Joint Lead: Professor Nisreen Alwan and Dr Dianna Smith.

Co Applicants: Nida Ziauddeen, Tim Lloyd, Dr Marta Disegna, Ravita Taheem, Sally Shillaker, Fran Richards, Duncan House, Sara Crawford.

Partners: Southampton City Council, University of Southampton, Bournemouth University, Solent NHS Trust.

starts: 1 November 2021

Ends: 31 March 2024

Publications:

Household food insecurity risk indices for English neighbourhoods: Measures to support local policy decisions

News: New map shows regions in the UK with a higher risk of food insecurity

Lay Summary

Aim of the research: We will explore the impact of system shocks on food security, diet quality and health in young families across Wessex, using the covid-19 pandemic and lockdowns as an example of such shocks. We will find out if Council-supported food aid initiatives to counter difficulties around adequate and healthy diet are acceptable, well taken-up and impactful in local populations. This will lead to a toolkit that can be used by Councils to decide which initiatives are best for their populations.

Background: The covid-19 pandemic restrictions are likely to have negatively impacted UK families in many ways, including food insecurity (not having enough food because of cost or other barriers, or not having good quality food). Food insecurity has negative health impacts in the short-term including weight gain, malnutrition, poor mental health; these may lead to longer term health outcomes including obesity, diabetes, anxiety, and depression. Local Councils in Wessex have a range of initiatives to help this situation, including food pantries, where eligible families can purchase a range of items at a greatly reduced price, and recipe boxes.

Design and methods During this 2-year project we will: Use statistical modelling to explore the effect of the covid-19 pandemic on important aspects of health and wellbeing in Wessex’s families with children under age 12, including their diet quality, food availability, weight status and mental health. Interview families to explore how they coped with the changing social and economic circumstances during the pandemic particularly in relation to their food quality and purchasing behaviours, Work with the local Councils in Southampton and Dorset to evaluate the initiatives to improve diet in disadvantaged families including food pantries.

Public Patient Involvement: We involved public contributors in the design of this research through three meetings with 12 contributors overall. We have a public contributor as a co-applicant. Our PPI activities will ensure the interventions reflect the individual needs of young families in the target groups, and that the outreach activities to support the interventions are properly communicated. We already have ongoing public engagement activities involving Sure Start within our existing ARC project which we will continue to utilise. We have and willcontinue to actively involve people on the frontline of food aid systems in shaping this research.

Dissemination: We will produce an implementation toolkit for Councils to aid decision-making on food-aid initiatives. Non-academic outputs will be specific to the audience and will include videos, presentations, social media posts and flyers. For public health/councils, short reports on the findings in the form of policy briefs will add to academic content and presentations. We will follow successful models like the oral health posters to Family Hubs delivered by Solent Health.

What did we find out?

We explored the impact of system shocks on food security, diet quality and health in young families across Wessex, using the covid-19 pandemic and lockdowns as an example of such shocks. We used statistical modelling to explore the effect of the covid-19 pandemic on diet quality, food availability, weight status and mental health in England. We wanted to find out if food aid supported by local councils to counter difficulties around adequate and healthy diet are acceptable, well taken-up and impactful in local populations.

We carried a review of the literature on the impact of food aid initiatives in households with children and found that accessing food aid was linked to reducing food insecurity and improving diet quality in some studies. Food aid initiatives that allow users to choose food items and provide other support services are most effective.  We also carried out a review of the literature on the impact of the COVID-19 pandemic on food insecurity in households with children and found that most studies showed that the pandemic worsened food security. 

We assessed the impact of food clubs (a type of food aid initiative that charges a small fee for a set number of items) on food security, diet quality and wellbeing in households accessing these clubs. We did this by recruiting people accessing food clubs to our study and asking them to complete a survey at recruitment and after at least three month of using food clubs in Southampton and Dorset. 97 people took part in the study and 49 people completed a follow-up survey. 11 participants also took part in a semi-structured interview that explore how they coped with the changing circumstances during the pandemic and their views on food clubs. We found that only 12 people (16%) were food secure (had reliable access to sufficient nutritious food) when they first started accessing food club. Among the 49 people who completed a survey after using the food club for at least 3 months, we found that 16 people (42%) were food secure. Diet quality increased in 22 people (45%) and mental wellbeing in 30 people (61%). We found that people’s food security diet and mental wellbeing improved after accessing food clubs.

What did we do with this new Knowledge?

We have produced a toolkit to aid decision-making on food aid initiatives, to allow them to assess the impact of the interventions and consider how best to implement new interventions.  This can be used by local councils  to plan new initiatives or by the interventions themselves to monitor impact.

We visited the food clubs we recruited participants from and shared the study results with the people accessing the clubs, as well as the staff and volunteers there.

What Next?

Future research will evaluate the process and impact of food aid interventions using the toolkit.

We have applied for further funding to explore how to improve the quality of food provided through aid.

We are also working on two further publications on the findings from this project.

Publications

1. Stahacz, A. Alwan, N.A., Taylor, E., Smith, D., Ziauddeen, N. (2024) The impact of food aid interventions on food insecurity, diet quality and mental health in households with children in high-income countries: A systematic review. Public Health Nutrition; 27(1):e195. https://doi.org/10.1017/S1368980024001769.

2. Williams, A. Alwan, N.A., Taylor, E., Smith, D., Ziauddeen, N. (2024) The COVID-19 pandemic and food insecurity in households with children: a systematic review. PLoS ONE;19(8):e0308699.  https://doi.org/10.1371/journal.pone.0308699

   
   

3. Ziauddeen, N., Taylor, E., Alwan, N.A., Richards, F., Margetts, B., Lloyd, T., Disegna, M., Mason, N., Taheem, R., Smith, D. (2024) A mixed methods study evaluating food insecurity and diet quality in households accessing food aid in England. medRxiv. https://doi.org/10.1101/2024.12.03.24318378