Income differences in food choice and social control of eating behaviors among southern rural women

Introduction: Rural populations experience high rates of obesity and maintain poor adherence to dietary recommendations based on national data. While limited access to healthy food is one potential obstacle to choosing nutritious food, the purpose of this study is to identify additional factors of a rural food environment that influence food choices among rural women.

Methods: Semi-structured qualitative interviews were conducted with 20 women in rural north central Florida. Women were purposively sampled and stratified by race and income. Low income was defined as household income at or below 185% of the federal poverty level. Interview questions were informed by three theories: Identity Theory, Social Network Theory, and Structural Functionalism to understand determinants food choice.

Results: Low-income women were more likely to experience direct social control of their eating behaviors, meaning social network members explicitly regulate or otherwise sanction their eating, whereas none of the higher-income women indicated a similar experience. High-income women were more likely to internalize social norms and self-regulate eating behaviors to maintain healthy habits. Additionally, high-income women were more likely to describe choosing foods for health reasons compared to low-income women who offered a variety of reasons including taste, convenience, and price.

Discussion: Findings suggest that women in different income categories may have different reasons influencing food choices, as well as different social influences working to help them regulate eating behaviors. Intervention strategies can use findings to inform the incorporation of social network members for low-income women, who may not be choosing foods based on healthfulness.