Low-Income Families Facing Food Insecurity in Amsterdam North: A Qualitative Analysis on the Barriers and Enablers of Healthy Food Choices

Abstract

Drawing on socio-ecology theory, this qualitative study seeks to explore the barriers and enablers of healthy food choices among Dutch low-income families experiencing food insecurity. The negative health effects of unhealthy food choices are more prevalent in low-income families who face food insecurity, than other socio-economic groups. In Amsterdam, these families often live in disadvantaged neighborhoods that are characterized by a high prevalence of obesity. This study therefore aims to inform targeted interventions and policy in Amsterdam North. Method: In-depth semi-structured PDPE (participant-driven photo-elicitation) interviews were conducted with parents (n = 10), residing in disadvantaged neighborhoods in Amsterdam North. Results: This study discovered six barriers (convenience, personal preference, children’s preferences, Ramadan, availability of unhealthy food, and rising costs), and eleven enablers (food knowledge and skills, personal preference, children’s preferences, parental encouragement, children’s activities and community support, family support, religion and culture, school environment, availability, and access to healthy food). Some factors were both barriers and enablers. Discussion: The contrast between healthy eating efforts, rising food costs, and the increasingly unhealthy food environment in neighborhoods like Amsterdam North shows how individual and social enablers may easily unravel. Conclusion: This study finds that efforts to modify food choices and eating habits should go beyond individual and social level interventions. The findings intend to contribute to more integrated policies towards the reduction of obesity, food insecurity, and health inequalities among disadvantaged neighborhoods of Amsterdam North.