Hunger alleviation, tackling food poverty or challenging the determinants of poverty:

What can Public Health do?

Tony CookeHead of Health Improvement

Kirklees Public Health

Food poverty is…“the inability to afford or to have access to food to make up a healthy diet” (Department of Health)

“Food poverty is worse diet, worse access, worse health, higher percentage of income on food, and less choice from a restricted range of foods.”(Tim Lang, Professor of Food Policy at City University, London)

Lower consumption of

fruit and veg and a higher intake of fats, sugars + salt. Problems

with overweight and underweight

Space for preparing and

eating as a family

Lack of cooking in the home. Families rarely sit

down together to eat a meal

Access to affordable

healthy food

Less opportunity for physical activity and large number of

takeaways in deprived areas .

Food poverty and diet of people on low incomes

Low income and less healthy eating

behaviours

Food budget will often be reduced before other household outgoings

Lack of cooking skills & confidence

Food behaviour linked to other health behaviours: physical activity ,alcohol, smoking

Lack of exposure to sunlight = Vit D

deficiency

Irregular meal times

Lack of cooking utensils

Shift work and irregular hours

Psycho-social stress and stigma

• Population wide people are eating less nutritious food

• Starker inequalities in income, stark inequalities in diets and food skills

• In Kirklees lower income groups less confident at cooking from scratch

• ‘Bad’ food can cost less per calorie• It is also more accessible/profitable

Increased numbers accessing food banksIncreased under nutritionIncrease in numbers overweight and obese Perfect storm

21%

16%

33%

Child Poverty

Working age Poverty

Pensioner Poverty

20,840

42,800

22,040

Poverty in Kirklees

Cost of living increases 2008 - 2012

1%Work

related benefitsuprating

25%

Minimum Income basket

2.2%

Disabled people and pensioners

uprating

2.2%

Universal uprating

18%

Food

27%

Energy

Annual benefits uprating2008 - 2012

Annual benefits uprating2013 onwards

Incapacit

y Benefits

Tax Credits

1% up-rating of m

ost working-age benefits

Housing Benefit r

eforms

£0.0

£1.0

£2.0

£3.0

£4.0

£5.0

£bn

average loss per affected

household/individual

£3,480

average loss per affected

household/individual

£810

The biggest losers

Some households and individuals, notably sickness and disability claimants, will be hit by several different elements of the reforms.

Discussions in Kirklees…All people in poverty are at risk of food poverty but individual circumstances are different• Some people are more resilient• Some have stronger communities/social capital• Some grow their own food or have an allotment

Benefit sanctions are an exception• Most people on benefits do not attend food banks

but most people sanctioned do• Increasing numbers are sanctioned

The Kirklees response: Proportionate universalism Narrative for change: the food charter and strategy

A population level approach where possible

• Food for Life Partnership in schools to improve quality and uptake of meals• Silver catering award provider supplies food to all but one Kirklees school • Projects to increase food growing across Kirklees• National Child Measurement Programme• Healthy Choice Award targets take-aways and restaurants• Recycling and food waste projects• Better procurement promotes more local jobs

Targeted services where necessary

• 40 growing sites in areas of multiple deprivation, focus on social housing, disabilities, LTCs• Settings based approach to target hospitals, early years and care settings, using FFLP and

development of similar standards to support sustainable food• Food banks+ i.e. skills training, cook and eat sessions and (planned) growing sites

Questions for consideration• Do we need to make a clear distinction between hunger, food poverty and

poverty?• Should we focus on alleviation of hunger, improvements to diet/nutrition or

both?• How to engage with public health teams to address food poverty?• How can public health engage other partners to address food poverty?• What are the consequences of food poverty?• Which areas can public health address? Focus on low / medium input, high

impact• Can local authorities develop systematic strategies to address health

inequalities including food poverty and poverty more generally• How can they join wider lobbying efforts around poverty and its impact• What action can you commit to taking forward when you get back to your

City/town?

What’s happened isthat the level of incomeinequality has beenincreasing. And by thatwe mean that the veryrich have been gettingmore and more money,and people lower down,have been getting less.

Michael Marmot, 2013