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Classification tree analysis for an intersectionality-informed identification of population groups with non-daily
Emily Mena1,2, Gabriele Bolte3,4,
1Department of Social Epidemiology, University of Bremen, Institute of Public Health and Nursing Research, Grazer Straße 4, 28359, Bremen, Germany. e.mena@uni-bremen.de.
BMC Public Health
|November 5, 2021
Summary
Men, especially blue-collar workers without financial support from a partner, have the highest prevalence of non-daily vegetable intake (non-DVI). Understanding these gendered differences is crucial for public health strategies targeting non-DVI.
Area of Science:
- Public Health
- Sociology
- Health Equity
Background:
- Daily vegetable intake (DVI) is a key health behavior linked to better immunity and reduced non-communicable diseases.
- Existing data show women and highly educated individuals consume more vegetables.
- Men and those with lower education are disproportionately affected by non-daily vegetable intake (non-DVI), highlighting potential health inequalities.
Purpose of the Study:
- To investigate the intersectional relationships between sex/gender, socio-cultural, socio-demographic, and socio-economic factors and non-daily vegetable intake (non-DVI).
- To move beyond a binary male/female understanding of health disparities by considering diverse gender roles and aspects.
Main Methods:
- Utilized classification and regression tree (CART) and conditional inference tree (CIT) analyses on cross-sectional data from a German National Health Telephone Interview Survey (n=19,512).
- Employed non-parametric, exploratory methods to identify subgroups with a high prevalence of non-DVI.
Main Results:
- While sex (male/female) was the primary differentiator for non-DVI (61.7% in men vs. 42.7% in women) initially, incorporating other sex/gender aspects revealed greater heterogeneity.
- Gendered differences in main earner status and blue-collar work status emerged as significant factors.
- Among blue-collar workers without reliable financial support from a partner, non-DVI prevalence was notably high (69.6% in men, 57.4% in women).
Conclusions:
- Public health monitoring should adopt an intersectionality-informed, gender-equitable approach.
- Integrating a broader range of sex/gender-related aspects into quantitative analyses is essential for accurately identifying at-risk populations for non-DVI.
- This nuanced understanding can inform more targeted and effective public health interventions.
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