abstract: 'Gastrointestinal infections are an important global public health issue.

  In the UK, one in four people experience a gastrointestinal infection

  each year and epidemiological research highlights inequalities in the

  burden of disease. Specifically, poorer children are at greater risk of

  infection and the consequences of illness, such as symptom severity and

  time off work/school, are greater for less privileged groups of all

  ages. Gastrointestinal infections are, however, largely `hidden'' within

  the home and little is known about the lived experience and practices

  surrounding these illnesses, how they vary across contrasting

  socioeconomic contexts, or how inequalities in the disease burden across

  socioeconomic groups might come about. This paper presents data from an

  ethnographic study which illuminate how socioeconomic inequalities in

  the physical and material management and consequences of

  gastrointestinal infections are generated in families with young

  children. The study shows how the `work'' needed to manage

  gastrointestinal infections is more laborious for people living in more

  `disadvantaged'' conditions, exacerbated by: more overcrowded homes with

  fewer washing and toilet facilities; inflexible employment; low

  household incomes; and higher likelihood of co-morbidities which can be

  made worse by having a gastrointestinal infection. Our findings call

  into question the current approach to prevention of gastrointestinal

  infections which tend to focus almost exclusively on individual

  behaviours, which are not adapted to reflect differences in

  socioeconomic context. Public health agencies should also consider how

  wider social, economic and policy contexts shape inequalities in the

  management and consequences of illness. Our findings are also pertinent

  to the COVID-19 pandemic response in the UK. They highlight how research

  and policy approaches to acute infectious diseases need to take into

  consideration the differing lived experiences of contrasting households

  if they wish to address (and avoid exacerbating) inequalities in the

  future.'
affiliation: 'Rotheram, S (Corresponding Author), Univ Liverpool, Natl Inst Hlth Res,
  Hlth Protect Res Unit Gastrointestinal Infect, Waterhouse Bldg,2nd Floor,Block F,1-5
  Brownlow St, Liverpool L69 3GL, Merseyside, England.

  Rotheram, Suzanne; Barr, Ben; Whitehead, Margaret, Univ Liverpool, Natl Inst Hlth
  Res, Hlth Protect Res Unit Gastrointestinal Infect, Waterhouse Bldg,2nd Floor,Block
  F,1-5 Brownlow St, Liverpool L69 3GL, Merseyside, England.

  Rotheram, Suzanne; Barr, Ben; Whitehead, Margaret, Univ Liverpool, Dept Publ Hlth
  Policy \& Syst, Whelan Bldg, Liverpool L68 3GB, Merseyside, England.

  Cooper, Jessie, City Univ London, Sch Hlth Sci, Div Hlth Serv Res \& Management,
  Myddelton St Bldg, London EC1R 1UW, England.'
article-number: '114131'
author: Rotheram, Suzanne and Cooper, Jessie and Barr, Ben and Whitehead, Margaret
author-email: 'suzanne.rotheram@liverpool.ac.uk

  Jessie.Cooper@city.ac.uk

  benbarr@liverpool.ac.uk

  mmw@liverpool.ac.uk'
author_list:
- family: Rotheram
  given: Suzanne
- family: Cooper
  given: Jessie
- family: Barr
  given: Ben
- family: Whitehead
  given: Margaret
da: '2023-09-28'
doi: 10.1016/j.socscimed.2021.114131
earlyaccessdate: JUN 2021
eissn: 1873-5347
files: []
issn: 0277-9536
journal: SOCIAL SCIENCE \& MEDICINE
keywords: 'Gastrointestinal infection; Health inequalities; Behavioural

  interventions; Ethnography; COVID-19'
keywords-plus: HEALTH; DISEASE
language: English
month: AUG
number-of-cited-references: '49'
orcid-numbers: 'Barr, Ben R/0000-0002-4208-9475

  Rotheram, Suzanne/0000-0002-4444-9796'
papis_id: 7e8ae940b1759bf462ae7089be4e477e
ref: Rotheram2021howare
researcherid-numbers: 'Barr, Ben R/W-9989-2018

  '
times-cited: '3'
title: How are inequalities generated in the management and consequences of gastrointestinal
  infections in the UK? An ethnographic study
type: Article
unique-id: WOS:000679176400010
usage-count-last-180-days: '0'
usage-count-since-2013: '10'
volume: '282'
web-of-science-categories: 'Public, Environmental \& Occupational Health; Social Sciences,

  Biomedical'
year: '2021'