Migration, nutrition and ageing across the lifecourse in Bangladeshi families. A transnational perspective
MINA is a three year NDA research project which addresses ageing, migration, and nutrition across two generations of Bangladeshi women. The Bangladeshi population is one of the fastest growing ethnic groups within the UK, and are amongst the most socially disadvantaged. They have poorer self-reported and measured health status indicated by higher rates of disability, centralised obesity and chronic diseases such as type 2 diabetes and cardiovascular disease. Older Bangladeshi women are particularly affected as they play a lead role in caretaking for multiple generations within relatively large extended families and many struggle to cope with the complex challenges of ageing, poverty, racism, and social exclusion.
The MINA interdisciplinary research team comprises partners from eight disciplines and universities: public health nutrition and exercise (Janice Thompson, Bristol), public health nursing (Joy Merrell, Swansea), biological anthropology (Barry Bogin, Loughborough), health psychology (Petra Meier, Sheffield), ethnobotany (Michael Heinrich, London), environmental and media design (Vanja Garaj, Brunel), migration and social anthropology (Katy Gardner, Sussex), and social gerontology (Christina Victor, Reading).
Additional MINA partners include researchers at the University of Dhaka in Bangladesh, the NGO Jubo Academy and local UK Black and minority ethnic (BME) organisations.
Janice Thompson, University of Birmingham
Partners and Collaborators:
As in the general population, nutrition plays a crucial role in the health status of the Bangladeshi population. Despite this there is no clear understanding of how eating patterns and migration affects this group’s nutritional status and experiences of ageing. Without this information we cannot develop effective culturally tailored interventions. MINA will address these gaps by combining approaches, methods, and expertise not used in previous research to gain an in-depth understanding of Bangladeshi women’s nutritional status, food practices, beliefs and experiences of ageing in the UK and Bangladesh.
The aim of this project is to develop processes and products to reduce existing health inequalities and promote healthy, active ageing among Bangladeshi women by gaining a better understanding of the impact of migration on nutritional status, food practices and beliefs, and experiences and perceptions of ageing amongst this group.
The project will draw upon existing UK national survey data to improve our understanding of mechanisms underlying well-documented health inequalities experienced by Bangladeshi women with a focus on nutrition-related behaviours and conditions.
The project will then expand on these data by conducting an in-depth exploration of the bio-social ecology of ageing in older Bangladeshi women (45+ years old) who migrated from Bangladesh to the UK, younger women (18-35 years old) born to migrants in the UK, and women of the same two age groups living in Bangladesh.. A public health perspective incorporating a social model of health will be used, which will allow us to locate individuals in their social context and explore the impact of psychological, social, cultural and environmental factors on ageing, nutrition, health and related behaviours.
Additional information will be gathered to explore the food ethnobotanical knowledge and food environments of Bangladeshi women living in the UK and in Bangladesh. The goal is to compare this information to determine how food-related knowledge is shared amongst two distinct generations, how knowledge sharing and food environments may differ between those living in the UK and those living in Bangladesh, and determine how these differences impact on the biological and social aspects of ageing amongst Bangladeshi women.
The research questions for this study are as follows:
A mixed methods approach utilising biological measures, in-depth interviews, observations, and survey data will be used to answer these questions. A secondary analysis of existing data of the Health Survey for England will be conducted to investigate underlying mechanisms that might explain existing health inequalities, with our focus being on nutrition-related behaviours and conditions. We will seek to answer questions on the relative importance of risk factors such as income, education, health behaviours, health care contacts, and living conditions in explaining why Bangladeshi women experience poorer health than women of other ethnicities.
Nutritional status, bone health, and physical function will be measured using anthropometry, Quantitative Ultrasound (QUS) of the heel of the foot, and a standardised battery of tests for leg muscle strength, walking speed, and standing balance.
A structured questionnaire and in-depth interviews will be used to: 1. obtain detailed accounts of the migration and biographical experiences and explore the impact on nutritional status, health behaviours and transmission of nutritional knowledge; 2. explore the influence of cultural beliefs on nutrition, health, and health seeking behaviours and how this has changed across the lifespan and between generations; 3. explore the impact of social inequalities on nutrition and health status; 4. explore changes in the roles, position and responsibilities of women in the household and the impact on their nutrition, the family unit and wider community; 5. obtain detailed accounts of the women’s perceptions and expectations of an older person in their community; and 6. gain an understanding of the extent and nature of transnational ties and their influence on issues related to nutrition and ageing.
Interviews, observations, and photo- and videoethnographic techniques will be used to document typical food environments (including acquisition, preparation and consumption) and traditional plant food uses, their social and medicinal meanings, and management of allotments and home gardens in the UK and Bangladesh. The information resulting from the use of these methods will provide a unique understanding of cultural, social and environmental factors which influence nutritional health status and health behaviours amongst Bangladeshi women living in the UK and in Bangladesh. Specifically these include food production, social and cultural meanings of food, access and availability of foods, and food environments encompassing living and housing conditions.
Policy and practice implications will focus primarily on reducing health disparities and improving the nutritional and health status of ageing Bangladeshi adults. The goal is to use the results of this study to improve access to culturally appropriate foods and food environments, and to inform the development and implementation of culturally sensitive and tailored interventions
Product development opportunities include:
Resources (e.g. website and multimedia educational materials) for health and social care practitioners to raise their cultural awareness and improve the care delivered to older people from Bangladeshi communities.
A multimedia collection (photographic, video, internet) of Bangladeshi food related stories, an interactive video-cookbook of traditional Bangladeshi meals, and a scratch-and-sniff food plant book for use by the Bangladeshi community.
Providing guidance on the design of food environments to avoid potential negative consequences of migration on nutrition and ageing, which may result in future product design interventions (e.g. in the kitchen environment).
Providing guidance on the design of care homes for older adult migrants, including information on physical design, social needs, and culturally sensitive treatment of Bangladeshi elders.
15 November to 11 December 2011, Cardiff