore, their feelings of hunger. Managing hunger on a day-to-day basis was tactically imperative for children themselves, as well as for the carers and community workers that they engaged with.
Children and their carers knew what the ‘healthy lifestyle’ messages were, and how these had been presented as choosing salads and fruit over fast food, and riding or walking to school instead of going in the car. However, in community settings such as after-school clubs, where the food was supplied by hunger-relief agencies, first priority was given to making sure children did not go hungry, with emphasis on healthy eating a less urgent concern.
The children at the centre of our study occupied a somewhat ironic position in that they were simultaneously being targeted by a major obesity intervention and by hunger relief initiatives. The children we spoke to described mixed feelings, including unease and disgust when they talked about having to eat food supplied by such agencies. They were clearly aware of where their food was coming from, and how this marked them out as ‘poor’.
Our findings show how restricted and constrained food choices are for children who are living in poverty, leaving little space for children (or parents and community staff for that matter) to make ‘healthy choices’ and active selections, and putting extra emphasis on the adult carers to negotiate and encourage children to eat what is available.
Our research shows that public health interventions need to more closely address the relationship between social and physiological causes of obesity. The dominant messages of ‘energy in versus energy out’ and ‘healthy choices’ do not take into account the urgent, day-to-day issues that take priority when living in low-socioeconomic settings. If we only see obesity in terms of excess – too much food, then we cannot understand why hunger and obesity can coexist.
For more information please contact Jessie Gunson by email.