Whose place is it?: examining the socio-spatial geography of obesity in young adults for an Australian context.

Abstract

This thesis was written in a climate of rising obesity rates within our population. In recent times, an inundation of media, marketing and health stories have focused on the ‘increasing waistlines’ of both adults and children. The research aligns itself with the ‘geographies of health’ perspective, utilising knowledge from geography, sociology, epidemiology and population health. Extensive literature has shown that those living in the developed world, who are locationally and socially disadvantaged, are more likely to experience the highest prevalence of obesity. This thesis contributes to a broader knowledge base on how socio-spatial factors impose barriers to achieving and maintaining a healthy weight within a young adult cohort (18 to 34 years). The research design consists of both theory and data triangulation. The theoretical underpinning utilises Giddens’ Theory of Structuration exploring the structure and agency debate along with a number of geographical theories on space and place. The overarching socio-spatial conceptual framework for the research captures four main theme areas; the social environment, socio-cultural factors, residential perceptions of local areas, and lay perceptions of weight status and health in the context of place. Data were obtained from a biomedical and socio-demographic cohort study (n=4056), the North West Adelaide Health Study (NWAHS) and longitudinal survey information from the South Australian Health Omnibus Survey (SA HOS) between 1994 and 2004. A follow-up telephone interview to NWAHS participants (n=2996) provides additional unique primary data around social environments, housing, residential migration, lifecourse and perceptions of health. Additionally, semi-structured interviews were undertaken with young women from the NWAHS cohort which addressed socio-demographic, geographical and lifecourse themes. Other secondary social environmental data were utilised on accessibility to services, Australian Bureau of Statistics (ABS) Population and Housing Censuses and property valuations data providing additional insight into the complexities of the macro or global level influences. The thesis discusses the themes from the socio-spatial framework highlighting the social, cultural, historical and geographical aspects that are important for understanding the current increasing prevalence of obesity within young adults. The findings highlight the importance of space and place when thinking about health. Obesity is a complex and multifaceted issue and there is the need for contemporary research methodologies to guide future policy development and interventions.