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A qualitative investigation of lived experiences of long-term health condition management with people who are food insecure.

Douglas, Flora; MacIver, Emma; Yuill, Chris


Chris Yuill


Background: As more people are living with one or more chronic health conditions, supporting patients to become activated, self-managers of their conditions has become a key health policy focus both in the UK and internationally. There is also growing evidence in the UK that those with long term health conditions have an increased risk of being food insecure. While international evidence indicates that food insecurity adversely affects individual's health condition management capability, little is known about how those so affected manage their condition(s) in this context. An investigation of lived experience of health condition management was undertaken with food insecure people living in north east Scotland. The study aimed to explore the challenges facing food insecure people in terms of, i. their self-care condition management practices, and ii. disclosing and discussing the experience of managing their condition with a health care professional, and iii. Notions of the support they might wish to receive from them. Methods: Twenty in-depth interviews were conducted with individuals attending a food bank and food pantry in north east Scotland. Interview audio recordings were fully transcribed and thematically analysed. Results: Individuals reporting multiple physical and mental health conditions, took part in the study. Four main themes were identified i.e.: 1. food practices, trade-offs and compromises, that relate to economic constraints and lack of choice; 2. illness experiences and food as they relate to physical and mental ill-health; 3. (in) visibility of participants' economic vulnerability within health care consultations; and 4. perceptions and expectations of the health care system. Conclusions: This study, the first of its kind in the UK, indicated that participants' health condition management aspirations were undermined by the experience of food insecurity, and that their health care consultations in were, on the whole, devoid of discussions of those challenges. As such, the study indicated practical and ethical implications for health care policy, practice and research associated with the risk of intervention-generated health inequalities that were suggested by this study. Better understanding is needed about the impact of household food insecurity on existing ill health, wellbeing and health care use across the UK.


DOUGLAS, F., MACIVER, E. and YUILL, C. 2020. A qualitative investigation of lived experiences of long-term health condition management with people who are food insecure. BMC public health [online], 20, article ID 1309. Available from:

Journal Article Type Article
Acceptance Date Jul 26, 2020
Online Publication Date Aug 28, 2020
Publication Date Dec 31, 2020
Deposit Date Jul 28, 2020
Publicly Available Date Aug 28, 2020
Journal BMC public health
Electronic ISSN 1471-2458
Publisher Springer
Peer Reviewed Peer Reviewed
Volume 20
Article Number 1309
Keywords Household food insecurity; Food poverty; Chronic health conditions; Long-term health conditions; Self-management; Self-care; Support for self-care; Lived experiences; Qualitative research
Public URL
Additional Information The preprint of this article is available under a CC BY licence from ResearchSquare:


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