Abstract
BackgroundEvidence suggests that people living in poverty often experience inadequate nutrition with short and long-term health consequences. Whilst the diets of low-income households have been subject to scrutiny, there is limited evidence in the UK on the diet quality and food practices of households reporting food insecurity and food bank use. We explore lived experiences of food insecurity and underlying drivers of diet quality among low-income families, drawing upon two years of participatory research with families of primary school age children.MethodsWe report on a mixed-methods study of the relationship between low income, food bank use, food practices and consumption from a survey of 612 participants, including 136 free text responses and four focus groups with 22 participants. The research followed a parallel mixed-methods design: qualitative and quantitative data were collected separately, although both were informed by participatory work. Quantitative data were analysed using binary and multinomial logistic regression modelling; qualitative data were analysed thematically.ResultsLower income households and those living with food insecurity struggle to afford a level of fruit and vegetable consumption that approaches public health guidance for maintaining a healthy diet, despite high awareness of the constituents of a healthy diet. Participants used multiple strategies to ensure as much fruit, vegetable and protein consumption as possible within financial constraints. The quantitative data suggested a relationship between higher processed food consumption and having used a food bank, independent of income and food security status.ConclusionsThe findings suggest that individualised, behavioural accounts of food practices on a low-income misrepresent the reality for people living with poverty. Behavioural or educational interventions are therefore likely to be less effective in tackling food insecurity and poor nutrition among people on a low income; policies focusing on structural drivers, including poverty and geographical access to food, are needed.
Highlights
Food insecurity, the “limited or uncertain availability of nutritionally adequate and safe foods or limited or uncertain ability to acquire acceptable foods in socially acceptable ways”1, has increased across Europe and in the UK since the 2008 economic crisis2,3
The findings suggest that individualised, behavioural accounts of food practices on a low-income misrepresent the reality for people living with poverty
Emerging research on food insecurity in the UK suggests a similar relationship with diet10,11 – analysis of the International Food Policy Study by Yau et al.11 found that food insecure adults have a lower probability of consuming fruits and vegetables than food secure adults, and a higher probability of reporting unhealthy diets
Summary
The “limited or uncertain availability of nutritionally adequate and safe foods or limited or uncertain ability to acquire acceptable foods in socially acceptable ways”, has increased across Europe and in the UK since the 2008 economic crisis. Emerging research on food insecurity in the UK suggests a similar relationship with diet10,11 – analysis of the International Food Policy Study by Yau et al. found that food insecure adults have a lower probability of consuming fruits and vegetables than food secure adults, and a higher probability of reporting unhealthy diets. Whilst the diets of low-income households have been subject to scrutiny, there is limited evidence in the UK on the diet quality and food practices of households reporting food insecurity and food bank use. Results: Lower income households and those living with food insecurity struggle to afford a level of fruit and vegetable consumption that approaches public health guidance for maintaining a healthy diet, despite high awareness of the constituents of a healthy diet. The quantitative data suggested a relationship between higher processed food consumption and having used a food bank, Invited Reviewers version 1
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