The social organization of nutritional inequities.

An institutional ethnography, a qualitative research methodology grounded in critical social science, was undertaken with the purpose of explicating the social organization of nutritional inequities among socially/economically disadvantaged women and their families living in an urban centre in Nova Scotia, Canada. Methods included participant observation of food and nutrition practices in the homes of five socially disadvantaged families and at a community drop-in center in a low-income neighborhood; in-depth individual interviews with family members; and group interviews with an additional 28 participants at the community center. Tape recordings and field observation notes were analyzed thematically, preserving the perspectives of the research participants. The explication began with the examination of the everyday household work of feeding the family which provided an entry point to broader social relations working outside of the households, but evident within them. At the household level, the gendered, 'invisible' nature of feeding work became readily apparent. The class context of feeding work became particularly evident upon examination of the practice of procuring food. The apparently simple act of buying groceries was complicated by limited access to inexpensive stores. The families developed innovative strategies to enhance their abilities to procure food within their limited means. However, because of inadequacies of subsistence welfare policies, they frequently were sufficiently short of funds to necessitate reliance on charity for food. Analysis of such social policy revealed that public and professional discourses organizing nutritional inequities were informed by individualistic ideology. Yet, individualistic discourses could not provide an adequate understanding of the experiences of the research participants. The impact of individualistic professional discourse included the irrelevance of nutrition education practices based upon information dissemination. In sum, the research revealed nutritional inequities as embedded within social constructs such as gender, class, commerce, policy and discourse. The educative nature of the participatory research process empowered study participants to initiate structural change in commercial pricing practices. Through making the analysis available to others, including policy makers, it may be possible to work toward changing the oppressive social organization which perpetuates inequities. The research calls for a reorientation in community educational practice from the dominant individual orientation to a social orientation.