Food poverty and children - transcript

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Aileen: Hello and welcome to the safefood podcast.

I'm Dr Aileen McGloin, Director of Marketing and Communications at safefood, the all-island agency promoting food safety and healthy eating.

safefood is one of six North-South bodies born out of the Good Friday Agreement. So developing partnerships across the food and nutrition sector, and with government agencies, is a big part of our job.

In nutrition, our role is to carry out research, develop educational tools, and run public-awareness campaigns. You may know us from our START campaign promoting healthy weights for children, or our research revealing the real nutritional content of foods like energy drinks and protein snacks.

We also run and sponsor conferences and events so that professionals and thought leaders can share their research and knowledge.

In this nutrition podcast series we will be hearing from leading experts on issues such as social prescribing, obesity, particularly in relation to children and food poverty, and community food initiatives.

Joining us today is Joana da Silva, safefood's expert on human health and nutrition, who talks about the work she does on food poverty and community food initiatives on the island of Ireland. And later we'll hear from UK-based food poverty expert Lindsay Graham, who talks about food insecurities in the UK.

Hi Joana, and thanks for joining us.

Joana: Thank you, Aileen.

Aileen: You've been working with us in the nutrition team at safefood for four years. And much of your work involves food poverty on the island of Ireland. Could you tell us a little bit about what this means?

Joana: Yes, and the first thing I have to say is that I've been learning a lot about food poverty. It's a very complex concept. I have a clinical background, so when I first heard about food poverty it was very much hunger and affordability.

Of course there is a link to poverty, there is a link to affordability, but it's a more complex issue. You have many factors like economics, skills, can we actually cook a meal?

Food poverty is about the ability to be able to afford a nutritious diet, a complete diet. And that's a diet that is going to meet your nutritional needs, that is going to keep you healthy, let's say, but at the same time there are also social factors involved. So do you have, you know, can you afford to have friends at home for a cup of tea, for example. Can you offer a biscuit when someone rings your bell and comes to visit?

So a lot of the work that we do is around enhancing people's ability to deal with food, around budgeting, around cooking, around planning. But we don't, of course, forget that poverty and economics is part of the equation, too.

Aileen: One of the other major public health issues of our time, of course, is obesity. Could you tell me a little bit about the link between food poverty and obesity? Which isn't actually intuitive.

Joana: Not at all, and it wasn't definitely for me a few years ago. So, first you can look at the stats, let's say, in relation to food poverty on the island Ireland. So one, we could say that one in ten in the Republic of Ireland experience food poverty, and in Northern Ireland we are still trying to look at different ways to measure food poverty. But we can say that 17% of the population in Northern Ireland is at risk of experiencing food poverty at some point. Saint Vincent de Paul for example released some numbers recently, and out of their calls for help, three relate to food poverty.

Aileen: That's one in three.

Joana: One in three, one in three related to food poverty. We know that we are sending children to school without food. And we know that there is a need, definitely for breakfast clubs, unfortunately. So, research has shown us that obesity has always been more prevalent in food-insecure areas, always. And this is because typically low-income-household families tend to have poorer diets. And that will of course mean that they have higher levels of excess weight, higher levels of overweight or obesity, which is going to increase their health risks and conditions like heart disease, cancer, or diabetes.

So it's very important that you close that health inequality gap. I'm not going to say that that's the secret to solve obesity, because just like food poverty it is a very complex issue; you have genetics, you have hormonal issues behind it, too. But it is paramount that we try to close that gap.

And research has shown that although the number of children that have obesity or are overweight have stabilised or even decreased slightly over the years, when you isolate the data in relation to more deprived areas, you can actually see that those vulnerable groups have higher rates of obesity.

Aileen: That the rates are actually growing there?

Joana: In low-income areas.

Aileen: Earlier we chatted to food-poverty expert, Lindsay Graham, who explained the link between food poverty and obesity, and experiences in the UK.

Lindsay: We know that in areas of deprivation there is higher incidence of childhood obesity and there's a whole raft of reasons around that, societal, being just the main one as well. And also the proliferation of fast-food outlets near areas of deprivation, which seem to do an awful lot better in those areas.

So there's a whole raft of reasons why we see an increase in childhood obesity. I think it's one in, by the age of 11, children who live in deprived areas are more likely to be obese than their peers who live in less deprived areas. That was from that piece of work from the Cambridge University.

Aileen: Is food poverty among children something that is increasing or decreasing? What's the current situation?

Lindsay: Oh, increasing definitely! Definitely, I mean, I've been working in the UK, looking at children's food insecurity for about six years now, and when I first started looking at it, I found that in some of the projects that supported communities were faith-based, and there was a relatively small number, but we've also seen an increase in food-bank referrals, as well we're seeing schools now setting up their own food banks.

So there is definitely, I think, the teaching unions talk about it as well, I think 53% of teachers from the National Union of Teachers said that they saw children arriving to school hungry, or they were concerned about what would happen to them at the end of the school day.

So I definitely think in the last six years, I've seen a real increase and part of that increase, in think, is down to the roll-out of Universal Credit.

Aileen: You're describing an increase in food poverty but also an increase in maybe the response to it, which is quite ...

Lindsay: Yes. I think civil society's done more than policy. I think I've seen a lot more community projects springing up to try and support families and children in particular, as well. You know, who are experiencing food insecurity. We did a year-long children's inquiry, future food inquiry which was a cross-party inquiry, where we spoke to young people around the UK and asked them their thoughts on food insecurity. And obesity was one of the issues that they spoke about there.

They spoke to us about planning, of all things, and about where there were fast-food outlets near their schools or within their communities. So young people are very aware of health inequalities, and indeed they also have some very good suggestions about what we should be doing about it.

One of the things that young people told us was about their cash cards, and the use of cash cards in the school – they get a certain amount on their cash cards. It's about £2.30, but the money wipes at the end of each day. So unlike their peers, whose parents might load their cash cards with £15 pounds at the beginning of the week, that money doesn't roll over for free school meals children. So they end up buying food, they either have to choose between food at the beginning of the day or lunchtime, because they haven't got enough money to cover both, or they have to buy a bottle of water at a pound. And they thought that that was wrong because that meant that they could buy less food.

So there was things like that they spoke about. They spoke about home economics and not having, excluding themselves from home economics because they didn't have the money to buy the ingredients. So while we think that, you know, teaching kids to cook is one thing, but if they don't have the money to take part, then they exclude themselves from that. And so they talked about all sorts of amazing things that we'd never even considered.

Aileen: And it's so obvious when you say it.

Lindsay: Yes, yeah.

Aileen: Yeah. Were you totally surprised by the kinds of things?

Lindsay: Oh definitely. Actually, some of the most harrowing stories that we got were from young people with, who had no recourse to public funds, who spoke about their parents not having enough money and you know, not being eligible for benefits, and of course if you don't get any benefits then you can't get access to free school meals.

So that was particularly harrowing, the way that families were coping with that, and not very well; the State wasn't doing a very good job on that.

Aileen: When you spoke earlier, you also mentioned the Children's Right to Food Charter.

Lindsay: Yes.

Aileen: Could you explain a little bit more about that and how it came about?

Lindsay: When we did the inquiry, I think one of the things that was really important for us was about what children thought about food insecurity and what they thought we should do about it. And so when we were doing the discussions with them, we said, well what do you think will make a difference? What things would you say to government needs to change?

So they came up with the Right to Food Charter, and there was five things that they said they wanted. A healthy lunch guarantee, where they wanted to improve access to good food. They wanted a healthy-food minimum, as well. And that included allowances for families. So increasing the family income, too.

They wanted a health food, a children's food watchdog, which I thought was amazing. They said, "Who's responsible for all this? "You know, how are we going to make things better "if nobody's being accountable for it?" And I loved that idea. I thought, children's food, well why have we not got one? It just makes complete sense.

And none of the things that they suggested will happen unless we do have that watchdog. So we're currently talking to central government about how we can make some of these wonderful charter suggestions happen.

The other one was health before profits. They talked about the big industry and how it influences children's choices. And they said that, you know, health comes before profit. These were their words. And also, stop the stigma, 'cause children are stigmatised whether it's because of their weight, or whether they don't have the same trainers as somebody. You know, when they go into the canteen and they get teased about it. Bullying because of being overweight, as well. There's lots of issues that they spoke about there.

But also they said, let's rename free school meals to school-meal allowance. That makes complete sense to me. I don't know why we never thought of that before. Stop the sort of, “free” element of it. So they came up with some great ideas. And the thing about it is, they're right to have their say in it.

Aileen: Have you talked about some of the shorter-term outcomes of food poverty there, the kind of, stigma that children and young people experience? Are there any other impacts, whether short term or long term?

Lindsay: We are seeing things like learning loss. So there's a disparity between the poorer children and the wealthier children that can be as much as two years by the time they finish school, through health inequalities. And that's, again, that you know, we're still looking at the impacts of diet.

We know that some of the choices that are available to young people, healthier food options are more expensive. So the children tend to take the cheaper option that fills them up, because they're so hungry. One wee girl was talking to us about having to buy, she bought two sausage rolls instead of a salad because the sausage rolls were cheaper at a local, you know, shop. Rather than the salad lunch at school. So that's what she'd do, 'cause she knew that that would fill her up for longer. So, calorie-dense foods the kids are choosing because they're hungry.

Aileen: Is this a problem that can be solved through policy? Or is it a combination of many actions that are required?

Lindsay: I don't think policy alone can fix it, and that was one of the things that was brought up in the event, was that, well, we can have great policy. And indeed that's what the children told us. We've got all of these wonderful policies but none of them are working, thanks very much. What are you going to do about it? So I think it needs a whole-systems approach. Again, that was talked about. And it needs to be cross-controlled. It needs to be multi-agency if we're going to tackle it. People need to be trained in the right kind of language to talk about it, being overweight or malnutrition or ...  And parents need to be engaged in it, communities need to be engaged in it. Planning needs to be engaged in it. Housing needs to be engaged in it. So it has to be a whole-systems approach. Having good policy and legislation will help. 'Cause it's got to be, the bottom needs to know what the top's doing and the top needs to know what the bottom's doing.

Aileen: There was one thing that you mentioned there and that was the, that this is a difficult issue for let's say, a health professional or someone working in care to raise, so whether it's food poverty or indeed childhood obesity. Would you have any advice that you would give to health professionals or any professionals working in this area?

Lindsay: Work within your own comfort and parameters, is what I would say, as well. Look at what training is out there. So, equip yourself with the knowledge that you need and the most up-to-date knowledge that you need to be able to put a good case to your, the parents of children that you're working with as to why they might want to change or what might need to change.

And engage with them at a level that they want to and ask the young people about what they're going to be comfortable with when they're making these lifestyle changes. It's not going to change over like, you know, it's going to take a decade to reverse it but probably more, to reverse the situation that we're in now. But health professionals need to be well-equipped, well-trained, they need to feel comfortable with what they're talking about, and knowledgeable. They need to be knowledgeable. And they themselves need to be fit and healthy. So there's a bit about that, too, self care.

Aileen: Lindsay, thank you so much for joining us today. That was fascinating.

Joana, we've heard about how children experience food poverty in the UK. Could you tell me a little bit about how children experience it here on the island of Ireland?

Joana: I would say it's pretty much the same. And you can look at numbers, but I think what we can't forget is that it's sad, it's very unsettling, and it's very unfair that a child actually has to experience that, to go through that. It's unfair for an adult, let alone a child.

It is a reality, it's more prevalent in families that are low income. I'll give you an example. Focus Island launched a report in 2017 and we were lucky enough to have one of the researchers speaking at one of our Food Poverty events in the past. And they looked at families where parents were actually employed, but they were renting. And for one reason or the other, they had to look for another house, they couldn't, and they ended up in emergency accommodation.

So you're talking about a couple that actually can afford food. But they can't cook. They have their children eating in the same area where they sleep. They have access sometimes to a kettle, not always. They can't really have breakfast in the hotel where they are staying, because they may need to get two or three buses to get the children to school. And that's a good example of yes, they can afford food but they don't have the facilities to cook.

Lack of skills is another one. In terms of children experiencing food insecurity, another good example is our research around the cost of a healthy food basket. I'll talk about Northern Ireland here. When our researchers got back to us with the data, we realised that there was money for school lunch there. That they wanted us to include on the budget. And of course we questioned it because, if you're talking about families that depend on State benefits or are earning the minimum wage, those children would qualify for free school lunches. And we asked them, why are you including money lunch if your child can get it for free at school?

The child doesn't want to be stigmatised at school. They don't want to be the ones that get the handout lunch. They want to bring lunch to school like any other child.

So those are two very good examples of how children get to experience food poverty, unfortunately.

Aileen: We also heard Lindsay speaking about the UK Children's Right to Food Charter. Is there anything we can learn here on the island of Ireland from that?

Joana: I think we need to learn how to listen to the child's voice, and it's something that we haven't been doing for years. We feel that we can do the research, we can present the findings, and that somehow we know what's best for our children.

And I think what the Food Charter has showed, is they know their challenges, they know how they feel and how they experience things. And they want to be involved when making decisions that will potentially impact their future. And I think that's a very valid learning. I know that Children's Ombudsman was doing some research too in relation to including the children's views in future policy, for example. And I think it's something that we should take on board.

Aileen: You mentioned policy there. Lindsay also talked about policy. And what approach do you think we need to take here on the island of Ireland to tackle food poverty?

Joana: I think we need to look at international evidence, other countries that were facing similar challenges as we do here; what is working in those countries? What's not working, so we don't even try it. Research funding, research finding the right questions to ask; it's not just about funding the research. It's finding the right topics to investigate.

And safefood has been quite good, I have to say, in terms of partnering with the right stakeholders, looking at measuring food poverty. We co-chair Food Poverty Network with partners both in Northern Ireland and the Republic of Ireland. We keep food on the agenda. We bring charities, we bring policy makers, we bring healthcare colleagues together to debate food poverty; we promote shared learning. That's very important, too.

We get involved in many pieces like minimum nutritional standards for school meals, that's a very important piece. It's also, it has also enhanced the new pilot that the Department of Social Protection is rolling out, in relation to hot meals for children in primary school, for example. And that's the shared learning that we brought from Northern Ireland to the Republic of Ireland.

In Northern Ireland we are piloting new models in communities, around social supermarkets. Trying to move from food banks to social supermarkets, for example. We know that food banks are needed, unfortunately. They are there for an emergency situation. But they shouldn't be, they shouldn't be a long term solution. So we have those learnings, too.

I think that interdepartmental cooperation is very important, too. Again, going back to the hot school meals pilot, you have Department of Social Protection working with Department of Health, working with Department of Education and the Children and Youth Affairs. I think that's very powerful, to have us all singing from the same book. I think our messages need to be consistent and strong.

Aileen: Joana, could you tell us a little bit more about the Community Food Initiatives?

Joana: So, the Community Food Initiatives is a programme that safefood has been funding since 2010. The current programme runs from 2019 to the end of 2021.

We have nine leaders in the Republic of Ireland and five in Northern Ireland. We work very, very closely with healthcare professionals on the ground. We have local leaders for these initiatives. And they are run by local development companies. So we know that we are targeting the right audience and we know that we have the right partners. And what we want is for people to learn the basic skills around food.

So you're talking about planning, you're talking about shopping, you're talking about budgeting. You're talking about cooking, you're of course talking also about food safety and reducing food waste, for example. These are usually very, very practical. And then that parents of children under the age of 12.

Aileen: Many thanks to Joana da Silva and Lindsay Graham for sharing their experience and valuable insight.

That's all from this episode in our nutrition series. If you would like further information on Community Food Initiatives or any aspect of healthy eating, do get in touch with us. Search safefood or look us up on social media. You'll know us by our purple tick. You can link in with our Food Poverty Network and All-Island Obesity Action Forum. Or to keep up with our latest reports and research, check out LinkedIn.

And remember to follow the safefood podcast series on iTunes, Spotify, or wherever you get your podcasts. Until the next time then, good bye!