Food poverty and health

Inequalities in people’s diets contribute to inequalities in people’s health. Survey data consistently show that people on low incomes tend to have less healthy diets, as evidenced by lower fruit and vegetable intakes and consumption of more processed foods which are higher in saturated fats and salt.

Food poverty is defined as ‘the inability to afford or have reasonable access to food which provides a healthy diet’. Food poverty is multidimensional, referring not only to the lack of access to a nutritionally adequate diet but also to the related impacts on health, culture and social participation.

The issue of food poverty has a significant interface with the obesity epidemic. Food poverty, and the inherent disadvantages associated with it, can be caused by a combination of the following distinct barriers:

• Financial access.
  Many low income households find it difficult to afford a healthy diet. A shortage of money also has a direct effect on physical access to food.

• Physical access.
  Many low income households find it difficult to access affordable healthy food. For example, edge-of-town supermarkets combined with poor transport facilities result in people having to shop in higher priced local shops where there may be less choice of reasonably priced healthy food.

• Access to information.
  Access to knowledge about what we eat has been affected by a dramatic change in the way food is supplied. It can be challenging for households, particularly those on a low income, to understand the nutritional value on food packaging and to be aware of key nutritional and food safety messages.

Decent Food for All (DFfA)  was a four-year integrated, partnership-based intervention committed to addressing inequalities in physical and financial access to safe healthy food. DFfA was led by Armagh and Dungannon Health Action Zone (HAZ) in Northern Ireland.

The aims of the intervention were to:

• improve the provision and consumption of affordable, safe and healthy food particularly among the disadvantaged groups;

• support local communities, families and individuals to achieve a balanced safe diet by providing practical, community-based and focused help and advice on food issues and nutrition.

• DFfA addressed the three dimensions of food poverty – financial access, physical access, and access to information (as outlined in the Food Poverty and Health subsection). The intervention incorporated

  • Financial Access
    Many low income households find it difficult to afford a healthy diet. A shortage of money also restricts physical access to food.

  • Physical Access
    Edge of town supermarkets and inadequate transport facilities mean that many find it difficult to go shopping. This often results in people having to go to (often higher-priced) local shops where there may also be less choice.

  • Access to Information
    People on low incomes are disproportionately affected by a general lack of knowledge or misleading information. This includes food safety issues, nutrition and labelling information, and food preparation.

1. Cook It, aimed at anyone interested in enhancing their cooking skills and healthier eating;

2. Balanced Beginnings, about the nutritional needs from conception through the early years of childhood;

3. My Body, to encourage children to look after their bodies in a healthy way; 

4. Looking Good Feeling Better, aimed at those wanting to shift towards a healthier lifestyle (diet, physical activity, smoking, alcohol…).

1. Balance of Good Health, developed for children to encourage fruit consumption and increase awareness about hidden sugars in foods;

2. Food Safety in the Home, covering topics such as food hygiene, storage and shopping tips;

3. Understanding Food Labels;

4. Budgeting and Money Management, to help increase expenditure on healthy food.

Initially planned as a three-year intervention, DFfA was extended for a year so that delivery of the intervention finished in late 2006/early 2007.

The Institute of Public Health in Ireland (IPH) was responsible for a significant research and evaluation project associated with the DFfA intervention. The overall aim of this All-Ireland Learning for the DFfA Intervention project was to assess the effectiveness of the intervention in reducing food poverty within the 12 target wards in Armagh and Dungannon HAZ.

The Program Logic Approach (PLA) was used to help ensure that the DFfA intervention was planned as a comprehensive multi-level programme that tackled the broad determinants of food poverty (see link below) and its evaluation was based on the shared understanding of how it was to achieve its aims.

Key expected outcomes and associated indicators were identified and these indicators were measured in pre-test and post-test community surveys. These also provided local contextual information about dietary and food safety knowledge and practices. These surveys were conducted in the intervention area, as well as in the Newry/Mourne area which served as a non-randomised comparison area.

Availability and cost of food was assessed through pre-test and post-test food basket studies. This analysis was complemented by qualitative information from a number of ethnographic studies, which explore the cultural aspects of food and food consumption.

Funding for the research and evaluation programme was provided by the Food Safety Promotion Board.

The report of the pre-test community survey, Food Poverty in Rural Northern Ireland: Factbook for the Pre-Test Community Survey, was published in 2006.

The report of the pre-test food basket study, The Availability and Price of Food in Rural Northern Ireland, and the report on the ethnographic studies, Food Culture in Rural Northern Ireland, are also available.

Data collection for the post-test community survey and post-test food basket study were conducted in late 2006/early 2007. Access the final report Tackling Food Poverty: lessons from the Decent Food for All (DFfA) intervention.