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

Author

Listed:
  • Rotheram, Suzanne
  • Cooper, Jessie
  • Barr, Ben
  • Whitehead, Margaret

Abstract

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.

Suggested Citation

  • Rotheram, Suzanne & Cooper, Jessie & Barr, Ben & Whitehead, Margaret, 2021. "How are inequalities generated in the management and consequences of gastrointestinal infections in the UK? An ethnographic study," Social Science & Medicine, Elsevier, vol. 282(C).
  • Handle: RePEc:eee:socmed:v:282:y:2021:i:c:s0277953621004639
    DOI: 10.1016/j.socscimed.2021.114131
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    References listed on IDEAS

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    1. Whitehead, Margaret & Popay, Jennie, 2010. "Swimming upstream? Taking action on the social determinants of health inequalities," Social Science & Medicine, Elsevier, vol. 71(7), pages 1234-1236, October.
    2. Ciara Kierans & Cesar Padilla-Altamira & Guillermo Garcia-Garcia & Margarita Ibarra-Hernandez & Francisco J Mercado, 2013. "When Health Systems Are Barriers to Health Care: Challenges Faced by Uninsured Mexican Kidney Patients," PLOS ONE, Public Library of Science, vol. 8(1), pages 1-7, January.
    3. Natalie L Adams & Tanith C Rose & Jeremy Hawker & Mara Violato & Sarah J O’Brien & Benjamin Barr & Victoria J K Howard & Margaret Whitehead & Ross Harris & David C Taylor-Robinson, 2018. "Relationship between socioeconomic status and gastrointestinal infections in developed countries: A systematic review and meta-analysis," PLOS ONE, Public Library of Science, vol. 13(1), pages 1-16, January.
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