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OCR for page 74
STUDY OF THE USE GE THE FRIJEN:!DSHIP
NUTRII~IO2; EDUCATION *
EARL LOMON KOOS
THE PURPOSE OF THE STUDY
PA T TERN TN
Gne of the urgent needs in health education, and especially nutrition edu-
cation, is for channels through which information can be diffused into the
population. This need is especially urgent in the low income urbar1 areas
where many factors militate against active participation by large :aumbers
of tl~e population. Not only do sheer numbers of people and the great need
for information add to the problem, but certain contributing factors are
present.
The most obvious of these is the physical condition of living to which the
low income urban dweller is subjected. However, the tenement is not only
a particular kind of building it is also "a way of living, a whole series of
limits, attitudes and sentiments." From this way of living a narcotization
results which renders the less able portion of the population insensitive to
social stimuli. A second factor is the lack of education which enables the
individual to cope with the problems of a complex urban environment. The
cultural heritage of the foreign-born and of the native-born-of-foreign-par-
ents provides a further handicap since Marty of our foreign-born come from
those areas which brave had the least contact with modern ways of living.
The fact that the transplanted cultural heritage rarely has a chance to be
wholly old- or new-world has a bearing here.
The difficulty for the low income family of living in a money-centered
culture adds to o'er general problem. The sense of security which comes
fry 'making a living rather than earning it" is lacking and the family supers
accordingly.
Attempts to set up channels to these groups ua-ve ~ Bully treks ens ,-~ ad_
other of three approaches: first, a spatial approach, such as the block plarl;
second, an orgar.izatiGn approach which sets up a super-organization to dic-
tate policies and procedures to existing organizations; third, by artificialyv
~r~sLrue'Led groups through which information is distributed. The first of
Sac seemed undesirable since it has been determined empirically that asso-
ciation tends to form without regard for area limits. The second appeared
weak ire that it depends upon the strength of individual personalities arid their
ability to finesse vested interests against each other. The third often failed
when initial enthusiasms had waned and left a residue of discouraged par-
ticipants.
*An experiment undertaken by the Department of Public Health and Preventative
Medicine of Cornell University Medical School in the Kipps-Bay Yorkville Area of
New York City, with a grant from the Committee on Food Habits, National Research
Council.
74
OCR for page 75
Friendship Pattern: ill ~\rutritio?r Education
75
A study of urban life shows that the old feel is, of belonging to or being
identified with a pa~ticutar ne~,3~borhood has waned. It is known however,
that associations between individuals, and families, continue and that these
assxiat~ons can be recognized as structures .~ the social pattern. The possible
utilization o; these `'1riendship patterr~s" as a channel for diffusing knowled~,e,
and as a possible channel through which the low income group can express
its needs, was the primary purpose of this research project. A second purpose
was to ascertain, in the brief time allotted ro the project, something about
the social patterns of tile nationality groups arid the place of nutrition ii-.
these patterns.
~ HE TECENIQUES EMPLOYFO
Potential leaders were nest picked from among the women known to settie-
ments and other agencies as leaders in community life. This was done because
of the brief time elerner~t. These women were asked to invite five or six
friends to a "nutrition luncheon" as guests of the leader. The luncheon was
carefully planned to include as much nutrition information as could be put
into the preparation and demonstration of one meal. Lyle purpose of this
luncheon was twofold: it was obviously bait to attract women into the group
but it had ~ folkway similarity in that it appealed to the "breaking bread witl:
friends" idea current among this group. Its second purpose was to interest
the women in nutrition and to make them a continuing unit in that interest.
This first contact vvas to be followed by conferences of the group, closely
following the outline of nutrition courses then being, offered in the area.
Also, the nutritionist was to continue as consultant to these women through
the course.oŁ the project. As their contribution the women were asked to
bring in menus and keep accurate shopping lists for the period of participation.
Case studies of the participating, families at the beginning and the end of
the project were to be made by the sociologist. An evaluation of the changes
taking place between the beginning and the end of the project and a study of
the patterns of friendship in relation to the natural areas and nationality
distributions would enable us to learn the degree of effectiveness of this type
of teaching.
The ability to widen the effectiveness of such a program depends upon the
fact that Mrs. A around whom the first group was built, invited Mrs. B. C
D, E and :F to participate. Each of these women, in turn, had a set of friends
not identical with those of Mrs. A; therefore each was potentially the center
of another teaching unit. This widening of the circle of effectiveness would
make it possible to reach a cross-section of the families ire any one natural area
of the city. For experimental purposes, however, groups from several areas
were to be chosen to show more clearly the results of such procedures and
so that the coverage of several nationalities might be facilitated.
THE OPERATION OF THE PROJECT
In all, ~77 housewives were contacted in the course of the project and only
~2, or 6.770, refused any cooperation whatever. One hundred and forty
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76
The Problem of Changing Food Habits
four, 8~.5 TO, of the total number refused to cooperate to the extent of
having a luncheon, but discussed one or more phases of the nutritional pat-
tern with the staff. Fourteen, or 7.8go, gave the luncheons and 7 others, or
470, agreed to do so but later failed to carry out their agreement.
Of the ~44 housewives who refused to give a luncheon, 5~, or 3670, ex-
pressed an interest in doing so but were sure their friends were not suf-
ficiently interested in nutrition to participate. It- was our impression that
this interest was in large measure a spurious one, since only 4 of these women
had previously availed themselves of nutrition courses. Twenty-nine, or
Promo, stated that they were unable to participate in the project because of
either part time or full time employment. An additional ~6, or Who, re-
garded their home duties as too strenuous to allow such participation. It was
our impression that this reason originated more from the concept of the role
of the woman in the low income home than from actual pressure of house-
work. This was substantiated in part by the fact that these women appeared
to experience little difficulty in shelving home duties when more interesting
activities were available. Only 9, or 6.370, admitted that they were not in-
terested in learning about nutrition.
The remaining reasons assigned for refusing to cooperate were for the
most part genuine and account for only hobo of the cases.
Only 3 luncheon units were carried through the complete schedule. Two
units, both Italian, were composed of relatives of the hostess, and these, to-
gether with 8 others, did not return for follow-up conferences. The remain-
ing luncheon (Hungarian) failed to attract any of the guests who had ac-
cepted. This failure to cooperate seems to have its genesis in certain factors
in the urban culture which have been mentioned in the Introduction. The
follow-up study of the failures indicated that neither the structure of the
project nor the methods employed by the nutritionist were at fault, since
both were acceptable to the participants.
THE FRIENDSHIP PATTERNS
The configurations of the friendship patterns showed in only one instance
a block pattern. They tend for the most part to confine themselves to the
natural areas of the city and any of the friendships which cross these boun-
daries appear to be the results of earlier associations.
Figure I shows graphically the spatial distribution of the members of an
Irish friendship pattern. It should be noted that none of these luncheons
drew guests from within any one census or social block; they were confined,
however, to the same natural area in the city. The sole exception was one
guest at the third luncheon, a childhood friend of the hostess, who lived some
fifteen blocks away.
The second factor in determining the configurations of the friendship pat-
terns was that of adherence to a local organization.
The friendship pattern of the Irish group illustrated in Figure I Is shown
in Figure II as it relates to the Mothers' Club in a local Catholic church. It
will be seen that with the exception of persons Nos. 6 and id, all of the
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Friendship Pattern in Nutrition Education
-
~r
:~[10111~0 1@~53~:
b nnnnnnnnn r
1; S;~F art| · FIRST LUNCHEON GROUP
Inn nnnnnnr oSE~D'u~-G~P
O THIRD ~ RECHEW CROUP
FIGURE I.-Spatial distribution of an Irish Friendship Pattern.
-INDICATES PARTICIPANTS INCLUDE') IN ~OTHERS' CLI)8
(NOB. 6 AND 14 ONLY GUESTS NOT WITHIN THE ORGANIZA1~10N)
FIGURE II. Relationship of Irish Friendship Pattern to established organization in
the community.
77
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_Q
The Problems of Gig Food Habits
luncheon participants were found inside the shaded area which represents the
aura of the ~Mothers' Club.
The tendency of native-born-of-fo~ei~-~-parents to mix nationalities in their
friendship patterns is seen in this project. The foreign-born hostesses invited
only guests of their own nationality (and significantly from Within Heir own
or:,anizations), whereas the r~ative-born hostesses failed to exercise such
choice. In the case of the Irish pattern illustrated in Figures I and lit the
fit st luncheon entertained ~ Irish and ~ Hungarian guests, the second, 4 Irish
and ~ Czechoslovakian, and the third (a FInngarian hostess), ~ Irish and
3 Czechoslovakian guests. This pattern of isolating or Nixing nationalities In
the friendship patterns has its chief significance in the idiomatic food pat-
terns, which are discussed in a later section.
IDIOM ATIC FOOD PATTERNS AMONG NATIONALITIES
The nationalities comprising the population of Lois section of New York
City are intermingled. Few tenements have residents of only one nationality
and this intermingling apparently has done much to break down the idiocratic
food patterns. While the foreign food patterns persist, there is apparently a
modification of the native diet. (The stores supplying foods for particular
rationalities have less of the special foods associated with particular groups
than is the case in some other parts of the city. A special shopping study
with volunteer workers was undertaken to ascertain this point.) Examples
of this modification are found in Italian families where the housewives indi-
cate an increased use of potatoes and ~ice, with a slightly decreased use of
spaghetti.
Of all the established diet patterns which are brou~-l~t to this country from
foreign cultures, the pork-potato-cabbage-tea pattern of the Irish appears to
continue with greater tenacity than does any other diet pattern. Several
Irish families which are two generations removed from $oreign-born stock
continue in this pattern, and it is a matter of some pride in the family. This
accompanies an identification with "the ould sod" which seems to persist
longer in the Irish families than in other nationalities. There are, however,
remnants of this pride in a nationality diet in most of the other groups.
The heavy diet of the meat-potato-vegetable variety which is enjoyed in the
central European countries continues here. The Czechoslovakian, Hungarian'
and German families studied all report adherence to this pattern. They do,
however, admit to a greater choice and variety of food than was utilized in
Europe. Regardless of the caloric requirements of the individual, these
groups consume quantities of heavy food, even when in straitened economic
circumstances. In this group, as with the Italians, food is mentioned re-
peatedly as being eaten for enjoyment. A further demonstration of the high
esteem in which these groups regard food is evidenced by the fact that it
is rarely used as a psychological weapon for forcing obedience or for the
punishment of children. Likewise, the families studied in these nationalities
exerted less pressure upon the children to eat particular foods than do the
Irish.
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Friendship Pattern its lV;ttrition Education,
79
Certain of the ideas and patterns idiomatic to these nationalities appear
to have sloughed off or are in the process of disintegration. Faced with new
patterns of food distribution and food preparation, many housewives have
found it expedient to forego established practices in food preparations. The
Italians' increased use of canned and other prepared foods is an example
of this. Nutritionists have told us that except for tomatoes and tomato paste,
the Italian woman regards tinned food as an abomination. In a majority of
the Italian homes, however, we found tinned food of other varieties, and
prepared cereals were in general use.
The influence of the school lunch, of the factory cafeteria meal, etc., is felt
among these families. Many reported some event or circumstance outside
the home which caused a new food to be adopted, or an old one to be dropped
from use. This was especially true where late adolescents were in the family
and certain foods had a high value for their status giving qualities.
FACTORS INFLUENCING THE FAMILY S NUTRITION PATTERN
The nutrition patterns of the families studied appear to be influenced by
two sets of factors those inherited from the past and those operative in the
environment. The relative weights of the two vary from family to family and
from nationality to nationality but a few are found consistently.
The first of these is the status giving quality of certain foods. A major
portion of the low income families we have studied came from European
peasant stock, and therefore had been confined to less varied and more~simple
foods than are available here. Foods which in our culture have only utility
value carry in European cultures a connotation of wealth and position. The
ability to buy meat at all times, and even on limited budgets, is status giving
and is not likely to be relinquished without adverse effects. The same atti-
tude seems to hold for white bread. Only a few families admitted the use
of whole wheat breads, and less than loft used enriched white bread. The
identification of whole wheat bread with the dark breads of low income
European diets militates against its acceptance. This attitude was so usual
about meat (especially beef) and bread, that it offers a clue as to reasons for
rejecting contemporary nutritional teachings. A summation of this idea is
represented in the statement of a Polish woman (not in the present group)
who was asked her reasons for not enrolling in a nutrition course: "Why
should I take a course those teachers just want you to do things a certain
way. In Poland we had to eat a certain way it was all we had to eat. Here
we can have what we want to eat-why should I let her (the nutritionist) tell
me what to eat and how to eat it?"
This desire for freedom of choice, and especially to choose those foods
which are symbols of status, appears to be so universal among the low income
groups as to warrant consideration by nutritionists when planning low income
courses. The outstanding example of this lack of consideration is the resent-
ment our respondents expressed at being told to eat the cheaper cuts of meat.
Our nutritionist was careful to avoid this mistake, but resentment on this point
was generated by current advertising and by the publicity of agencies and
industry
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80
The Problem of Changing Food Habits
In addition to the symbolic values of certain foods, the unregimented use
of foods appears to have a "release" value. Whether or not the respondent
buys wisely or prepares the food well is not important here the important
thing seems to be that choice and the ability to "splurge" on food provides a
psychological release from the problems of urban living.
The buying patterns of these families vary greatly as to place and time,
but they are confined largely to day-by-day buying. Most of the women rec-
ognized the value of quantity purchases and of planned purchasing, but the
physical environment prohibits storage of perishable and bulky foods. Meal-
by-meal buying has a psychological value, too, for many of these women,
since it provides an excuse for getting out of the tenement. Here again a
conflict exists between the low income consumer of nutrition information and
the nutritionist whose orientation, in the main, is not toward the low income
group.
The fact that the number of prepared foods has increased greatly in recent
years, coupled with the physical limitations of the low income homes, seems
to have an effect upon the nutrition patterns of these families. Overcrowding
is so universal, and housing conditions in general are so poor, that the
utilization of things which make the task of food preparation less complicated
is understandable. Here again it seems to us to be necessary for the nu-
tritionist interested ire implementing a program to consider the nutrition pat-
terns as single facets in the whole problem.
The cultures out of which our respondents have come, either directly or
one generation removed, have stressed the sanctity of the home and have
emphasized its place as a training center for living. From this has come the
practical attitude that "what we did at home, what we were taught, is right,"
even when forced adjustments to the present environment are made. Eighty-
nine respondents mentioned the strength of this influence when discussing
reasons why they were not affected by nutritional teaching. However, this
resentment seemed to arise only when the food pattern as a whole was at-
tacked. When pressure was exerted on isolated items in the diet, a more
favorable response resulted. The educational campaign for increased use of
milk, for example, has occasioned less resentment than the "You Must Eat
These Five Foods Every Day for Health" campaign recently instituted.
The former is additive, and therefore not necessarily destructive of values
inherited from the past.
SUMMARY
Our original premise included an indictment of the "block plan" and of the
"organizations" plan, with the assumption that the natural friendship pattern
would be more effective for diffusing information on nutrition. This as-
sumption seems unwarranted in view of the fact that the destruction of the
peer-nature of the friendship pattern, or the introduction of an ulterior
motive, tends to render ineffective this pattern.
The fact that friendship patterns operate for the most part within the
confines of existing organizations suggests that strong local organizations
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Friendsl~;p Pattern in Nutrition Educatio;r
81
can be utilized as channels for the diffusion of information. The fact that th
urban culture is crowded with organizations which overlap spatially seems
to indicate a possible coverage that would be adequate.
The wide variety of foods available to the low income family, the inter-
digitation of nationalities, and the pressure of American institutions on the
family through the children and through industrial and social contacts, have
all tended to weaken the idiomatic food patterns.
The psychological value gained frown the use of certain foods and in par-
ticular ways is greater than are the benefits from the usual nutrition course.
Unless the nutritionist is willing to recognize these factors, the effectiveness
of her work with the low income group is doubtful.
6
Representative terms from entire chapter:
friendship pattern
