Reflections on food poverty – what is the evidence and what can we do ? Dr Liz Mitchell, IPH

1. Reflections on food poverty – what is the evidence and what can we do? Dr Liz Mitchell, IPH http://www.publichealth.ie/

2. Aims of Belfast Food Network Food Poverty Working Group • Increased access to affordable healthy food in Belfast • Fewer people experiencing food poverty in Belfast • Place food poverty on the policy agenda

3. Article  25 of the Universal Declaration of Human Rights (1948) Everyone has the right to a standard of living adequate for the health and well-being of himself and his family, including food.”

4. Sustainable Food Cities Award Framework – food poverty • Multiagency partnership to assess and tackle full range of issues • Living wage being promoted • Relevant agencies providing rapid referral to hardship funds and emergency food aid • Relevant staff trained and able to advise on accessing healthy foods and skills training • Healthy weight services being provided – healthy diet and physical activity promoted • Efforts being made to maximise uptake of social food provision • More healthy options available in shops, takeaways, vending machines, catering settings • City working to prevent food deserts and food swamps

5. Sustainable Food Cities Bronze award March 2016

6. What do we mean by food poverty? The inability to have an adequate and nutritious diet … due to issues of the access to and affordability of food … with related impacts on health, culture and social participation.” Friel and Conlon, 2004

7. How do we measure it? • 2009 – 15% NI households at risk of food poverty (IPH - Living Costs and Food Survey) • 2012 – 29% have ‘sometimes’ or ‘often’ skimped on food so that others in the household would have enough to eat (ESRC - Poverty and Social Exclusion Survey of Living Standards in NI) • 2014 - 32% in NI said the cost of food was the most common barrier to eating healthily increased from 11% in 2010 (FSA - Food and You survey)

8. National Diet and Nutrition Survey • Fruit and vegetable consumption in NI was significantly lower than in the UK as a whole • 82% of adults and 96% of 11-18 yrin Northern Ireland did not meet “5-a-day”recommendation

9. Measuring food poverty • No accepted food poverty indicator • Typically use the EU SILC Food Deprivation Measures • UU planning to compare SILC , FAO UN Measuring Household Food Insecurity and Canadian tools

10. Existing routinely collected data does not tell us • Degree of uncertainty about being able to put food on the table • Duration and frequency of constrained food intake • Food was obtained in a socially acceptable way • What we can do about it

11. 3-day emergency food parcel from a food bank in 2015

12. Food banks in Belfast in 2015 3 Trussell Trust 6 Independent 4,338 people fed by 5 independent food banks in 2014

15. Search of Systematic Reviews • Described in UK The Faculty of Public Health response to the all Party Parliamentary Inquiry into Hunger and Food Poverty in Britain – Appendix two

16. Interventions with strong evidence • Economic interventions (e.g. subsidy or vouchers) • Multi-component approaches • School and educational settings • Workplace targeted nutrition • National or local policy or legislation

19. Welfare reformmitigation … Stormont should pilot strategies to tackle food poverty, potentially through a network of community food shops, social stores and supermarkets.

20. Interventions with moderate evidence • Changes to food environment • Food sale promotions • Agriculture or garden based

22. Interventions with weak evidence • Cooking skills and community kitchens • Economic effectiveness

25. Cochrane Database of Systematic Reviews • Community level interventions to improve food security in developed countries (Protocol) 2010 • Community-level interventions for improving access to food in low- and middle-income countries (Protocol) 2015

26. Cochrane Database of Systematic Reviews Search found more than 23,000 articles.  Reading 444 full papers for inclusion/exclusion. Thus far, identified 40 papers and about 100 more to screen. Interventions in the included studies included Women, Infants and children in the U.S. , Farmers market vouchers, vouchers for fruits and vegetables, building grocery stores in food deserts and meal delivery to seniors.    Plan to be done by late 2016. Professor Elizabeth Kristjansson Centre for Research on Educational and Community Services University of Ottawa

27. Enough is Enough - Collaborative Response • Promoting access to healthy fresh food through community shops/social supermarkets and surplus food redistribution • Building community food knowledge, skills and cooking • Tackling child hunger • Promoting the availability of fresh healthy food through community gardens • Increasing access to advice and support services • Determining best practice for monitoring food poverty • Strengthening advocacy and influencing food poverty related policies

28. The Nobel Peace Prize 1964

29. Thanks! Any questions? Institute of Public Health in Ireland Email elizabeth.mitchell@publichealth.ie @publichealthie www.publichealth.ie