The costs of a healthy diet, can we afford higher food costs? My interests are in health inequalities in childhood, so my focus on the foods available and eaten by people (particularly families with children) Patricia.Lucas@Bristol.ac.uk School for Policy Studies University of Bristol @PatriciaJLucas

2014-16 estimates of undernourished MDG: “Eradicate extreme poverty and hunger” undernourished or food deprived where “food intake falls below the minimum level of dietary energy requirements” 2014-16 estimates of undernourished Number of people (millions) % World 794.6 10.9 Developed Regions 14.7 <5% Developing Regions 779. 9 12.9 Also looking at child underweight, which is also showing decline over tme…but weight in childhood is a tricky thing because it is volatile and (excluding periods of absolute starvation) the relationship between poor nutrition and weight is complex. So first I’m going to try and persuade you that food insecurity is not only an issue in poorer countries. (Data from Table 1, p.8)

1996 World Food Summit ‘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’ SDG: “End hunger, achieve food security and improved nutrition and promote sustainable agriculture” My view on food security is the one adopted by the WFS in 1996, where…

How many people used food banks in the UK in 2013? 13,000 25,899 913,138 20,247,042 How worrying is this increase? Well there are a couple of stories that you might need to think about here…. @PatriciaJLucas

approximate number using food banks in Bristol in 2013 13,000 approximate number using food banks in Bristol in 2013 25,899 number of people given 3 days emergency food by the Trussel Trust in 2008/09 913,138 number of people given 3 days emergency food by Trussel Trust in 2013/14 20,247,042 estimated number of meals provided in 2013/14 by the Trussel Trust, Fareshare and Foodcycle Just a note to say Bristol is not excluded – conservative estimates suggest that there are over 13,000 people using food banks in Bristol. This trend is not exclusive to the UK – huge increases in use of food banks has also been observed in Canada, Sweden (check Loopstra papers for other countries) @PatriciaJLucas

Taylor-Robinson et al Rise in use of emergency food assistance of varying types increased in Greece, Spain, France, Canada, Finland, and Germany. @PatriciaJLucas

Who lacks food? Defined as lacking at least one of meat/fish/vegetarian equivalent every other day, fruit and vegetables every day or two meals a day 17% of UK adults food deprived in 2012 (up from 12% in 1999) 13.4% of adults couldn’t afford meat/fish/nutroast every other day 20.8% of adults living in poverty couldn’t afford to eat fruit and vegetables every day 10.8% of children living in poor households couldn’t afford to eat fruit and vegetables every day 10% of adults couldn’t afford to have friends or family around for a meal at least once a month >5,000 HHs including ~12,000 people 13.4% of adults couldn’t afford meat/fish/nutroast every other day (less than 1% of pensioner couples) The proportion of adults living in poverty who couldn’t afford to eat fruit and vegetables every day? 20.8% (and this isn’t because they didn’t want to – we asked that too! 6.9%) The PSE team estimates that there were around 4% of children (over half a million) are living in food poverty.   #foodpoverty #TF2015 @PatriciaJLucas

Sample of > 5,000 HHs, ~12,000 people Overall all, prices of food have increased (taking out underlying effects of inflaction) 2006-2009, stabilised til early 2014 when they declined slightly over the year (but not back to 2006 levels). @PatriciaJLucas

Affordability of a healthy diet In 2012, the weekly cost of a healthy but realistic diet for a lone parent with one child (under 2 years) £52 ($82) But the average amount actually spent in these families was £36 ($57) on food and non alcoholic drinks was Weekly average in 2014 per person was £35 @PatriciaJLucas

Affording Healthy food Parent experiences of food vouchers: £3.10 a week when you’re working doesn’t feel like much but when you’re not working and are on benefits it does make a difference. Mother of 2 yr old We got quite a lot of veg before but it was mainly tinned stuff. We tend to go more for fresh veg now and a lot more fruit. (pregnant mother with 5 year old) I was able to get him on different types of veg and fruit and not think about the cost. (Mother, one child) Consistent pattern in studies from developed nations that as income falls, diet changes. Move from fresh foods to processed foods - a long shelf life and foods everyone in the family is certain to eat. We can see this ‘trading down’ in the FFS already mentioned and elsewhere @PatriciaJLucas

Buying Less, paying more, and trading down As prices go up, spending changes…. Beef, Butter, Lamb, Pork, Poultry over the period 2007-2014 Taking beef as the example here, prices went up 35%, purchase reduced by 20%, expenditure by 24% and households reduced the unit price paid (traded down) by 10% The size of the impact is greatest for the poores @PatriciaJLucas

Buying Less, paying more, and trading down 43% price increase On average: 2.4% less butter bought, 50% more spent, unit price reduced by 13% In lowest income group: 20% less butter bought, 29% more spent, unit price reduced by 9.1% The size of the impact is greatest for the poorest because they don’t have the option of increasing spend or trading down. They just can’t buy the stuff. So increasing prices increases ‘trading down’ for all, and non-purchase for the poorest. @PatriciaJLucas

@PatriciaJLucas

What does sustainable farming look like? So the challenge is to protect both food security AND planetary health. Because the thing is, producing enough food does not in itself produce food security…. What does sustainable farming look like?

Can we afford higher food costs? Malnutrition ≠ under nutrition Food insecurity is not confined to developing nations Price alone is a blunt instrument Increases in price tends to increase inequality in diet and health in developed as well as developing countries Those with greater resources are more resilient to price increases New Statesman 2013 British cartoon archive www.cartoons.ac.uk @PatriciaJLucas

Thank you @PatriciaJLucas