Rachel Loopstra

Background: The SALIENT consortium aimed to bring together research, government and food system stakeholders to co-design, implement and evaluate public-facing food system interventions targeting health and sustainability whilst maintaining affordability and commercial viability. A total of 40 organizations engaged with SALIENT; 8 progressed to deliver and evaluate a total of 10 interventions. We conducted an evaluation to understand how and why the SALIENT stakeholder engagement process worked for different organizations and to inform future food system intervention research. Methods: Using theory-based evaluation principles, a theory of change (ToC) was developed to describe how the SALIENT process was expected to function. A total of 38 semi-structured interviews were conducted with government partners, researchers and food system representatives. Data were thematically analysed and interpreted in relation to the ToC. Results: Findings highlighted the fragmented nature of existing health and sustainability actions across the food system, shaped by differing priorities, agendas and constraints of stakeholders. Power dynamics influenced stakeholder participation, with engagement strongest when research was aligned with core stakeholder goals and offered them tangible benefits. Whilst pragmatic co-design processes built trust and feasibility, they sometimes led to interventions with limited potential to address critical uncertainties in the evidence base. Academic processes were often perceived as misaligned with stakeholders’ practical needs. Conclusions: Long-term government direction, stronger accountability, and incentives are needed to foster meaningful collaboration between researchers and food system stakeholders. Future partnerships should balance flexibility with rigour, build trust through sustained relationships, and establish strong governance, communication and evaluation processes early to generate robust, scalable evidence for meaningful food system change.

This paper evaluates the UK Government’s decision to increase the main form of social security by £20 per week during the coronavirus disease 2019 (COVID-19) pandemic, exploring whether increasing the generosity of social security for some, but not all, claimants affected food insecurity. Using the Family Resources Survey, we found a decline of about 7 percentage points in food insecurity amongst benefit claimants affected by the uplift compared with claimants not affected (95% CI −13.9 to −0.9%). This association did not change substantively following adjustment for covariates, nor when the model was re-estimated using matching methods. Results were not driven by changes in the composition of claimants over time. These analyses suggest food insecurity could be reduced if the generosity of the social security system increased. In actuality, the UK government went in the opposite direction, removing the £20 uplift in October 2021, potentially exposing claimants to higher rates of food insecurity again.

The present paper reviews the growing body of literature on food insecurity and food bank use in the UK. It provides an overview of food insecurity in this context, followed by a description of the emergence of food banks, highlighting how any role that food banks play in the food insecure population is limited. Data on food insecurity and food bank use suggest many people experiencing food insecurity do not receive help from food banks. To better understand the factors influencing the relationship between food insecurity and food bank use, a conceptual framework is outlined, suggesting the relationship is far from straightforward and contingent on many factors. The nature and availability of food banks and other local support services and individual-level factors influence the likelihood of food banks being used in the context of food insecurity. Then, the extent to which food banks can impact food insecurity is also dependent on the quantity and quality of food distributed, as well as other support services offered from food banks. Closing reflections highlight rising living costs and food banks reporting that they do not have capacity to cope with increasing demand, underscoring the need for policy interventions. Reliance on food banks to respond to food insecurity may ultimately impede formulation of effective policy interventions to reduce food insecurity, giving the illusion of widespread available support, whilst food insecurity persists among those receiving help from food banks and those who experience food insecurity but do not use food banks.

Food bank use has risen rapidly in the UK since 2010. The negative health impacts of food insecurity are well‐documented, but there is a lack of quantitative research exploring the health of people using food banks, who are most often severely food insecure. To address this gap, this study compares health outcomes between working‐age adults using food banks and those in the general population in England, investigating whether adults using food banks are disproportionately affected by poor health, even after accounting for socioeconomic differences. Data from a survey of 598 adults using Trussell Trust food banks in 2016–2017 were merged with data from the Health Survey for England (HSE) from 2016. Outcome variables of interest were: self‐rated health, life‐limiting health conditions (disability) and self‐reported metabolic, cardiovascular, musculoskeletal and mental health conditions. Logistic regression models were used to examine the odds of adults using food banks having health conditions, disability and poor self‐rated health compared to the general population. The prevalence rates of poor self‐rated health, disability, mental health disorders and musculoskeletal conditions were significantly higher among adults using food banks than the general population (p < .05 for all outcomes). These associations remained after accounting for gender, age, marital status, employment and education. This comparative study highlights the many health disadvantages among adults using food bank compared to the general population. The higher risk of poor self‐rated health, disability and mental health conditions was not fully explained by measures of low socioeconomic status. Possible explanations for these findings include: first, that poor health may increase vulnerability to food insecurity, and, in turn, use of food banks; second, that experiences of food insecurity and food bank use may cause declines in health; and third, that food bank use and poor health may be joint outcomes arising from the last decade of austerity in the UK.

Food bank use in Great Britain has risen substantially over the last decade. The considerable socioeconomic disadvantage of the food bank user population has been documented, but little research has examined whether housing problems intersect with insecure food access. Using data from 598 households accessing assistance from twenty-four food banks operating in Great Britain in 2016–2017, we found that nearly 18 per cent of households were homeless, with more having experienced homelessness in the past twelve months. Renters from both the private and social rented sectors were also overrepresented in the sample. Households in both private and social rented housing reported high rates of rent arrears and poor conditions; those in private housing were also more likely to live in homes with damp, to have moved in past year, and to be worried about a forced move in future. Overall, housing problems are widespread among food bank users; policy interventions are needed.

Food banks are a common community-based response to household food insecurity in high-income countries. While the profile of their users and nature of the quality of food they provide have been researched, few studies have examined their operational characteristics to explore the accessibility of their services for people at risk of food insecurity. This study describes the nature of operations in a food bank network operating in Britain and explores how operations are associated with volume of use. Data from The Trussell Trust Foodbank’s network of 1145 distribution centres in 2015/16 on hours of operation, locations, and usage were combined with national statistics on Working Tax Credit claimants, disability and unemployment. Descriptive statistics focused on how often and when food banks were open within local authorities. The relationships between operational characteristics and volume of use were examined using regression analyses. Interaction terms tested how relationships between indicators of need with food bank usage changed with operational characteristics. Weekday operating hours were primarily between the hours of 10 a.m. and 2 p.m., but at any given hour no more than 20% of distribution centres were open, with fewer than 3% open after 4 pm. Where food banks had fewer distribution centres and operating hours, the volume of food bank usage was lower. In-work poverty, disability, and unemployment rates were all associated with higher volume of usage; however, the relationship between disability and food bank use was modified by the density of food banks and number of operating hours. Where food banks were less accessible, the relationship between disability and food bank use was diminished. These findings suggest operational characteristics are an important part of access to food banks and raise questions about the ability of food banks to meet the needs of people at risk of food insecurity in Britain.