Experiences of Food Poverty: Literature Review by Samuel Lindskog

This literature review sets out to explore some of the different discussions relevant to the subject of food poverty “in societies where systems for employment or welfare were thought sufficient to ensure universal food entitlement” (Dowler 1998:59), in other words, the industrialised global North, where food poverty is not a question of supply failure (Dowler and O’Connor 2011:45,47).

The review is arranged thematically and deals with the experience of food poverty in particular. Texts by government and charities have been limited to the UK, while some academic studies also look at other countries in the global North.

food array

This literature review uses food poverty and food insecurity interchangeably. Both terms refer to a concept that has both quantitative and qualitative components. Food poverty has been defined and operationalised for measurement in several ways. The measures include absolute quantitative measures, such as poverty lines based on calories (Dowler 1998:58); relative quantitative measures, such as percentage of money spent on food (Church Action on Poverty and Oxfam 2013:4); and qualitative measures, such as the definition raised at a Food Partnership workshop:

“when food ceases to be a pleasure and social tool for a family, and becomes a source of stress and ill-health” (2012b:4). The most inclusive definition has been supplied by Dowler and O’Connor, which incorporates qualitative and quantitative measures. They define food poverty as “the inability to acquire or eat an adequate quality of sufficient quantity of food in socially acceptable ways (or the uncertainty of being able to do so)” (2011:44).

Many of those that suffer from food poverty belong to the most vulnerable communities: members of black and ethnic minority communities, people with disabilities, older people, households with dependent children (especially single parents) and low income and unemployed people (Dowler and O’Connor 2011:47; Faculty of Public Health 2005:2; Holmes 2007:201). In addition to these, there is a new group at risk – the working poor who are insecurely employed, low-waged or migrants (Dowler and O’Connor 2011:47-48).

Wages and welfare entitlements are simply not keeping up with the rate of inflation. As the gap between income and cost of living grows (Caraher, Lang and Carr-Hill 1998; BHFP 2012b: 3-4; Family Action:3,5; Church Action on Poverty and Oxfam 2013:3; Dowler 1998:59), the relative elasticity of the food budget means it is the first one to be squeezed (Family Action n.d:14; Dowler 1998:62). Food poverty is further compounded by access problems (Caraher, Lang and Carr-Hill 1998:195; Dowler 1998:59) as described further below.

This study has been carried out in the light of a sudden increase in the number of people using food banks. Both local food banks (BHFP 2013a) and the national Trussell Trust have experienced increased pressure, the latter by a 610% increase in service users between 2012 and 2014 (Trussell Trust 2014) . The political opposition is eager to blame this on coalition welfare policies (Commons Hansard 2013: cols 829). In a recent press release, the Trussell Trust (2014) states that “83 percent of Trussell Trust foodbanks surveyed recently … reported that benefits sanctions, which have become increasingly harsh, have caused more people to be referred to them for emergency food.”
Elizabeth Dowler, one of the  most prolific writers on food poverty in the UK, proposes that we take a rights-based approach to food poverty. This approach is very much inspired by the writing of Riches (1997). The human rights approach highlights that food poverty has its roots in inequality and is a symptom of a system of distribution, through welfare, that has failed (Dowler and O’Connor 2011:46, 48). The real potential of this approach lies in changing the way people perceive themselves in relation to their government and other actors: ‘problems’ become ‘violations’, something that doesn’t need to be tolerated (Dowler and O’Connor 2011:46). The rights-based approach re-politicizes an issue that became de-politicised when charities stepped in to fill the gaps in the welfare system (Riches 1997:70; Dowler and O’Connor 2011:49).

social geography

The Experience of Food Poverty

Sociologist have used many different approaches to analyse food poverty, including social geography of food deserts (Caraher and Lang 1998; Caraher, Lang and Carr-Hill 1998) social class analysis (Molcho et al 2006), applied social policy research (Lambie-Mumford 2013a, 2013b), phenomenology (Dibsdall et al 2002) and social psychology (Carter et al 2011). The findings of these studies vary widely depending on whether a quantitative or qualitative approach was taken.
In quantitative data, the experience of food poverty is framed in terms of barriers to food security, of employing coping strategies and of ill-health. Barriers to food security include food deserts, an area devoid of outlets with fresh foods (Caraher and Lang 1998:202; Faculty of Public Health 2005:3; BHFP 2012b:2,4; Dowler and O’Connor 2011:46), lacking knowledge about nutrition and budgeting or cooking skills (Caraher, Lang and Carr-Hill 1998:197; Faculty of Public Health 2005; BHFP 2012b:4; BHFP 2013a), storing food and transport (Caraher, Lang and Carr-Hill 1998:196-97; Dowler 1998:62) as public transport may be unreliable, expensive or absent altogether.
Coping strategies include parental buffering (Dowler 1998:59; Holmes 2007:201), skipping meals (Holmes 2007:204) and buying lower quality food at cheaper outlets (Caraher, Lang and Carr-Hill 1998:195; Holmes 2007). People in food poverty have worse nutritional outcomes (Faculty of Public Health 2005; Holmes 2007:206), resulting in higher risk of somatic and mental symptoms (Molcho et al 2006:366, Gabhainn, Kelly, Friel and Kelleher:364,366; Faculty of Public Health 2005:1,2; Dowler and O’Connor 2011:44; FPH:2; Carter et al 2011:1464; BHFP 2012a:3). This has a knock-on effect in other areas, such as drops in educational attainment (Speight, Holmes and Wells 2007:187).
Some other interesting themes in quantitative studies is the concern of food poor people to find foods that fill them up, rather than bring health benefits (Caraher, Lang and Carr-Hill 1998:194; Dowler 1998:62). 36% of the UK low-income population felt they couldn’t eat balanced meals (Holmes 2007:201).
Qualitative accounts of experiences are, unsurprisingly, better at capturing the subjective and affective experience: the emotions, the social implications and attitudes. While many of the texts have included qualitative data (Church Action on Poverty and Oxfam 2013; Family Action n.d), they have used it non-systematically, resulting in very anecdotal documentation. This is also true for the parliamentary debate of food bank use (Commons Hansard 2013).

After excluding studies that rely on anecdotal data, we are left with two qualitative studies of the experience of food poverty. This highlights a significant gap in the literature, especially as we consider the fact that neither was carried out in the UK. The first looks into the experiences of food insecurity among soup kitchen consumers in Australia (Wicks et al  2006) and the second at feelings, characteristics and effects of food insecurity in Quebec (Hamelin et al 2002).

As with the quantitative studies, the Australian study does identify some barriers and coping strategies (2006:921, but in addition they have rich data on the affective experience. They highlight the social component of food (2006:923) and the stoicism or humour used (ibid) to overcome the feeling of disempowerment around food choice. This leads them to conclude that dietary education is not the answer (ibid) to food poverty, but that solutions should be practical and direct, such as improving facilities. They also highlight the importance of contextual information for effective response (Wicks et al 2006:921), something that a quantitative survey would not be as well-suited for.
The qualitative study by Hamelin et al (2002) has a depth and breadth makes it the most comprehensive study of the experience of food poverty covered by this review. Hamelin et al identify several core characteristics of food poverty (2002:121). Apart from a quantitative lack of food, the diet is also often unsuitable (of low quality), food is often not fresh, lacks in nutrition and the overall diet is monotonous (ibid). People in food poverty are often preoccupied with the access to enough food due to a lack of control over the food situation. They often feel the need to hide this lack of control, leading to feelings of alienation (2002:123-124).

Food insecurity

Food insecurity has several effects and reactions that go beyond those recognised by quantitative surveys. Feelings of distress are common. Food poverty may force you to go against your held norms and values and cause you to experience a loss in dignity (2002:127). The experience permeates your life, not just psychologically and physiologically, but your social life as well (2002:124-125,129). Distorted strategies for food acquisition and management, modified eating patterns and rituals and disrupted household dynamics are some of the implications identified (ibid). Their study also emphasises the dynamic nature of experiencing food poverty (2002:127). The experience varies over time, both in the long term and seasonally (ibid). It also affects parent-child relationship, where parents act as “buffer” (ibid) to protect their children from being affected, such as  reducing the size of one’s meal so that the child can have a full portion.
There has been no comprehensive or formal research on food poverty in Brighton and Hove. The experience of food poverty has only been documented by statistics and some anecdotal evidence from service coordinators. Local food banks have noted increasing demand and pressure on their services (BHFP 2013a). Before 2013, there were only two food banks operating in Brighton and Hove (ibid), this has in 2014 increased to at least 12 emergency food providers, of which I have personal knowledge.
Obesity has been called ‘modern malnutrition’ (Faculty of Public Health 2005:2). While not all overweight individuals suffer from food poverty, there is a strong correlation between the two. In Brighton and Hove 43600 adults are obese and 6400 are morbidly obese. 30% of children in Year 6 are obese or overweight (BHFP 2012a:5). Poor diet is one of the factors contributing to a 10 year difference in life expectancy between most and least affluent areas in Brighton and Hove (BHFP 2012a:5). The number of people admitted with malnutrition in Brighton and Hove PCT has slowly but steadily increased since 2008 (Commons Hansard n.d: cols 620W). It is clear that food poverty is a growing concern for the city, but despite calls for local research (BHFP 2012a), none has been carried out as of yet.

The gap in research on experiences of food poverty both nationally and locally may have severe implications for our understanding of a growing phenomenon, an understanding that will be crucial in working with people in poverty to alleviate the problem.

There is a tension between structure and agency regarding food poverty demonstrated by a significant difference between reports commissioned by the government (Homes 2007; Faculty of Public Health 2005; Speight et al 2007) and academic studies. The government reports tend to locate the cause of food poverty in the individual, while academic studies point to structural constraints, such as those suggested by Dowler and O’Connor (2011).

This literature review has set out to increase the reader’s understanding of what food poverty is. It is clear that food poverty in the UK and in Brighton is increasing dramatically and that this has implications for people’s mental and physical health. This review has covered potential causes and contributing factors.

A great variety of approaches have been used to understand food poverty and has produced a multitude of publications on the subject. Despite this there is a significant gap in the literature around the qualitative experience of food poverty in the UK, a gap that this research project hopes to begin to close.

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