Faculty of Public Health
Of the Royal Colleges of Physicians of the United Kingdom
Working to improve the public’s health
UK Faculty of Public Health response to the All Party Parliamentary Inquiry into Hunger and
Food Poverty in Britain
About the Faculty of Public Health
The Faculty of Public Health is the standard setting body for specialists in public health in the United
Kingdom. The Faculty of Public Health is a joint faculty of the three Royal Colleges of Physicians of
the United Kingdom (London, Edinburgh and Glasgow) and also a member of the World Federation of
Public Health Associations. The Faculty of Public Health is an independently constituted body with its
own membership and governance structure.
The Faculty of Public Health is the professional home for more than 3,300 professionals working in
public health. Our members come from a diverse range of professional backgrounds (including
clinical, academic, policy) and are employed in a variety of settings, usually working at a strategic or
specialist level. The Faculty of Public Health is a strategic organisation and, as such, works
collaboratively, drawing on the specialist skills, knowledge and experience of our members as well as
building relationships with a wide range of external organisations.
Introduction
The Faculty of Public Health welcomes this opportunity to respond to the All Party Parliamentary
Inquiry into Hunger and Food Poverty in Britain. There is a worrying gap in health circumstances and
outcomes between rich and poor people in the UK. Complex though the reasons for this inequality are,
the reality is that many hardworking families in the UK are living in poverty and do not have enough
income for a decent diet. UK food prices have risen by 12% in real terms since 2007, returning the
cost of food relative to other goods to that in the 1990s. 1
In the same period, UK workers have suffered a 7.6% fall in real wages.2 It therefore seems likely that
increasing numbers of people on low wages are not earning enough money to meet their most basic
nutritional needs to maintain a healthy diet. We should not accept this situation in the UK, the world's
sixth largest economy and the third largest in Europe.
We wish to draw attention to three specific issues. First, food poverty is increasing.3 It is not just that
more people are using food banks. Food banks are a symptom of a more extensive pressure for
emergency food aid, which was recently summarised in a report to the Department for Environment,
Food and Rural Affairs (DEFRA) released this year.4
Food bank numbers are an inadequate indicator of need, because many households only ask for
emergency food help as a last resort. A huge amount of on-the-ground experience and Trussell Trust
data, including the rise of food aid, suggests that the welfare system is increasingly failing to provide a
robust last line of defence against hunger. More and more households, now including those in work,
find themselves unable to afford a decent diet. Reliance on food aid should not be part of any modern,
society-wide and evidence-based approach to public health policy.
Second, there is the underlying issue of food costs and prices. The Office for National Statistics (ONS)
and DEFRA have shown that the rising costs of food during the past 6 years are proving increasingly
1
DEFRA. In: Food Statistics Pocketbook. London: DEFRA, 2013: 18.
Wales P, Taylor C. Economic review, April 2014. London: Office for National Statistics, 2014.
3
Taylor-Robinson D, Rougeaux E, Harrison D, Whitehead M, Barr B, Pearce A. The rise of food poverty in the UK. BMJ 2013; 347: f7157.
PubMed
4
Lambie-Mumford H, Crossley D, Jensen E, Verbeke M, Dowler E. Household food security in the UK: a review of food aid. London:
Department for Environment, Food and Rural Affairs, 2014.
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hard for lower-income households to manage. The food industry is well aware of these problems;
nevertheless, food is likely to continue to cost more in the future.
During the past five years, food has been one of the three top factors in price inflation, sufficient to
worry even higher-income consumers. In a time of high fuel prices, this inflation has translated into
families cutting back on fresh fruit and vegetables and buying cheap, sweet, fatty, salty, or processed
foods that need little cooking. A vicious circle is set in motion, with poorer people having worse diets
and contributing to the worrying rise in obesity, diabetes, and other dietary-related diseases.
The third issue is the problem of stagnant incomes and wages among the low paid. In real terms,
according to the ONS, incomes have fallen in the first substantial manner since the 1960s.5 The ONS
calculates that UK workers have experienced a 7.6% fall in real wages during the past six years.6
Increasing numbers of people on low wages are not earning enough money to meet their most basic
nutritional needs.
Our concern is that this situation puts an overwhelming strain on household food budgets. An
affordable, nutritious diet is a prerequisite for health. We view the rise of food poverty as an indication
of the reversal of what was a long process of improvement in food availability and affordability since
World War Two. The full situation is complex. Nonetheless, public debate about food poverty is
sometimes too quick to blame the poor without understanding the pressures poorer families are under.
As public health professionals, our role is to improve the health and wellbeing of the people we serve.
The Chief Medical Officer for England has recently raised concerns about obesity becoming the norm.
Our organisations and fellow health professionals are committed to helping the public and the food
industry to take the healthier route. Failure to do so will come with immense costs to individuals,
families, communities, employers, the National Health Service, and government.
We require a mature and courageous government to recognise food not only as a commodity, but as a
utility that can advance health, wellbeing and sustainability. We understand and respect the UN Right
to food and strive to advocate that right of our citizens through our membership. The economic and
welfare trade-offs made by governments can be seen in food.
This work should be rooted through the governmental departments and local authorities, but should
not get stuck within public sector structures and processes. Equally, too much power has been given
to the food industry and private sector to make decisions that affect our ability to create healthy
sustainable communities. Communities must be supported to develop their abilities and co-produce
change but not left to carry the burden – which is what food banks are now evidence of.
Food poverty has never been acceptable in a modern UK. The Faculty of Public Health welcomes this
Inquiry and looks forward to supporting the All Party Group as work progresses, and ensuring that the
Government pay full attention to the recommendations the Inquiry is to make.
The Faculty of Public Health has published two resources relevant to this Inquiry’s work, and is keen
for these to be factored into its analysis. These are as follows:
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Food Poverty and Health: Briefing Statement (2005) http://bit.ly/1mu8oiM
nutrition+ food poverty: A toolkit for those involved in developing or implementing a local
nutrition and food poverty strategy (2004) http://bit.ly/1nTDymd
Office for National Statistics. An examination of falling real wages, 2010—2013. London: Office for National Statistics, 2014.
Wales P, Taylor C. Economic review, April 2014. London: Office for National Statistics, 2014.
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The extent and geographical spread of hunger and food poverty in this country
General Principles
At the outset, the Faculty of Public Health draws attention to the recent Report of the UN Special
Rapporteur on the Right to Food, March 2013, and both welcomes and supports the key principles of
this important report. In particular, the Faculty of Public Health notes that:
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the right to food is the right of every individual, alone or in community with others, to have
physical and economic access at all times to sufficient, adequate and culturally acceptable
food that is produced and consumed sustainably, preserving access to food for future
generations
individuals can secure access to food (a) by earning incomes from employment or selfemployment; (b) through social transfers; or (c) by producing their own food, for those who
have access to land and other productive resources
through these channels, which often operate concurrently, each person should have access to
a diet that “as a whole contains a mix of nutrients for physical and mental growth, development
and maintenance, and physical activity that are in compliance with human physiological needs
at all stages throughout the life cycle and according to gender and occupation
thus, the normative content of the right to food can be summarized by reference to the
requirements of availability, accessibility, adequacy and sustainability, all of which must be built
into legal entitlements and secured through accountability mechanisms 7
The Faculty of Public Health is deeply concerned that the alarming and increasing manifestation of
food poverty and hunger in the United Kingdom is in large part determined by structural mechanisms
that lie outside of the control of the individual.
The Faculty of Public Health recognises the ‘duty to protect’ under the International Covenant on
Economic, Social and Cultural Rights (ICESCR), which states that all citizens should have access to
adequate diet without having to compromise other basic needs. 8
Definitions of food poverty: no established definition, but common themes
 households spending more than 10% of their annual income on food are in food poverty
 an individual or household is not able to obtain healthy, nutritious food – they have to eat what
they can afford, not what they choose to
 food poverty is worse diet, worse access, worse health, higher percentage of income on food,
and less choice from a restricted range of foods
 the inability to consume an adequate quality or sufficient quantity of food for health, in socially
acceptable ways, or the uncertainty that one will be able to do so
Trussell Trust data, April 2014
 913,138 people (582,933 adults and 330,205 children) received three days’ emergency food
from Trussell Trust foodbanks in 2013-14 compared to 346,992 in 2012-13
 83% of foodbanks report ‘sanctioning’ is causing rising numbers to turn to them
 163 percent rise on numbers helped in the previous financial year, yet only a 45% increase in
the number of new Trussell Trust foodbanks opening in the last year
 The Trussell Trust has launched over 400 foodbanks across the UK to date
 Foodbanks open for three years or more have seen an average increase of 51% in numbers
helped in 2013-14 compared to 2012-13
 Trussell Trust foodbanks are partnering with other agencies to provide additional services such
as welfare advice, budgeting help and debt support
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United Nations Report of the Special Rapporteur on the right to food, Olivier De Schutter: The transformative potential of the right to food
January 2014
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United Nations International Covenant on Economic, Social and Cultural Rights January 1976
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They are providing essentials like washing powder, nappies and hygiene products
Trussell Trust and Netmums Survey March 2014 (2,178 working families)
 1/5 working parents have had to choose between paying an essential bill or putting food on the
table in the last 12 months
 78 per cent of parents in working families have cut spending over the last 12 months
 56 percent are buying cheaper, lower quality food
 43 per cent are only 'just about coping' with balancing their family budgets
 ¼ have suffered stress as a result of not eating properly
 Only 1 in 40 had turned to a foodbank for help, with more than 70 percent saying that they
would only do so as a last resort
 foodbank figures only reflect part of the problem of UK food poverty
Other evidence from the Trussell Trust
 over 65 percent of foodbank users were only helped once over a six month period
 only 7.5 percent needed four or more vouchers
 Trussell Trust foodbank users are referred by professionals such as social workers, health
visitors or schools liaison officers
 over 27,000 professionals referred people to Trussell Trust foodbanks in 2013-14, and 50
percent are statutory agencies
Oxfam – “Walking the Breadline”
Cooper, N and Dumpleton, S, May 2013
 estimate over 500,000 people are now reliant on food aid – the use of food banks and receipt
of food parcels – and this number is likely to escalate further over the coming months
 this is substantially higher than the figure supplied by the Trussell Trust (as of May 2013)
 at least half as many people again are provided with food parcels or other forms of food aid by
non-Trussell Trust food banks and other emergency food aid projects
 these include parallel growth in independent food banks and other informal emergency food
aid interventions provided by churches, charities, housing associations and community groups
 food banks report that most of those accessing their services are low income families in crisis,
many of which are working households
 62% of children in poverty are in families where at least one parent has a job, indicating wages
are too low and Minimum Wage legislation not adequate to lift people out of poverty via work
Malnutrition and economic crisis - The rise of food poverty in the UK
BMJ 2013; 347 doi: http://dx.doi.org/10.1136/bmj.f7157 (Published 3 December 2013)
 the Institute for Fiscal Studies has reported a decrease in calories purchased and substitution
with unhealthier foods, especially in families with young children
 figures from the Trussell Trust show an exponential rise in the number of people being issued
food bank vouchers by frontline care professionals
 this has all the signs of a public health emergency
 in England between 2008/09 and 2012/12 there has been a nearly twofold increase in hospital
admissions linked to malnutrition in England — from 3000 to 5500 cases
Food Security in the UK (Modified from Church Action on Poverty newsletter April 2013)
Professor Elizabeth Dowler, University of Warwick
 Government figures show that in 2011/12, about 13 million people were in poverty (and nearly
six million of them were in deep poverty)
 62% of poor children are in households where one or more adults are in work
 the UK’s income distribution is highly skewed, and worsening – leading to a growing gap and
rise in the number of people who are ‘near-poor’, at risk of falling into poverty
 in 2010 2/5 in five people were finding it much harder to afford the variety of foods they wanted
to buy – especially those on low incomes.
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1/5 said the cost of food was a serious source of stress
3/5 were cutting back on other things to buy food – heating, travel, clothes, eating out, holidays
Living Standards in the UK; the Poverty and Social Exclusion Research Report (March 2013)
 In households which cannot afford an adequate diet for their children, 93% have at least one
adult who ‘skimps’ on their own food to try to protect the children
 Half a million children are not adequately fed in the UK today, not as a result of negligence but
due to a lack of money
Joseph Rowntree Foundation
 there is evidence of a rising number of people sleeping rough, and destitution is reported with
increasing frequency
Economist/Ipsos MORI November 2013 Issues Index
 1/6 of the British public is worried about poverty and inequality, the highest figure the polling
company MORI has ever recorded
The underlying causes of hunger and food poverty in this country
Rights-based approaches to addressing food poverty and food insecurity in Ireland and UK
Dowler A and Conner D, Social Science and Medicine, 2012
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Implementing international obligations to the right to food is a complex process, given the
multifaceted nature of the food system, increasing dominance of global food industries in the
private sector not under obligation to States, and the fact that nation States are increasingly
bound by rulings of supranational entities such as the EU and the World Trade Organisation
Such non-state actors are changing food governance so that much policy is delegated to
private or civil society sector organisations, which makes it harder both to establish State roles
and responsibilities within the food system, and to monitor and enforce implementation
The UK faces an economic crisis which is widening inequalities, and, as in other European
countries, has an emerging ‘new poor’ among those with insecure employment and low wages,
and migrants with uncertain work and welfare entitlements, as well as longstanding poverty in
households of lone parents, older people, those with disabilities, the unemployed or homeless
Those in receipt of means tested benefits, unemployed, or in lone parent households have
worse micronutrient intakes and dietary patterns than those not in these circumstances
Thinking about ‘food security’; engaging with UK consumers
Dowler et al, Critical Public Health, 2011
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vulnerabilities of the international food system to short- term shocks as well as to longer term
challenges present important factors in the rise of food poverty in the UK
the global food price spike of 2007–2008 triggered considerable anxiety internationally about
civil unrest and provoked re-emergence of concern over the security of food supply and
access, at global and national levels
the reasons why prices rose as fast and as suddenly as they did and remained volatile since
probably include systemic factors such as:
o rising oil costs
o droughts in grain-producing nations reducing world stockpiles
o possibly increased use of crops for biofuel
o growing international demand for meat
o increased commodity speculation in financial markets
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BMJ: Doctors need to take the lead on poverty’s effects on health
BMJ2013;347doi: http://dx.doi.org/10.1136/bmj.f7540 (Published 18 December 2013)
 prices of fish, fruit, vegetables, bread, and meat have all risen by more than 30% since 2007
 the most common reasons cited for food bank referrals are benefit delays, low income, and
benefit changes
 changes to the tax and benefit system are leading to a reduction in the adequacy, eligibility,
and access to benefits, especially for some of the poorest families with children
 cuts to the public sector are hitting services on which poor families with children rely, with the
largest spending cuts to local authority budgets occurring in the most deprived areas
 cuts are affecting vital children’s services e.g. Sure Start centres - 580 have closed since 2010
 the erosion of these safety nets in the UK is of grave concern, because those European
countries that have more adequate social protection experience better health outcomes
Food Security in the UK (Modified from Church Action on Poverty newsletter April 2013)
Professor Elizabeth Dowler, University of Warwick
 out-of-work benefits have for some time been inadequate to meet the basic costs of living, and
this has worsened over the last three years
 austerity cuts in other areas are also making things worse
 the 2011 increase in VAT from 17.5% to 20% was regressive – it has cost the average
household with two children about £450 per year
 child benefit has been frozen, costing average households another £400 over three years
 low–middle income households have lost their child tax credits, costing another £545 a year
 low-income households working less than 24 hours a week have lost their working tax credit,
which was worth about £3,800 a year
 families with children are the worst off, and it’s likely that the cuts are affecting women much
more badly than men
 in 2009, expenditure on food took up 11.5% of average household income, but 16.1% for the
lowest-earning fifth of households
 From 1998 to 2009, the average income of low-income households rose by 22%, but food
prices rose by 33%
The Joseph Rowntree Foundation’s ‘Minimum Income Standard’ research
 the minimum income standard assesses the cost of living by using a consensual ‘budget
standard’ methodology – a costed list of acceptable essentials
 the costs are now higher for many items on this list which are key for poorer people (food, bus
fares and council tax)
 In 2011, the prices on the MIS list had risen by 43%, compared with just 27% for the items on
the ‘Consumer Price Index’ used by the government to uprate benefits:
Wage income
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Out of work benefits
The rising cost of food commodities
 The UN Food & Agriculture Organisation is the latest to highlight the rising cost of food
commodities following disastrous grain harvests in the US and Russia
 for European consumers this adds to the problems of poor fruit and vegetable production from
the summer’s mix of extreme heat and drought – or lack of sun and torrential rain
 these factors translate into ever rising prices at the supermarket till for UK consumers as well
as the (rightly) more lamented poor farmers and consumers elsewhere
 Oxfam have reported that food prices have risen by 30.5% in the last five years; double the
rate of inflation, and two and a half times the rate of increases in the National Minimum Wage
Oxfam – “Walking the Breadline”
Cooper, N and Dumpleton, S, May 2013
 Some of the increase in the number of people using food banks is caused by unemployment,
increasing levels of underemployment, low and falling income, and rising food and fuel prices
 up to half of all people turning to food banks are doing so as a direct result of having benefit
payments delayed, reduced, or withdrawn altogether
 figures gathered by the Trussell Trust show that changes to the benefit system are the most
common reasons for people using food banks. These include:
o changes to crisis loan eligibility rules
o delays in payments
o Jobseeker’s Allowance sanctions
o sickness benefit reassessments.
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welfare payments rose by only 1% this year; well below the rate of inflation, currently at 2.8%
cuts to housing benefit, the benefit cap and the introduction of Universal Credit have a major
impact on the poorest and most vulnerable
FPH recognises the warning that Oxfam’s UK Poverty Programme presented in 2010 that the
new sanctions regime introduced alongside Universal Credit could
“expose people to the risk of destitution. Removing benefits and leaving people with no
income will result in extreme hardship for them and their families.”
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in April 2011, The Guardian analysis of DWP statistics showed a 40% increase in the number
of people who have lost their Jobseeker’s Allowance (JSA) between April and October 2010
in October 2012 a new JSA sanctions regime came into force, which introduced a new and
‘more robust’ system, with low-, intermediate- and high-level sanctions
a broadly similar sanctions regime will be introduced under Universal Credit
in January 2013, an internal DWP ‘scorecard’ leaked to The Guardian revealed that more than
85,000 sanctions had been applied or upheld against JSA claimants in one month alone
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according to the Trussell Trust, nearly 1/3 of food parcel recipients had been referred to the
Trust because their social security benefits had been delayed
a further 15% came as a result of their benefits being cut or stopped (up from 11% in 2011/12)
delays determining benefit or tax credit claims and appeals can have devastating effects
where the delay relates to housing or council tax benefit, there can be serious consequences in
terms of problems with bailiffs and, ultimately, food poverty, hunger and homelessness
according to the DWP’s own official estimates, some £1.3 billion of benefit expenditure was
underpaid in 2011–12
in 2011, the Public Accounts Committee criticised DWP for focusing on reducing overpayments
and neglecting underpayments, despite the hardship that underpayment of benefits can cause
it recognised the material hardship and emotional problems associated with sanctions
The Faculty of Public Health in making this submission also recognises evidence papers one and two
presented to the Inquiry by the Rt Hon Frank Field MP on expenditure.9 We recognise the conclusions
of both papers, that:
“…hunger and food poverty should not be viewed in isolation. They must instead be analysed within
the context of the poorest households having to budget for rising housing and fuel costs by cutting the
amount they spend on food.”
“…spikes in food prices are thought to be a result of a range of global factors including drought, rising
demand from countries such as India and China, increased oil prices, currency fluctuations, and
export restrictions (the latter resulting from Chinese policies to reduce grain stocks, population and
economic growth in transitional economies, poor wheat harvests in 2006/7 and the growth of biofuels”
The circumstances behind the rising number of people requiring emergency food assistance in
this country
Rights-based approaches to addressing food poverty and food insecurity in Ireland and UK
Dowler A and Conner D, Social Science and Medicine, 2012
 in the UK, 22% of the population were in households with income <60% median in 2008/9,
which is 13 million people, more than a third of whom were very poor (income at least one-third
below the poverty line)
 by mid-2010, nearly 2.5 million were unemployed, and almost twice as many were wanting
work Health inequalities have widened in the UK over the last 20 years, with variation in life
expectancy between local authorities of 11 years for men and 10 for women, despite
considerable effort to reduce them
BMJ: Doctors need to take the lead on poverty’s effects on health
BMJ2013;347doi: http://dx.doi.org/10.1136/bmj.f7540 (Published 18 December 2013)
 the poorest households have reduced their consumption of fresh fruit, vegetables, and fish,
with evidence of substitution by unhealthier foods, especially in families with young children
 more children are turning up to school hungry in the UK, with teachers reporting that hunger is
influencing children’s ability to concentrate and learn
 frail elderly people are also at risk of food poverty, with the combination of inadequate heating
and nutritional intake over the winter being particularly dangerouss
Food Security in the UK (Modified from Church Action on Poverty newsletter April 2013)
Professor Elizabeth Dowler, University of Warwick
 the Government’s response has been to individualise the problems and solutions
 the response is increasingly left to local-level charitable food redistribution
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food banks, independent or set up by charities, distribute food, but the quantities are too small
and too piecemeal to meet systematic need, and quality is variable
sustaining the operation of such systems takes considerable work, much by volunteers
Institutionalising the response depoliticises the problem, and locates solutions at local levels,
rather than tackling structural causes
It confirms the status of recipients as lower, needy and often disempowered
there is a struggle to sustain patchy funding, logistical and volunteer skills, and to avoid
continually filling gaps left by the state as it retreats from responsibilities
Oxfam – “Walking the Breadline”
Cooper, N and Dumpleton, S, May 2013
 4/5 teachers are reporting that some of their children are arriving at school hungry
 61% of teachers have given food to their students at their own expense
 Professionals who signpost people to food banks have spoken of their clients’ reluctance to go
because it feels like charity or begging
 Many distributors of food bank tokens have talked about how the people they refer find it
humiliating to be forced to turn to a food bank
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Limited access to food is indicative of broader socio-economic inequalities
Areas where food poverty is high are often synonymous with a number of other factors that
marginalise people and limit options
People on low incomes in the UK pay higher prices for many essential goods and services than
people who are better off
Save the Children has estimated that it costs the average low-income household an extra
£1,300 a year, as they pay more for food, fuel, finance and other goods and services
superstores and out-of-town shopping developments have driven local, independent retailers
out of business and left the poorest in ‘food deserts’ without access to affordable, healthy food
superstores are difficult to reach for people on low-incomes
at least four million people in the UK do not have access to a healthy diet
nearly 13 million people live below the poverty line
Lower-income families in the UK have cut their consumption of fruit and vegetables by nearly a
third in the wake of the recession and rising food prices
At the end of 2010, lower-income households were buying 2.7 portions of fruit and vegetables
per person, per day, compared to the average household buying about four portions
People who are forced to live on an inadequate diet have a significantly increased risk of
developing serious health conditions such as cancer, heart disease, obesity and diabetes
they are also more likely to suffer from stress, ill health, poor educational attainment and
shortened life expectancy
Poor children suffer from lower nutritional intake, bad dietary patterns, hunger, low fruit and
vegetable consumption, and problems accessing food in the school holidays
A poor diet which results in people being overweight or obese is known as modern
malnutrition, a phenomenon which more common in people from lower socioeconomic groups
Poor diet is a risk factor for the UK’s major killers of cancer, coronary heart disease and
diabetes: poor diet is related to 30% of life years lost in early death and disability
evidence shows that people on low incomes are aware of the need to eat fresh produce and
are keen to do so
people are spending more on food but eating less: expenditure on food and non-alcoholic
beverages has increased by almost 20% in the last five years, but the volume of food being
consumed has fallen by 7%
it is predicted that the average food bill will increase by £257 over the next five years, further
increasing the number of people affected by food poverty
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A recent survey found that one in five mothers regularly go without meals so that their children
can eat, 16% are being treated for stress-related illnesses (due to financial worries)
1/3 are borrowing money from friends and family to stay afloat
In answering the following questions, FPH draws attention to the recent report by the Food Ethics
Council and the University of Warwick, Household Food Security in the UK: A Review of Food Aid
February 2014
The extent, nature and organisation of emergency food assistance schemes in this country
 There are some key organisational models – for example The Trussell Trust Foodbank – which
have come to particular prominence in the UK in public knowledge and actual practice
 on the basis of the REA and literature review, mapping and case study research undertaken
the UK, the food aid landscape appears to be both diverse and difficult to document
 In particular, there are a number of independent initiatives, which offer different types of food
aid, but their existence and extent of reach can be hard to capture
 It is impossible at present to give an accurate estimate of the numbers of people fed by food
aid providers in the UK, in total or on a regular basis (monthly or annually).
 broader socio-economic shifts that have adverse impact on household food security are
important pointers to understanding trends in the growth of food aid provision and its demand
 A clear important pattern is that reductions in governmental food aid lead to increased uptake
of non-governmental food aid in international studies
 UK case study research revealed significant operational diversity in terms of the range of
existing food aid types and ways in which food aid projects of the same type were run
 There are many different patterns of food provision organization in the UK, which partly reflects
different aims and/or levels of operation
 Some structured systems run through franchise/networks, others are independently managed
 Furthermore, some organisations running food aid projects were also running other food
initiatives (such as community cafés, cook-and-eat clubs, purchase co-operatives)
 UK-based (non-REA) research, supported by findings from the project case studies, showed
other formal and informal (non-food) support was often provided by food aid organisations
 This support included emotional help, other practical services and signposting to help
 There is considerable evidence in the international literature on effective monitoring of levels of
household food insecurity and food aid trends, contrasting with paucity of literature in the UK
The source of emergency food assistance providers’ supplies – how much is supplied by
consumers and institutions?
 over 90 percent of food given out by Trussell Trust foodbanks is donated by the public
 an estimated 30,000 people volunteered with a Trussell Trust foodbank in 2013-14.
The effectiveness of emergency food assistance in meeting immediate and long-term needs,
and the possibility of these schemes becoming permanent features of the welfare state
 Very little research is available to provide evidence or informed comment on the benefits and
drawbacks of different types of food aid provision or on alternative ways of addressing
household food insecurity
The effectiveness and sustainability of our food model in providing universal access to
healthy, affordable food in this country
 There is a need to address both the immediate situations which lead people to seek food aid,
and underlying social and economic circumstances which are limiting access to food
 The current economic and policy context means increasing numbers of households are having
to deal with changes in circumstances which are potentially having negative impact on their
food security in the immediate (and possibly longer) term
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Some see it as appropriate for local groups to meet short-term food needs through temporary,
non-governmental provision, but the evidence from international food security research
suggests this is likely to be of limited effectiveness
A broader approach to sustaining food access, which takes account of longer-term and
underlying dimensions to household food insecurity is needed
The international literature evidence highlights that those looking to monitor and respond to
household food insecurity in the UK, from across government (at different levels), business and
civil society, should focus on the root causes of this insecurity, rather than on numbers claiming
food aid, which are unreliable indicators of problems
North American international literature shows that growing complexity of large-scale nongovernmental food aid systems, and increasing social acceptance as an appropriate way to
deal with problems of food access, contribute to de-politicising household level food insecurity
the international evidence also suggests that civil society, which is where most food aid
providers are located, can have an important and constructive role to play in terms of advocacy
and lobbying, and in giving a voice to those who experience household food insecurity
There is insufficient systematic evidence in the UK to establish models of best-practice, not
least because aims and objectives vary between providers and systems
co-ordination both between different food aid providers, and between food aid providers and
other agencies, was seen as key to their functioning and success
When the food provided and the means of distribution are adequate, food aid may provide
immediate relief from the symptoms of food insecurity for household members
However, the evidence suggests that food aid has a limited impact on overall household food
security status
Recommendations
 Empowering communities at the local level, in order for them to identify the obstacles that they
face and the solutions that suit them best, is a first step
 local authorities and health services can help to develop joined-up local strategies, to collect
better data, and to provide staff and facilities
 royal medical colleges should take up the challenge of leading doctors against poverty
 There is a clear need for better data, improved monitoring, and an increased awareness of the
health impacts of poverty that are all too evident at the sharp end of healthcare.
 The medical profession also has an important role in assessing the adequacy of welfare
benefits for supporting health and for maintaining the principles of equity in the NHS
 public health professions have a key role in influencing local authority decision making on
where the cuts fall in local services
 welfare reform must be equitable with the test that they must protect the most vulnerable,
particularly children
 the solutions to hunger and food poverty lie in wider collaborations with social, economic and
environmental work flows, e.g.
o supporting traditional community food development work and prioritising assets based
approaches
o learning from food projects how to deliver economic regeneration responses and
transforming local environments through healthy urban planning focused on food
 Towns and cities across the UK should build on strong evidence and coherent local strategies
to reduce food poverty through economic regeneration and food system planning
 This inquiry should be related to the findings of the recent Environmental Audit Committee’s
Sustainable Food inquiry as the two problems are interconnected
 We must improve coordination across sectors, across time and across levels of governance
 this must be complemented by supportive policies at the national level that ensure the right
sequencing between the various policy reforms that are needed, across all relevant sectors,
including agriculture, rural development, health, education and social protection
 an enabling international environment, in which policies that affect the ability of countries to
guarantee the right to food – in the areas of trade, food aid, foreign debt alleviation and
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development cooperation – should be realigned with the imperative of achieving food security
and ensuring adequate nutrition
food sovereignty, in an increasingly interdependent world requires deepening cooperation
between States.
We need voices from the ground, telling it ‘like it is’, to those with power to change things
We need ‘hybrid’ food and community initiatives, where people engage in policy analysis and
advocacy as well as offering a practical, ground-level response, with voice, creative ideas and
shared possibilities for action
food aid should be only a short-term emergency response to the problem of food poverty
Food banks are currently plugging a hole in the social safety net, locating the solutions at a
local level rather than looking at the structural causes – upstream national work must be
undertaken to address these key problems
Food banks should not be seen as a normal part of our social security system, and should not
become a substitute for an effective welfare system and decent work (including a Living Wage)
FPH urges the DWP to undertake research into the wider impact of welfare reform on food
poverty, including on physical and mental health
FPH draws attention to the recommendations made within its briefing statement, Food Poverty and
Health: (2005) http://bit.ly/1mu8oiM
FPH also welcomes and supports the preliminary recommendations made by the All Party Inquiry on 2
June 2014:
“1. The food industry should set itself a target of reducing the amount of surplus food disposed of
in landfill, and turned into compost or energy, by 100,000 tonnes each year by the end of the
next parliament. This should be achieved by preventing waste in retail and supply chains, and by
redistributing surplus food through the voluntary sector. If FareShare and organisations that
promote the equitable distribution of surplus food were given the resources to double their
output, they would save the voluntary sector £160 million over the next parliament.”
“2. The Inquiry has been told of the Fund for European Aid to the Most Deprived, designed to
support food assistance activities by re-allocating EU Structural Funds. Third Party
Organisations have expressed concern at the Government’s decision to withdraw the smallest
possible amount to bolster its welfare-to-work programmes. The Inquiry is asking the
Government to allocate the UK share of the Fund to FareShare and organisations that promote
the equitable distribution of surplus food”
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Appendix One – Northern Housing Consortium
Evidence to the Faculty of Public Health for APPG Inquiry into Food Poverty
The Northern Housing Consortium (NHC) is a membership body representing social housing providers
and local authorities across the three northern regions of England. We are very pleased to submit the
following evidence to the Faculty of Public Health.
NHC members recognise the growing issue of food poverty and witness its impact on the communities
and neighbourhoods they serve. There will not be one single cause of food poverty but NHC
members report growing concerns about this issue following the welfare changes arising out of the
Welfare Reform Act. In a similar vein the responses to the challenge of food poverty will be complex
and require strong partnership working across local government, health, housing, education sectors as
well as working with the voluntary and third sector.
The NHC has been supporting a project – Real Life Reform – for the past year. The project aims to
understand the impact of welfare changes (both positive and negative) and tracks around 80
households across the North. The participants are interviewed every three months on a wide ranging
topic including financial circumstances, employment circumstances, neighbourhood changes,
household spending patterns, health and well being. Issues around food poverty have emerged from
this study including the following


Average spend per person per day is £2.81
In the most recent report (March 2014) – almost a third of all households spent less than £20
per week on food
The qualitative evidence supplied by the research gives greater depth to these headline figures.
“We don’t have breakfast and dinner now. We have one meal a day. We’ve been doing that for about
two months and we’ve got used to it”
Participants reported having to buy “less healthy” food as it was deemed too expensive. Households
which included children reported that they as parents often went without eating to ensure their children
had a meal.
The impact of food poverty on health is also raised by the participants;
“I suffer from diabetes and sometimes I’m not able to buy enough food. A few months ago I went hypo
as I hadn’t eaten enough. I went unconscious… there are no positives”
Within communities families and neighbours are trying to support each other but it is not clear how
sustainable this is in the long term.
“I have neighbours who sometimes cook extra and bring a meal round for me. Sometimes they drop
off a bag of shopping at my door”
Outside of the Real Life Reform project, NHC members also report concerns about food poverty.
A food bank in Scarborough provided the following statistics to illustrate the rise in foodbank usage
which are in line with those supplied by the Trussell Trust.
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December 2012 192 food parcels issued
December 2013 650 food parcels issued.
Areas in both Yorkshire and Humber and in the North East report spikes in food bank usage around
August, coinciding with the school holidays. The presumption is that families whose children benefited
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from free school meals were not able to provide food themselves. Many of our members are looking to
work creatively with their partners in education to provide alternative provision during the summer
holidays and on a wider basis looking to poverty proof the school day.
It is important to recognise the complex interdependencies around poverty – including fuel, food and
other household spending choices. Our findings from Real Life Reform suggest that many social
housing tenants do not have a financial safety net of any kind. Our first report (September 2013) found
that 65% of participants had less than £10 per week to live on after paying for essentials (food and
bills) 37% of households reported they had nothing left to live on. This situation means that
households facing an unexpected cost will have to cut elsewhere – and many indicated that food
spending would be the area they’d most likely cut from.
What we’d like to see:
 More consistent intelligence gathering on food poverty
 From health perspective where in the system is the focus for intelligence gathering and coordinating service interventions to support health of people in food poverty.
 How can sectors better co-ordinate and work in partnership at local strategic level to analyse
and respond to food poverty data.
 What support does the voluntary sector need in short/medium term
 What are the drivers of food poverty and what does the future look like
For more information on any of the issues raised in this short report please do contact Charlotte
Harrison – charlotte.harrison@northern.consortium.org.uk or 07843 356 443
June 2014.
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Appendix Two
The Food and Cornwall Programme Submission to the All Party Parliamentary Inquiry into
Hunger and Food Poverty
Background and introduction
The focus of the Inquiry has been weighted towards an understanding the extent of food poverty, its
causes and emergency food support. This submission provides timely evidence on the effectiveness
of different interventions to promote food security upstream – from community to national level.
There has been no recent summary of evidence relating to the effectiveness of food poverty initiatives
or interventions in the food system in the UK, although a Cochrane Review of community interventions
to improve food security is in its early stages10. As part of a Systems Leadership focus on Food
Poverty in Cornwall a piece of research was commissioned from the European Centre for the
Environment and Human Heath, Exeter University. A search of Systematic Reviews 11 from published
literature was undertaken, the quality of each review was assessed and the findings summarised. The
full paper is available on request.
The Inquiry’s terms of reference lists 10 areas of focus. This paper provides some evidence for points
7 -10. These are set out below with our comments.
7. To consider the effectiveness of emergency food assistance in meeting immediate and longterm needs, and the possibility of these schemes becoming permanent features of the welfare
state.
Whilst food banks may provide effective emergency food assistance they do not address the
underlying causes of food poverty. Food poverty is not just about immediate hunger. It is the inability
to afford, or to have access to, food to make up a healthy diet.
Community food security is dependent on all components in the food system and a whole system
approach is required to ensure a good quality food supply and resources and capacity to acquire food
(see Figure 1 overleaf). We use the term food security to describe an ideal situation where:
‘All people, at all times, have physical and economic access to sufficient, safe and nutritious food to
meet their dietary needs and food preferences for an active and healthy life’12
10
Burns et al (2010) http://summaries.cochrane.org/CD008913/community-level-interventions-to-improve-foodsecurity-in-developed-countries
10 A Systematic Review is considered one of the best forms of evidence. It involves a recognised methodology
and attempts to identify, appraise and synthesize all the empirical evidence to answer a given research question.
11 FAO (2010) http://www.fao.org/cfs/cfs-home/en/
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Figure 1: Determinants of Food Security (from Burns et al, 2010)
8. To examine the effectiveness and sustainability of our food model in providing universal
access to healthy, affordable food in this country.
The Food and Cornwall programme has put together a film submission to the Inquiry from people
experiencing food poverty in Cornwall13. We have also produced a briefing on what we know about
food poverty in Cornwall14 which highlights many of the failures of our current food model. These
include:
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Rising food prices which put pressure on budgets in low income households.
Increasing need for emergency food assistance via the 15 Food Banks in Cornwall.
Unprecedented levels of obesity amongst children and adults. In Cornwall, a third of 10-11 year
olds and two thirds of adults are overweight or obese.
Low income families and vulnerable groups are most at risk of poor diet and poor health.
Only one in five people eat five portions of fruit and vegetables a day.
Poor diet accounts for a third of all cases of cancer, and a further third of cases of
cardiovascular disease.
Our current system results in around 40% of food being wasted.
9. To consider approaches to improving household food security in this country.
In this section we present the key findings of our review. This is described in four sections, the first
three describe interventions to promote food security with strong, moderate and weak evidence of
effectiveness15. A final section identifies gaps in research evidence.
9.1 Interventions with strong evidence (++)
13
http://www.foodandcornwall.org.uk/fac-conference/food-poverty---telling-it-like-it-is/
What we know about food poverty in Cornwall, December 2013 (available on request)
15 See appendix for quality criteria used to assess strength of evidence in this review.
14
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Economic Interventions: There was strong evidence of effectiveness of a range of economic
interventions including subsidy, vouchers and monetary incentives in increasing the consumption of
healthy foods. Food subsidy programs among disadvantaged families (particularly pregnant and
postnatal women) were shown to increase intake of healthy foods by 10–20%. Subsidies from 10-50%
on fruit/veg and low fat snacks were found to increase consumption by 2-4 fold. Monetary incentives
also appear effective in changing dietary behaviour.
Multi-component approaches: There is strong evidence of the effectiveness of multi-component
interventions including a combination of behaviour change approaches, group work, goal setting,
nutrition education and IT approaches. Behaviour change methods involving face-to-face education or
counselling are consistently effective, but also telephone contacts or computer-tailored information.
These interventions appear to have a larger effect in individuals with pre-existing health conditions.
School and educational settings: There is good evidence that school and educational settings can
be effective in promoting a healthy diet in children and adolescents. These include fruit and vegetable
schemes, educational approaches, school food policies and nutrition guidelines. Different approaches
appear to be more or less effective according to age group.
Workplace Targeted Nutrition interventions: There is good evidence that
diet-related worksite interventions have positive impacts on employees' nutritional knowledge, food
intake and health and on the firm's profitability, mainly in terms of reduced absenteeism and
presenteeism.
National or local policy or legislation: There is some good evidence that national or local policies
and legislation can increase healthy food consumption. For example through healthy food
procurement policies in public settings, local or national bans (e.g transfats) although there is less
evidence of effectiveness of voluntary regulation and taxation.
9.2 Interventions with moderate evidence (+)
Changes to the food environment: There is moderate evidence of the effectiveness of changes to
the food environment which increase the availability of healthy foods, promote or price healthier
options in food outlets and community availability of fruit and vegetables.
Food Sale Promotions: There is moderate evidence that food sale promotions in shops,
supermarkets, workplace and food outlets such as product health information at the point of purchase
is effective in promoting healthy dietary choices. Interventions on worksite and university ‘‘limited
access’’ sites (i.e., where few other choices were available) had the greatest effect on food choices.
Agriculture or garden based interventions: There is some moderate evidence that agricultural
strategies and policies can have an effect on population-level nutrition and health outcomes by for
example changing food prices or promoting household food growing. There is also some moderate
evidence that garden based nutrition programmes can improve consumption of fruit and vegetables in
children.
9.3 Interventions with weak evidence ( - )
Cooking skills and community kitchens: There is some weak evidence that community kitchens
may be an effective strategy to improve participants’ cooking skills, social interactions and nutritional
intake. There is also limited evidence that teaching cooking skills leads to healthier eating habits.
Economic effectiveness: There is a limited amount of economic evaluation of interventions listed
above. Few reviews have focussed on economic effectiveness of food intervention and where this was
included few reliable studies were found.
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9.4 Gaps in research evidence
Through this review of published systematic reviews there were some gaps in evidence relating to the
food system described in figure 1.
On the Supply side there was a lack of evidence on: Local supply chains; Rurality; Land based
agricultural schemes – e.g. zoning; Waste reduction.
On the Access side there was a lack of evidence found on: Different population groups (age groups,
BME, rural; households); Computer multi-media channels; Breakfast clubs and type/ composition of
breakfast; the association between availability and intake; Policy-level interventions and large
community based interventions
10. To make recommendations.
Based on a review of the best available evidence there are a number of approaches that we
recommend to promote food security and improve health. In prioritising next steps we urge the Inquiry
to focus on the most effective interventions which we have strong evidence to recommend. These
include:
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Use of economic interventions including subsidy, vouchers and monetary incentives in
increasing the consumption of healthy foods especially for those most at risk of food poverty.
Employing multi-component interventions including a combination of behaviour change
approaches, group work, goal setting, nutrition education and IT applications - particularly for
those with pre-existing health problems.
Prioritise school and educational settings for addressing food poverty through fruit and
vegetable schemes, educational approaches, school food policies and nutrition guidelines.
Locate nutrition interventions in workplaces which benefit both employees and employer in
terms of reduced illness and absenteeism.
Use national, local and institutional levers to promote access to healthy food, change the food
environment and protect consumers from foods high in sugar and saturated fats.
To commission research to further explore effectiveness of interventions to promote food
security and fill the research gaps identified in this paper.
Quality assessment of Systematic Reviews:
+/+
++
Poor quality of Review (search strategy, selection and quality appraisal) and poor
quality of included studies
Moderate quality of Review and weak quality/ number of included studies
Good quality of Review and moderate quality/ number of included studies
Good quality of Review and Strong quality/number of included studies
Statement of strength of evidence:
‘Strong evidence’ of effectiveness was judged where more than one Systematic Review of
good quality were included (++) or (+) which provided evidence of effectiveness.
‘Moderate evidence’ of effectiveness was judged where at least one Systematic Review of
good quality was included (+) and/ or Reviews of moderate quality were included.
‘Weak evidence’ of effectiveness was judged where either a Systematic Review of moderate
quality was included (+/-) and/ or Reviews of poor quality were included (-).
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Prepared by Rachel Wigglesworth, Specialty Registrar in Public Health
Appendix Three – Sandwell Local Authority response (contribution to UKFPH submission)
Inquiry into hunger and food poverty in Britain June 2014
Food Poverty in Sandwell
Headline poverty figures
 More than a fifth of households in Sandwell are workless compared to
17.5% nationally
 38,700 Sandwell families receive working tax credit and or child tax
credit (both in work and out of work families)
 Due to the way poverty is measured (those earning less than 60% of the
median income), relative poverty is decreasing. This reflects that all
incomes have fallen in recent years
 Median gross weekly full time earnings are £425.20 compared with £508
nationally
Children in poverty
 Approximately 23,000 children live in relative poverty in Sandwell
(HMRC figures 2011). 20,000 are under 16 years old
 23.7% of Sandwell Children are eligible and claiming free school meals
compared to 19.6 in the West Midlands and 17.1% in England (2013)
 There are breakfast clubs in almost every primary school in Sandwell
 Housing Associations are reporting a need to tackle holiday hunger
Lack of information on food poverty in
older, cared for and vulnerable people
 We do not currently have good information on hunger and food poverty
from hospitals, residential care homes, meals on wheels and lunch clubs
Indication of families under extreme
pressure
Increase in food poverty reveals
problem with whole system
Responding to food poverty in
Sandwell
 Local foodbanks are reporting a huge increase in the number of families
and individuals referred to them for emergency food parcels
 West Bromwich gave out an average of 47 food parcels per week last
year (a total of 2,464 parcels over the year)
 Smethwick foodbank gave out an average of 38 parcels a week (total
1,951 parcels)
 Black Country foodbank says their enquiries increased by over 75% since
January 2013
 All the local (and national) foodbanks are reporting that that people
having their benefits sanctioned is a significant factor in this increase in
demand
 ‘The right to food is the right of every individual, alone or in community
with others, to have physical and economic access at all times to
sufficient, adequate and culturally acceptable food that is produced and
consumed sustainably, preserving access to food for future generations’.
United Nations Right to Food Expert’s Final report: The transformative
potential of the right to food* 24th January 2014
 UN Right to Food Expert’s recommendation to states is ‘to reshape food
systems for the promotion of sustainable diets and effectively combat the
different faces of malnutrition’
 Continued support to food banks to respond to food poverty crises
 Identification of new actions required that fill gaps in our provision
 Collaboration and co-production/creation of solutions through economic
regeneration led food sector innovation and food systems planning work
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To understand the extent and geographical
spread of hunger and food poverty in this
country
National information
Health Impact Assessments
Households affected
Children affected
 See Oxfam ’Walking the breadline’ report
 In search of the low fat pork scratching – potential of food system
 Health Action Zone ‘Measuring access to healthy food in Sandwell’ was
initiated through the Agenda 21 Sustainable Development Strategy
 Community Food Mapping – participatory – assets based approach
 Food access within HIAs therefore visible for Healthy Urban Planning
 Nutritional analysis (Quality of food access) Environmental Health/TS
 An increase in the number of Food Banks in Sandwell
 An increase in the number of people referred to and using Food Banks in
Sandwell
 Lifestyle services observation (Slimming, Cooking, ShopTours, Mothers)
 Increase in malnutrition (both hunger and obesity)
 Family Information Service (Family Support Workers)
 Community and Voluntary Sector observation (Smethwick in a stew)
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Child Poverty Action Group ‘Poverty Bites’ book is still as relevant now
Holiday Hunger (Housing Associations)
Healthy Start (beneficiaries (entitled, uptake – registered outlets)
Free School Meals (eligibility, uptake – primary and secondary)
Breakfast clubs (in Schools)
To investigate the underlying causes of
hunger and food poverty in this country
Households affected
 Increase in food poverty reveals problems with whole food system
 Understanding Sandwell’s food system (supply chain, food sector)
 Hunger and obesity - malnutrition
 Understanding Sandwell’s interdependence with hunger and food poverty
in developing countries. Welfare reform, food industry, agriculture etc
Children affected
Food system planning
 ‘The impact of welfare reform is being felt acutely in Sandwell and is
driving poverty, not driving people into work as the government intends.
We estimate that the local economy will have £110m less income as a
direct effect. The cumulative effect on households of the various housing
benefit changes and the benefit cap is putting further downward pressure
on households and their ability to support their families with the basic
essentials of food and warmth.’ Child Poverty Strategy consultation
response 2014-17 Sandwell MBC.
 Poverty, Food System not based on health and sustainability principles
To identify the circumstances behind the
rising number of people requiring
emergency food assistance in this country
Numbers increasing significantly
 ‘An FOI request to government on the scale of sanctioning across the
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country has revealed that between October 2012 and September 2013,
the monthly total of JSA sanctions with adverse decisions increased by
86%, 53% and 37% in each of the borough’s three job centres. The
consequence of this is that as our local advice service providers and
libraries tell us that there is an increasing stream of clients approaching
them who have had their benefits sanctioned, in many cases, unfairly.
This leaves people with no means to feed their families. The most
damning indicator of poverty created directly by welfare cuts and reform
and the cost of living crisis is the scale of people being referred to
foodbanks for emergency food to feed their families. This is a sign that
the welfare system is failing at a fundamental level’. Child Poverty
Strategy consultation response 2014-17 Sandwell MBC.
 Recession – fragility of family finance ‘Financial wellbeing sessions’
 It is about power and influence, the economy and environment.
 Use our local data and quotes from e.g. family food and wellbeing event
To understand the extent, nature and
organisation of emergency food
assistance schemes in this country
Food poverty and fuel poverty
Family food and wellbeing
Pathways out of food poverty
 Soup Kitchen – Heather Chinner (number of food banks) Black Country
Emergency providers network. Who provides? (churches and schools)
 Health visitors and other key workers
 Family Information Service/Family Practicioners
 Early Help Capacity Group
 West Midlands Strategic Food Board
 HWBB, sustainable communities
To discover the food choices and other
forms of support available to clients when
using emergency food assistance
Right to food
Range of support
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


Cans, dry food, no fresh fruit and vegetables,
Link to fuel poverty – Smethwick in a stew,
Not just one response – families are complex and changing
Range of support – including Credit Unions, lifestyle services, welfare
rights, mental health and wellbeing
To investigate the source of emergency
food assistance providers’ supplies – how
much is supplied by consumers and
institutions?
Food as a utility: Food security for all
Citizens and Institutions taking
responsibility - is not acceptance




Schools
Churches
Employers
SMBC has contributed £75,000 towards Sandwell’s food banks this year
 Need to investigate other methods of improving the existing infrastructure
 CSR supermarkets etc
 Fairshare, food waste etc
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To consider the effectiveness of
emergency food assistance in meeting
immediate and long-term needs, and the
possibility of these schemes becoming
permanent features of the welfare state
Power in this
Government
decision
is
with 



Effectiveness – partial effectiveness short term but not long term
Will UK Citizens accept it?
Power in this decision is with Government
Welfare state? Britain? Next generations future
To examine the effectiveness and
sustainability of our food model in
providing universal access to healthy,
affordable food in this country
Universal access to healthy
affordable, food
Food systems planning
 Making links between public health and economic regeneration and
identifying how to deliver shared outcomes. Environmental Audit
Committee ‘Sustainable Food Inquiry’.
 Sandwell Healthy Urban Development Unit
 Housing and Developers
 Food Industry, Food sector innovation (Knowledge Transfer)
To consider approaches to improving
household food security in this country
The food sector can provide the focus
to achieve multiple outcomes
We recognise that health can be a driver for economic regeneration and that
the food sector can provide the focus to achieve multiple outcomes.
‘’From an economic development perspective - development of the local
food supply chain is necessary to offer local people employment and to
increase the overall output of the borough, at the same time improving the
health of local people through healthier food production’’. Andy Bywater,
SMBC Economic Regeneration
Nourishing the City? the urban food
question
 Optimism - assets based approach, the way we learn and make solutions
 Sustainable Food Cities, AESOP, TCPA, Garden Cities etc
 Need solutions at city regional and national level, not only household
level
Sandwell’s recommendations
Food Democracy
We understand and respect the UN Right to food and as a democratic
institution we strive to uphold that right for our citizens in Sandwell.
‘Democracy and diversity can mend broken food systems’ - final diagnosis
from UN right to food expert
Too much saturated fat, added sugars
and salt and not enough fruit,
vegetables, oily fish and fibre
The latest National Diet and Nutrition Survey (NDNS) data was released on
Wednesday 14 May 2014 as an official statistic. NDNS is an annual survey
designed to assess the food consumption and nutritional status of a UK
representative sample and indicates that overall the population is still
consuming too much saturated fat, added sugars and salt and not enough
fruit, vegetables, oily fish and fibre. There was evidence of an increased
4 St Andrews Place  London  NW1 4LB  Tel: 020 3696 1452  Fax: 020 3696 1457
Email: enquiries@fph.org.uk  Website: www.fph.org.uk  Registered Charity No: 263894
22
risk of vitamin D deficiency in all age/sex groups.
Black Country Core Strategy (H0U2) Housing Policy, Access to fresh food
Social infrastructure: Housing policy
This is the moment of consolidation for the government to decide to accept,
or reject food poverty. This decision will lead to the design of either a food
systems plan or a food assistance scheme. This decision is about looking
backwards or looking forwards in time. We have no doubts in Sandwell
that we will use our local evidence and learning to do all we can locally,
and in the west midlands, to improve food security for the next generation.
How the government responds to hunger and food poverty truly
demonstrates what the government’s vision for its country and citizens is.
Long term food system planning
Healthy sustainable communities
In the meantime (next 10 years) we will continue to support the emergency
support infrastructure, as this is the current reality and we see it worsening.
We will not reduce our focus or investment in our long-term food system
planning involving e.g. Economic Regeneration, Spatial Planning, Housing,
Community Development, Sustainable Development and Anti Poverty.
How we work on food poverty indicates directly to our community and our
businesses our commitment to creating healthy sustainable communities.
Approaches to food poverty/hunger/food policy are not fit for purpose –
requires wider collaboration and design led coproduction of solutions
Collaboration and co-production
food poverty is a national crisis in
urgent need of attention’
 Co-production/Co-creation – assets based approach, involving citizens
 Design, innovation and citizenship – requires a different way of seeing
and working
 Collaboration – the way in which we learn about this and seek solutions
currently out with what is offered through current policy and projects.
 Income and jobs
 Increasing knowledge and learning about food and financial wellbeing.
School, institutions e.g. LA/NHS
 Social, economic, environmental
 Economic regeneration, planning, community development
 ‘Provide sustainable funding to help local partners respond to the
increasing numbers of people presenting in crisis situations and recognise
that food poverty is a national crisis in urgent need of attention’ Child
Poverty Strategy consultation response 2014-17 Sandwell MBC.
4 St Andrews Place  London  NW1 4LB  Tel: 020 3696 1452  Fax: 020 3696 1457
Email: enquiries@fph.org.uk  Website: www.fph.org.uk  Registered Charity No: 263894
23
Appendix four and five
The Faculty of Public Health would be grateful if the following two reports could be taken into
consideration as part of this Inquiry:
Saunders P and Saunders A. Access to Healthy Food in Sandwell: A Spatial and Demographic
Analysis, March 2014 http://bit.ly/1qJY6jN
Saunders P and Saunders A. Composition and Dietary Quality of Hot Food Takeaways in Sandwell,
Impact on Public Health and Recommendations for Action, March 2014 http://bit.ly/1mN4m9Y
4 St Andrews Place  London  NW1 4LB  Tel: 020 3696 1452  Fax: 020 3696 1457
Email: enquiries@fph.org.uk  Website: www.fph.org.uk  Registered Charity No: 263894
24