Sarah Hickey, Programme Director, Guy's and St Thomas' Charity
Nov 12, 2020
We welcome the announcement this week that in response to the co-ordinated campaigning led by the Food Foundation, with high-profile voices such as Marcus Rashford, the government has announced a winter package to provide extra support for children and families. This package of measures will provide critical support for families struggling with the financial impacts of the pandemic. It takes steps to temporarily mitigate - but far from solves - the underlying inequities around children’s diet and health.
Our Childhood obesity programme focuses on tackling the ‘childhood obesity inequality gap’. This gap is the stark difference in children’s ability to access nutritious diets. Children living in the lowest income areas in England are more likely to be flooded with High Fat, Sugar, Salt food products and less likely to have readily available healthy options. They are often in households with lower budgets, and with less time and headspace, to navigate our unhealthy food environments. They are significantly more likely to be consuming too many excess calories and too few high-quality nutrients, with a detrimental impact on their health, including greater risk of obesity. This link between poverty and diet is not new. It is a correlation that, depressingly, has continued to strengthen over time. However, COVID has both exacerbated this inequity and put it into the spotlight.
At the heart of this issue is poverty, and campaigners are right to call this out. It was difficult to listen to Parliamentary arguments against extending Free School Meals (FSM) suggesting that child poverty is inevitable or was worse under a previous administration. It’s not. The Child Poverty Act (2010) committed to eradicating child poverty by 2020. The Act was abolished by the government in 2016. It’s clear that the need to hold policy-makers to account in tackling this issue is greater than ever.
That aside, food subsidy programmes have a really important role to play in mitigating the effects of poverty on diet and health. For food programmes to have a meaningful impact on health inequities, they need a persistent eye on two things: access and quality.
To benefit from these programmes, children need to be able to access them in the first place. Families need to fit eligibility criteria and they need for the programme to be readily available. The easiest way to make sure those most in need can access a subsidy is to make it universal, i.e. open to all. This removes stigma, increases awareness and reduces administrative burdens in delivery. It also addresses the fact that families’ circumstances can quickly change and many families in need just miss out on the income threshold criteria. It is estimated that 1.7m families currently living in food insecurity are not eligible for FSM or Healthy Start. In addition, the gaps in availability of FSM (only delivered in term time) translate into dips in children’s health during school holidays.
The new COVID holiday programme extends the availability of FSM into the holidays until Christmas 2021. It will allow children to continue to access at least one good meal per day throughout the year; an anchor to maintain their health. This will hopefully further the argument to make Free School Meals available year-round a permanent commitment from Government.
However, this announcement doesn’t change eligibility criteria for FSM or Healthy Start. The Healthy Start voucher scheme especially consistently struggles from low take up, because of lack of awareness and burdensome administration requirements for families, vendors, and health professionals who need to act as gate keepers to ensure only those eligible receive vouchers. Intake of fruit and vegetables is too low across the entire population so expanding the eligibility of this subsidy could have wider benefits.
In summary, to build on the new steps towards increasing access, Government needs to address barriers around eligibility.
The second issue is nutritional quality. Children living in low-income households and neighbourhoods are more likely to be both malnourished and obese. Increasing the value of Healthy Start speaks to this point. As highlighted by Alexandra Rose Charity, who run a voucher scheme with features that the Healthy Start scheme could emulate, this is the first increase in this subsidy since 2009. The increase will better match today’s prices and allow access to a volume of fruit and vegetables that will cover the nutritional needs of a family. The potential for collaboration around this subsidy with industry is starting to be uncovered, which could go some way to making food retail environments healthier. Tesco and Iceland have already committed to adding further value to Healthy Start, by pledging additional offers for voucher holders.
The issue of school food quality still hasn’t been fully addressed. The Government first introduced School Food Standards as a minimum quality threshold in 2013 because they agreed that every child deserves access to a nutritious diet, no matter where they go to school. As our recent report shows, the School Food Standards are not yet translating into consistent, good quality food on children’s plates.
Emergency food provision focusing solely on addressing hunger, with high salt fat and sugar foods featuring prominently, risks exacerbating dietary inequality further. During lockdown we partnered with School Food Matters and Chefs in Schools to deliver an emergency food scheme that was both tasty and healthy. This scheme showed how food can both address immediate need and maintain focus on nutrition and quality.
The new Government COVID food programme supports the impact that can be achieved through Healthy Start. To build on this, we need to look at how the incentives in the school food system - for schools and caterers in particular - can be realigned to focus on quality, not only cost, as well as how this emphasis on quality can be maintained even in emergency provision.
Ultimately, permanent changes around access and quality in food subsidy programmes are needed to address deep inequities in children’s diets and health. The new policies introduced during the pandemic show that big system changes (including very rapid ones) are perfectly possible. There is a growing and mobilised citizen voice holding the Government and industry to account to follow through on this important mission. Over a million people including children and young people have just said loud and clear: the food system is designed and can be redesigned. We demand better for children and families.
Programme Director: Sarah Hickey
15 October, 2020
Sharon Bligh, Healthier Lives Director at The Consumer Goods Forum, shares lessons learnt from our collaboration to test in-store health initiatives.