What’s the link between hunger and childhood obesity?
Last weekend, we published an open letter to the Prime Minister, signed by over 2200 paediatricians, calling for the extension of free school meals to cover holiday periods, through the provision of food vouchers to the most vulnerable families.
Children not having enough to eat is clearly a health issue and one that doctors care deeply about. Children and young people can’t enjoy good health and wellbeing without good nutrition.
The reasons for this outpouring of support for the campaigning work of Marcus Rashford are set out clearly in the open letter. Our members see the impact of hunger and malnutrition in their daily work.
Opposition to the campaign from within Government and among some commentators has focused on the suggestion that food vouchers are not the best method to tackle food poverty. We agree that wider policy change is needed but the campaign is focused on the ‘here and now’ reality of people’s lives, and food vouchers do provide a limited and short-term remedy. That’s why we’re supporting Marcus Rashford’s campaign.
We’ve also seen questions about the extent of childhood hunger in the UK given the parallel obesity crisis. These problems are evidence-based and not mutually exclusive.
Our State of Child Health 2020 report found that the most deprived children aged 4–5 years in England were 1.6 times more likely to be overweight than the least deprived in 2018/19. (This is the most recent set of data currently available.) In 2017/18, the prevalence of severe obesity among 4–5 year olds in England was most four times as high in the most deprived areas as the least deprived areas.
Historically, obesity has been associated with wealth. But as the data shows, this trend is reversing and this health inequality, like many others, is widening.
The reality is that we need to address both obesity and hunger through policies and programmes that help people access nutritious food. For millions of people, this is much easier said than done.
In response to Marcus’ campaign lots of people have shared ideas and posts about making nutritious meals on a budget. While well-intentioned, these suggestions don’t always consider the costs, financial and also in terms of time, of producing these meals when you live in poverty. A per serving costing of cooking oil may be three pence, but the outlay of purchasing it is significantly more. If you’re living in poverty, you are much less likely to have the money and space for cupboard essentials. It costs money to use the oven for hours to cook a casserole, and if you have a pre-payment metre — as many living in deprivation do — your bills are already more expensive than those who can pay by direct debit because they have a regular income.
As James Bloodworth observes in his book Hired: Six Months Undercover in Low Wage Britain, ‘poverty is the thief of time.’ Parents in insecure, low-paid and often-manual work, quite understandably, do not have the time or energy to cook from scratch after a long working day. They may be reliant on public transport, and the closest shop may not sell healthy, affordable food. The mental health burden of living in poverty can also make planning and preparing home-cooked meals a potentially overwhelming task, as campaigner and food writer Jack Monroe powerfully expressed in her blog You Don’t Batch Cook When You’re Suicidal.
Tackling child hunger and childhood obesity means looking at policy in the round; mitigating unintended consequences of policies that can entrench inequality and working in a cross-government way to consider child health across all policy-making.
Paediatricians understand through their practice that health outcomes have social drivers. There is no contradiction between campaigning for policies to reduce rates of childhood obesity while also fighting to ensure that all children and young people have enough to eat.
Ensuring all children and young people get the best start in life means tackling health inequalities, preventing ill health and ensuring the necessary funding and workforce for the provision of local children’s services that meet local need. A cross-government Children’s Health and Wellbeing Strategy would facilitate the fulfilment of these priorities, and improve the health outcomes of children and young people across the UK.