Routine & Manual Workers

1. Routine & Manual Workers Insight Presentation 31st March 2008

2. Speakers • Stephen Hooker, COI • Kirsty Boyce, Director, Directions • Amanda Anderton, Director, 2CV • Joceline Jones, Director, Define

3. Agenda for today Who are routine & Manual Workers? Why are they Important? Rich insight into their lives (barriers to behaviour change & possible solutions) Summing up & discussion Stephen Hooker, COI Kirsty Boyce, Directions Joceline Jones, Define Amanda Anderton, 2CV All, led by Richard Bowyer, DH

4. Sources of Insight • Infant and Toddler Nutrition (DH) • NHS Partnerships Research (DH) • Medicines Labelling (DH) • LSSS Advertising Development (DH) • Health Challenge Wales (WAG) • Parent Child Bonds Segmentation (DCFS) • Parents Segmentation (DfES) • Parents Direct (DfES) • Folates (FSA) • Food Labelling (FSA) • Green Behaviours (DEFRA) • Green Behaviours (WAG) • Student Finance studies (DfES) • 14-19s reforms (DfES) • Specialised Diplomas (DfES) • Reasonable Care (HMRC) • Tobacco Education (DH) • Obesity Strategy (DH) • Obesity Marketing Development (DH) • Harmful Drinking (DH)

5. Who are R&M workers?

6. Insight - Routine and Manual Workers

7. Managerial and professional 41% Routine and manual 35% Intermediate occupations 18% ‘Routine and manual’ is an occupational category in government statistics • National Statistics Socio-Economic Classification NS-SEC • Used across the Census (from 2001), General Household Survey, HSE • Full-time students, long-term unemployed and ‘never worked’ usually excluded from occupational classification Definition England, age 16+ population, by NS-SEC General Household Survey (2006) Source: General Household Survey (2006), Age 16+, socio-economic classification of household reference person1

8. R&M covers some technical & supervisory occupations Definition % UK Females / UK Males(working age) UK R&M adults (working age) Lower supervisory and technical Managerial and professional 41% Semi-routine Intermediate occupations 18% Routine Men predominate in R&M jobs but not across the board Source: Data for working age only, % UK population (Autumn 2005) . Men aged 16-64, women age 16-59. Labour Force Survey, Office of National Statistics2

9. R&M workers overlap with C2D, but can also span C1 (and exclude E) Definition • C1 includes supervisory & admin roles • C2 includes skilled manual workers (bus drivers, air stewards, postmen) • D includes semi-skilled and unskilled manual tasks (dustmen, cashiers) • E contains mainly unemployed (excluded from R&M) A E B D C2 C1 UK, age 15+ population Social Grade distribution, NRS 2006 ‘R&M workers and their families’ have a lot in common with the C2Ds but are more tightly defined Source: Data for 15+ only, % UK population (2006) . Extracted from Marketing Pocket Book 20062

10. Routine and manual workers and their families have less healthy foundations for life Key health indicators Obesity Early years Binge drinking Smoking

11. Inequalities in key health indicators Life expectancy at birth for men in manual jobs 7 yrs lower Mortality Death rates are higher for routine and manual workers Men more than twice as likely to perceive severe lack of social support Age-standardised mortality rate by NS-SEC: men aged 25-64, England and Wales 2001-033 Source: Mortality rates 2001 Census/Death registrations, ONS Longitudinal Study; Office for National Statistics3, General Household Survey, GB, across all age groups based on household reference person4

12. Health inequalities start in the early years Incidence of breast feeding Managerial/ Professional Intermediate Routine and manual Other Pregnancy and Birth • Infant mortality highest for parents in routine or semi-routine occupations – 5.9 /1,000 births • Aware of benefits of breastfeeding • 91% managerial • 72% R&M • Only 26% R&M mothers use antenatal classes, vs 50% managerial and professional Source: Infant mortality – Deaths within one year of birth 2005, Office of National Statistics; Infant Feeding Survey 2005

13. Incidence of smoking highest and more entrenched Smoking • Latest smoking prevalence data, England (GHS 2006): Compared to other employees, R&M occupations.. • Start smoking earlier (45% before the age of 16) • Show the most evidence of addiction Source: Smoking data - General Household Survey (2006), England, aged 16+; Infant Feeding Survey (2005); Lung cancer stats JRF (Office National Statistics)5

14. More likely to be obese (women & children) Obesity Prevalence of obesity, % England, aged 16+ • 29% R&M women obese (23% average, HSE 2003) • 18.7% 2-15 year-olds R&M children obese (cf. 14.6% average) • 20% R&M eat 5 a day, cf 26% others NS-SEC 5 class occupational scale Source: Health Survey for England (2003); Childhood obesity data aggregated HSE 2002-2004

15. More likely to binge drink Binge drinking R&M adults more likely to have consumed no alcohol previous week BUT Routine and semi-routine most likely to binge drink (27%) compared to c.20% in the other groups (HSE 2003) Source: Health Survey for England (2003); Health Survey for England (2002),

16. Children half as likely to achieve 5 GSCE A-C grades Educational achievement Percentage achieving 5 A-C grades (2002) • 60% of 16 year olds with parents in R&M occupations are in full time education – versus 87% others Source: A Summary of Focus on Health Inequalities, Office of National Statistics 2005

17. Insight into R&M workers

18. Hear it first hand…

19. ‘Worker’ Status • Separatist Mentality • Rebellion Working Class Pride Embracing Consumer Culture Collective Mindset Boundaried Aspiration • Resist Individualism • Community & Relationships • Authority from within • Traditional Values • Learning by Modelling • Fatalism • Old School vs. New School • Consumption is Happiness • Excess is Success

20. Working Class Pride I don’t make much money … but it’s better not to be on the dole – lots of them are scroungers Male, 35-55 ‘Worker’ Status Smoking is something that working class people really enjoy - we can’t afford to eat out in fancy restaurants Wellbeing is what rich people do at health farms isn’t it? Male, 25 I don’t want to sit around in self help group talking about giving up smoking with people I don’t know. That’s middle class rubbish! Separatist Mentality I am in favour of more government encouragement in the media, but I get annoyed when I see them in their fancy cars Male, 56-65 The ban is just another way of the government picking on smokers.If everyone stopped smoking tomorrow then the government would go bankrupt because of what we pay in tax. Rebellion

21. Resist individualism Authority from within Community & Relationships Collective Mindset

22. Of course everyone’s different but we all have the same things to deal with, no-one’s different in that way Dad, 35-45 There are people who drink too much - they should think about it and cut down Mum, 45-55 Resist individualism It’s a nightmare trying to give up. You get to the pub and all your mates are smoking and then they offer you a fag If you want to do something else sometimes people give you a hard time because they think you’re trying to be better than them Boy, 16-17 Everyone round here tends to work there … sometimes they move away … maybe because they have to? Male, 16-24

23. I love being with my family – they’re the best thing in my life. It’s great living round here – my mum and brothers live next door and we look after one another Chatrooms are good for [awkward things] … it’s not like we don’t all have to deal with it but you don’t want everyone to know Dad, 35-55 Community & Relationships We look after my daughter’s boy in the weekend and my son’s kids are mostly here at the weekend.. It’s hard work for us but it’s best for them Female, 55+ Why would I want to go anywhere else? I like it here, I know where everything is… who everyone is Male, 16 People look out for each other round here. Male, 25

24. It’s up to them [GP] to keep an eye on you .. . If they give you something, check it’s working ...How will be sure otherwise? Older Family, 45-60 We used to have the same family doctor and now it’s all changed – you don’t know who you’ll see. They know you, you know? … it was much better the way it was Female, 35-45 Authority from within The NHS are like the council, they take all your money and keep you on waiting lists Female, 18-30 It’s very important to me that the house is spotless – it says a lot about you. Even when you’ve got small children – or especially actually, there’s no excuse in the kitchen Mum, 30-40 Our home is our castle! Well it’s a bit cramped when we’re all there but the kids are out most of the time now they’re teenagers Dad, 30-50

25. By custardo on Tue 19-Oct-04 20:19:44 I dont want to go on a diet but the food we eat as a family is pure crap … we need to change. my husband is a big man who wont do "namby pamby shit" … … you have to be realistic in your advice - i cannot possibly spend ages in preparing food - peeling potatoes is my limit. …potatoes are a staple part of out diet - which ways are best to use them? ...lean mince - is this ok - how should i cook it - with what? How do you actually make a tasty spag bol and is it good for you? …muller corner yoghurts - we eat a tonne of these - are these bad? … tell me about new salads and new low fat dressings …we are not fish people (unless it is covered in batter) with the exception of tuna - not salmon. tuna comes with mayo - any low fat mayo ok? any other ways to prepare it? if we cant get a decent filling meal we will go mad. My cupboards are empty - help me fill them with delicious filling healthy foods - not diet stuff - am not interested - interesting and healthy. i just got paid - we shop at tesco. if it comes from a packet it is my best friend help me thank you

26. Mumsnet Chat Thread 1. Do you shop like this every month Miaow? Or is this the start of anew regime? 2. Well wehad to tighten our belts when we moved six weeks ago - our rent is £75 more and I'm no longer working so we are about £300 down on the month (from £1100 to £800, to give you a context). So after we have paid our bills we have about £120 per month for food! 1. im very impressed! 3. thats good! bet you'd like to spend more though. i get very jealous in the supermarket when im spending ages checking/rechecking my list and dithering if i can afford an extra something and see some lucky person with a trolley loaded up with really yummy grub 4. thats about all we have a month for EVERYTHING except nappies and its bloody hard! Well done for doing it though 2. Well, I can't deny it can be time-consuming, but tbh we actually eat really well on that! "Treats" for me aren't bought stuff (well, chocolate is nice ); I bake all our own biscuits/cakes etc … And we do pick up bargains too 5. You are my new role model. We are remortgaging later and will see a similar increase in monthly payments, coupled with a similar drop in income as I go from part-time work to stat maternity pay. I need to cook better and more economically and DH needs to learn not to be a food snob! My hat is off to you! 6. Wow, I am so impressed. We try and budjet for food, but never get it anywhere near that amount. I suppose you don't buy organic then? 2. Er – no. I'm afraid that on that budget organic is a no-no in general 7. how many people are in your family and what are their ages? we spend £200 a month and i thought that was good going, although dp does like his meat. 8. Seriously impressive. Can you post the list of what you bought, plus list of meals? It would be a great resource for when people ask "what can I cook on a tight budget?"

27. Learning by Modelling Traditional Values Fatalism Boundaried Aspiration

28. I don’t like [the word] stretching makes me think that I’m going to get stressed – but if it was a bit challenging AND inspiring then that would be good Girl, 18-19 Theoretical knowledge and classroom learning – that ‘s boring would put people off automatically [Mum, 36-55] Learning by Modelling sometimes you forget what potential you have [Girl 16-17] 10 things to do…simple punchy tips Male, 26-35, BBC News it’s a bit technical, it frightens me and makes me feel helpless Female, 55-64 I can’t see why its 6 months now when it was 4 months before and none of mine had any trouble with it at 4 months [Mum, 31] He’s very fussy so I have to give him what he wants or he won’t eat anything… Mum 27

29. The iron works … it’s caused a lot of diseases around here… Female, 45-54 When it’s your time, it’s your time Male, 35-55 Fatalism You could get run over by a bus tomorrow so you can’t worry about the fact you might get lung cancer. I’m happy now that’s what matters How can you be so sure what the modern world is and what it will be in the future ? Female, 16-17 You hear that doctors and nurses are losing their jobs, it seems that the NHS is out of control 18-30, Female My dad smoked, my mum never smoked in her life, and now it’s my mum who’s dead and my dad’s still alive

30. I just do with my kids what my Mum did with me. It might be old fashioned in some ways … I think she did alright! Mum, 25-35 Traditional Values Valued by employers … any child knows what valued is and they want to leave school and be employed Male, 35-55 Well there’s stuff that’s different for girls. My daughter couldn’t talk to her Dad about girls things it’s not right. Same with boys – it’s the other way round Mum, 36-55 My daughter, she doesn’t sleep around …but sometimes she doesn’t come home at night. And we don’t want a pregnancy in the house … they [NHS] should do something [to help with information] Male, 45-55 My Mum gave us our values. We respect hard work and money … I go around on a nightly basis turning the lights off, draw the curtains … money is important. Female, 55-65

31. Consumption is Happiness ‘Choice’ as a way of life Excess is Success Embracing Consumer Culture

32. “I suppose we recycle. I’d never thought of it like that. I just believe that you shouldn’t waste things. Its the way I was brought up you see. Waste not want not, as they say” (Male, 55-65) “I’m a sucker for buying stuff me. It sends my mums hair grey because she just isn’t from that generation but we are different now. We want it all…” (Male 18-24) ‘Choice’ as a way of life I let my kids choose what they want for their tea. My mum & dad would never have let us do that but we do. I don’t know why… maybe its because I never had that choice I want it for my kids?” (Female, 35-45) “When I was growing up I wasn’t allowed nothing. I don’t want that for my kids. I want to give them what they want. I don’t see anything wrong with that!” (Female, 35-45) “I suppose we are lucky today. We have so much more than our parents ever had. So much more than when I was growing up. I feel I should go for it! Make the most of it!” (Female, 25-35)

33. “To be honest, I only care about what makes my kids happy & if that means giving them fish fingers & beans for their tea tonight then that’s good enough for me” (Female, 25-34) “I don’t control what my kids eat. I give them what they want. Cakes, sweets, biscuits. Whatever… its what makes them smile & as a mum that’s what makes me smile” (Female, 35-45) Consumption is Happiness “My step-dad would never drink in the week – he can’t he’s an electrician, does big council jobs on the roads, away most of the week, hates it … but he’d go through half a bottle of whisky on a Friday ..find him passed out in his chair when I come in from the pub” [Male, 18-30] “When I get in from work I just want to reward myself & my family so we head out to McDonald’s for something to eat. I can’t imagine stopping that. It would feel like a punishment” (Male, 45-55)

34. “I know its only round the corner but I always drive the kids to school. All the mums drive so I want my kids to be the same as their mates” (Female, 35-45) Excess is Success “I know its probably cheaper to buy fresh food but you can get some good deals on pre-packed kids foods & at least you know that way its going to get eaten & that’s what really counts – seeing them wolf their tea down” (Female 35-45) “My kids wouldn’t even touch supermarket versions of the chicken nuggets. They know what the branded ones taste like. They prefer them. I couldn’t get away with putting anything else on the table” (Female 25-35) “I smoke Bensons when I’m out. They look better cos they’re more expensive than Royals “(Male 25-35)

35. Implications

36. Implications Harness the power of brands & mass media to promote +ive health behaviours adopt the language & tonality of mass media & brands that currently drive behaviour Attraction to community doesn’t mean channels are limited newer media (e.g. chat rooms, web forums) are being used to establish communities around health issues Promote a proactive not reactive approach to (long term) health focus on now rather than the future messages and solutions need to be demonstrated rather than just theory

37. Target R&M more specifically so that they are able to identify themselves within communications create health messages and strategies which are less middle and more working class room for communications modelling to reflect traditional values Provide a forum for ‘encouragement’ rather than judgement (to avoid rebellion) in messaging social proof is important for buy in benefit of others (esp. family) is a compelling reason to believe in changing attitudes Implications

38. We hope we have helped to further the twin agendas of “audience based social marketing” and “segmentation” given practical guidance for messages & targeting Demonstrated value of research and insight Closing thoughts