Why do nutrition interventions have less impact on those with a lower level of education? That is what sociologist Tim van Meurs is researching in his dissertation. A deep-rooted opposition to institutions appears to be the main reason. "Campaigns must find a better way to connect with people with a lower level of education. The Netherlands Nutrition Centre ran a campaign to encourage people to eat more green asparagus. This was wasted on people who are used to eating traditional Dutch sausages and mash (stamppot boerenkool). And asparagus is really expensive too."
"White or wholemeal" and "energy drink or coffee". These are just two examples from the Netherlands Nutrition Centre’s Eetwissel (food swap) campaign, which encourages people to take small steps towards a healthier diet. Examples include replacing white bread with wholemeal bread and drinking coffee rather than energy drinks. "This campaign has some good aspects. The examples that they use are very much things that people eat and drink on a daily basis, and it’s clear that they’ve tried to reach different target groups," says sociologist Tim van Meurs.
"Lower educated people are less receptive to interventions. They are perceived as patronizing and as an attack on freedom of choice"
Major gap in health
On average, people with a lower level of education eat less healthy than people who have completed a degree programme at a research university or university of applied sciences, and they are also more likely to be overweight. It is also clear from previous research that nutrition and health interventions are less effective among citizens with a low level of education, which further increases the already significant gap that exists in the field of dietary health. Through his dissertation "No Appetite for Meddling", the PhD student is keen to provide insights into why interventions (and campaigns like the Eetwissel campaign) are less effective among this group. Van Meurs researched how citizens perceive different interventions and to what extent level of education plays a role in this.
It is often assumed that a lower income, financial stress or a lack of understanding of what is healthy (dietary cognition) can explain the health gap in relation to level of education. Van Meurs demonstrates in his dissertation that there is more to it than this. His research indicates that opposition to institutions is far higher among people with a lower level of education and that this anti-institutionalism is a key factor. "There is a major aversion to the organisations behind these interventions. People don't like being told what to do," says the researcher. "This is more common among people with a lower level of education, and this also makes them less receptive to interventions. They are perceived as patronising and as an attack on freedom of choice."
A week without meat or an extra rasher of bacon?
For his research, the PhD student conducted a number of interviews with people with a lower level of education (which, unfortunately, he had to suspend due to COVID-19). He also analysed news reports and reactions on social media. A prime example was a Tweet that he came across as a reaction to an article on the National Week without Meat. "Someone posted a photo of a pan containing four rashers of bacon and wrote: 'Normally 2 rashers, now it’s 4! That’s how I make up for someone who’s not eating any meat today. Same again tomorrow!'. For me, these kinds of fierce, angry reactions illustrate the aversion to meddling. But the Week without Meat didn’t force anyone to do anything. It was intended rather to encourage people who want to eat less meat but often don’t succeed in doing so."
Van Meurs also conducted a survey experiment to see whether how the information is conveyed makes a difference. While one group received totally factual information about the importance of adequate and healthy drinking, a second group was also told that the information, for example, was based on scientific research. A third group received the same message but in simplified language. Adapting the use of language or naming institutions or otherwise did not appear to make a difference.
"You can't avoid a sugar tax. But lower educated people in particular have become more negative about the institutions in question when interventions are far-reaching"
Sugar tax works but has a downside
Clearly, you can also introduce more far-reaching measures such as a sugar tax, to discourage people from drinking soft drinks that contain a lot of sugar, for example. But according to Van Meurs, there is also a downside to this in the long run. "You can’t avoid a sugar tax because sugar becomes more expensive. But it appears from my research that far-reaching interventions cause people with a lower level of education in particular to think more negatively about the institutions concerned. When they are confronted with interventions, they become even more negative about the government. You see a kind of negative feedback loop. This doesn’t help the legitimacy of institutions and can therefore be detrimental to future interventions."
Breaking this vicious circle is no mean feat, says the PhD student. Like previous sociological studies, it highlights the fact that there is a major gap between institutions such as the government and academia and citizens with a lower level of education. "Campaigns must find a better way to connect with people with a lower level of education. The Netherlands Nutrition Centre is doing its utmost, but it is interesting to note that most of the people who work there have completed a degree programme at a research university or a university of applied sciences. For example, they ran a campaign to promote the consumption of fruit and vegetables. Then they tried to encourage people to eat more green asparagus and aubergines. Asparagus is really expensive and aubergines are not to everyone’s taste, especially when their staple diet is traditional Dutch sausages and mash. You won’t reach that group through a campaign like that."
The research project is funded by the Erasmus Initiative Smarter Choices for Better Health.
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For media requests, please contact:
Marjolein Kooistra, communicatie ESSB, 06 83676038, kooistra@essb.eur.nlTim van Meurs in the Dutch media:
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