Covid 19 and the Future of Public Health Nutrition (PHN): a call to action!

Sharon Noonan-Gunning, Registered Dietitian, PhD.

Health and social care crises are rightly at the forefront of critique about the government’s lack of preparation for an inevitable pandemic such as Covid 19. Nutrition is an important and integral part of public health. Alongside the restructuring of public health, PHN has steadily moved away from being a strategic sector of state responsibility. What it actually is, has been almost forgotten. We argue that its meaning should be redefined and its purpose – as re-centred and fully resourced by the state – should be campaigned for.  This means we have to reclaim public health nutrition from private companies – quasi or multinational – from charities. It means all PHN workers should be paid, from directors of public health to community emergency food aid volunteers, according to trade union negotiated national agreements including grading scheme.   

Public health nutrition according to the UK Nutrition Society is the application of nutrition and physical activity to the promotion of good health, the primary prevention of diet-related illness of groups, communities, and populations (not individuals)’. FIR includes PHN’s role in the cultural, social and economic wellbeing of populations. Further, it is transdisciplinary and not elitist, exclusive. e.g. it includes unpaid community food workers on the estates, food bank workers etc.

We use the terms ‘community’ and ‘social’ nutrition to encompass any environment where food is a public service and as a social collective practice e.g. its preparation and eating. This includes range of environments covering all ages: nurseries, children centres, schools, hospitals & health-care systems, care homes & social care environments, meals-on-wheels & meal-delivery systems, social services organisations, food banks, prisons, community workplaces and all types community food projects. We ‘name’ all of this within a clear discipline/field of PHN because ‘food and health’ has become so fragmented and populated by charities, social enterprises etc. The big NGOs and third sector organisations (TSOs) brilliantly focus on food poverty and insecurity and campaign for universal free school meals, meals on wheels. We advocate the whole public nutrition system itself should be strategically led and funded by central government with the meaningful democratic involvement of grassroots communities and workplaces. Only government has the resources and therefore ultimate responsibility for population health.

While defending PHN as central to public health policy we believe it should be re-established in a different way that is fully democratic way involving grassroots.  In this Covid crisis, there is a further danger that due to the crisis in local government funding, public health will face more redundancies, privatisation and charitisation. In London, who gets PHN is a post code lottery for example, involving differences in budget allocations, prioritising of universal free school meals (including NRPF) and interventions of powerful charities. The charities are being pushed heavily. Although they are committed and passionate about tackling food poverty and inequalities, they cannot solve either. It is the responsibility of central and local government. How will London PHN emerge from this crisis – greater privatisation, charitisation, fragmentation and inequalities or fighting for a strategic and democratic approach to tackling food and health inequalities?

What FIR is doing:

1. Allyson Pollack has a bill to re-establish the NHS. We are looking at this to see how it includes PHN. 

2.We are carrying out research that focuses on grassroots experiences to explore the current state and capacity of PHN from a range of views and settings.

3. Opening a discussion on food and health democracy and public health nutrition

If you can get involved please contact foodinequalitiesrebellion@gmail.com or phone Sharon on 07941 733372.

Stay well and get organised!

Ending child poverty … feeding our children and communities in this crisis

Building a society that cares for children and communities is the heart of Food Inequalities Rebellion. The uncaring values at the heart of neoliberalism, are laid bare in this unprecedented health crisis. For decades, its policies, in practice, have rolled back children’s rights to food and health. Part of this is the privatisation of local government, health, social care and public health nutrition. Hence, we see chaos as charities try to cope in distributing food to unprecedented numbers of people in need. The scale of the crisis requires central strategy and coordination that only the state can provide. People … children … will go hungry. Children will suffer.

Child poverty has increased by 100, 000 over the past year. Now around 30% of all children live in poverty. Social/community nutrition services have become skeletal. Think about the nutrition services provided by Sure Start. Since 2010, £1 billion have been cut from children centres and 1000 closures.

Today, Unison has launched a pamphlet, Ending Child Poverty: Twenty Years On. It’s a collection of essays, to mark the original 2020 deadline for ending child poverty in the UK. The essays consider where we are now, and what we need to do next to help eradicate child poverty in the UK. We’re proud that it includes: Health Equity and Civil Society: Levers for Reducing ‘Child obesity’ by FIR members Sharon Noonan-Gunning and Eileen O’Keefe

‘Don’t blame the people: blame the system!’

Thinking about how to stop child poverty is timely, given that it will inevitably increase due to the Covid-19, public health and economic crises. For us, the immediate question is how to feed children and ALL in need during the crisis. We have been advocating to open the school kitchens as food preparation and distribution centres to ALL in need. Our regional and borough Public Health departments can integrate food supply (food companies, supermarkets) and distribution networks (City Harvest, Fareshare, Felix), and link with their counterparts in Education and Community Engagement, and the school headteachers to use the industrial scale kitchens for community food. A centralised strategy can scale up preparation and distribution according to need. It can do so reducing transmission risk rather than 100s of local volunteers delivering food to those self-isolating and/or in need.

Only the State can organise mass food provision. The emergency food aid systems are in crisis as Professor Martin Caraher spells out:

  • the current network of food banks is falling apart, not the right food, shortage of donations/waste food 
  • system relies on people going to food banks, so with current restrictions on travel etc not a solution
  • food banks and other food aid outlets are staffed by volunteers, many of whom fall into the at-risk categories for the virus and now cannot travel out to families/households in need
  • many food banks are not set up to deal with fresh foods only highly processed long storage goods e.g. dried and tinned goods
  • our welfare system (UC) is not set up to deal with food insecurity and the policy has been to refer clients to food banks as opposed to giving them money for food. They used to give money for people to buy food, not any more
  • research shows that the amount of money people currently receive for welfare is not sufficient for them to buy a healthy diet even if they could access it
  •  a lot of panic buying and stockpiling with subsequent increases in the amount of domestic food waste  
  • those at risk of food insecurity are now doubly at risk and we don’t even have a national system to identify them 

There is not a shortage of food per se, the problem is access and up-front availability.  For example, due to the restrictions on the hospitality sector there is £20million worth of food sitting in warehouses. A restaurant group was suggesting the other day that restaurants such as Leon be allowed act as shops i.e. distribution centres for such food, so while not allowed to serve food canteen/restaurant style these outlets could provide baskets of food. They have the storage facilities, which food banks do not. In some areas, restaurants have done this and are distributing food baskets, these are not necessarily targeted at those in need but just communities in general. 

A problem remains in identifying many of those at risk from food insecurity as many are/were self-referring to food banks and there is no central data source. Of course, we can identify groups in general:  the frail elderly, those in receipt of free school meals, those on welfare etc. But we know the working poor, those in the gig economy, rural areas etc are often food insecure. Many of the current workforce – those working on the front line – were themselves subject to food poverty and were surviving not by going to food banks but by using pay-day loans, credit cards and family and community networks to survive.  Among those identified at risk were nurses and employees of some large supermarkets. These groups are in the same position now with the added pressure of being front-line workers.

Stay well in this crisis; put pressure on the state to organise safe food distribution and help where you can. This too will pass.  We MUST then organise to end child poverty, and re-establish a state centred, public health nutrition system as part of a democratically decided, national food plan that ends food insecurity and hunger!

Covid-19, UFSM and schools as centres of community nutrition: Our views raised with the GLA

Covid-19 is affecting global health and economy. It interacts with a fragile world economy and that now threatens a crisis on the back of the 2008 financial collapse. A crisis from which millions never recovered. Instead suffering has increased as the austerity project shifted the debts of the bankers onto working people.

As the fear of Covid-19 spreads and governments take draconian measures to contain it, we need to be wary of the ethical questions, dangers of social control and using Covid-19 as an excuse to further restructure our food and health economies. For example, the Food and Manufacturing Industry has argued for deregulation so they can be flexible on sources and ensure adequate food supply. It provides the opportunity for emergency legislation that in the name of feeding people opens the door to US and other food industries that have lower food standards: we are working on are the need for the Department of Transportation (DOT) to relax their rules and regulations during a pandemic emergency

Members of Food Inequalities Rebellion work in the supermarkets where shelves are emptying and in community food projects for which there will be less ‘leftovers’. We are campaigning for Universal Free School Meals for all children and young people, and for schools to become centres of community nutrition. Now our immediate attention is on supporting our communities to ensure we come through this crisis. We have raised our concerns with the Greater London Assembly, London Food Board and London Labour:

With Covid-19, we face new challenges in feeding children, especially those in poverty in our communities. The GLA and Borough Resilience Boards have an absolutely vital part to play and no doubt have plans in place to ensure food supply.

We wanted to share our immediate thoughts about preparing for the worse-case scenario with Covid-19. These relate to feeding children and food distribution at the community level:

  • Boroughs should carry out urgent and rapid assessments of nutritional needs within communities, and identify potential sites for the provision of localised communal feeding (e.g. schools)
  • Parent/carers are key routes to our communities. Their help can be mobilised through immediate school meetings. Through these meetings, they may inform what action is needed by policy makers and practitioners, and seek volunteers
  • Immediate ward level meetings of food and health services: GPs, parent/carers, charities, councillors, schools, faith groups and others to set up ‘Food and Health Action Groups’ with democratically elected leaders to monitor local food crises
  • Open up the industrial scale school kitchens and canteens so we may feed our communities in need
  • Communal feeding and food distribution should take place via the schools so children do not go hungry (if schools close what happens to those children on UIFSM and free school meals?)
  • Can we tap the resources of Unite the Union – Community sector for help in organising community level groups?

Latest news

Petition launched: Save UIFSM

Even harder times ahead? How do we feed our children?

Last week it was reported that UK life expectancy has stalled, and fallen for the poorest 10% of women. World stock markets have taken the biggest tumble since 2008. The ensuing likely downward revision for UK economy lowers the possibilities for government spending, improvements in working lives and better employment. Already it’s clear that the costs of this latest crisis will be burdened by ordinary people through stimulus packages such as €3.5 billion in Italy through tax credits to companies. Pre-Brexit promises to farming and fishing industries are being broken. We have a government that hired an advisor, a reported believer in eugenics, and a right wing home secretary declaring war on the department that led the Windrush scandal. An even more oppressive approach is on the way. The NHS crisis deepens with record numbers of patients waiting over four hour on trolleys and potential of coronavirus. This week the trajectory certainly points to increases in hard times, inequalities, poverty and social division. This political and economic context does not bode well for child health. As March begins, there are rumours that universal infant free school meals (UIFSM) are to be stopped in the imminent spending review.

Food and health inequalities loom large among UK children. Children’s health in the UK already scraps the bottom across comparable countries. 400,000 children in London alone, live in food insecurity. The ideological context is transparent. Ideas of inequality are used in ‘othering’ and creating social divisions. This is epitomised with the refusal to provide free school meals to children in families with no recourse to public funds. Now there is the threat to remove UIFSM. It is argued the cost of £600 million, is ‘unsustainable’. That, instead this money should be used for holiday hunger and improved access to families on universal credit. But this is a divisive argument. We should be united to defend the rights of all children to food and nutrition that underpins growth and cognition.

Access for all children to good nutrition and health are political decisions. As are the existence of poverty and inequity. Insight into this is provided from research with South London carers, of high weight children: mothers articulated that industry and government do not care about their children’s health. They argued ‘it was all about money’. That It’s not rocket science government could do something but they’re obviously choosing not to. That was in 2014. Will this government’s choices be different?

What now for food activists? Knowing what we know……

  • The depths and oppression of food poverty
  • The institutionalisation of food banks
  • Teachers feeding hungry children of all shapes and sizes
  • A growing food voluntariat

We argue that we need to step up our activities to organise against food inequalities, build power of our communities using narratives that organise, not charity:

  • Food rights centres not food banks
  • Universal free school meals for all children
  • Schools as centres for community nutrition
  • Politicisation not charitisation
  • Unity not stigmatisation of poverty and other-weight bodies
  • Immediate campaign to stop the rolling back of UIFSC

Sign the petition: https://you.38degrees.org.uk/petitions/save-universal-infant-free-school-meals?share=2978bf10-61a9-4acd-96e8-af37c8f50632&source=email-share-button&utm_source=email.

Join us now! Email foodinequalitiesrebellion@gmail.com or phone Sharon on 07941 733372

Universal Free School Meals: London

On 19/12/19 Greater London Association member, Dr Fiona Twycross, tabled this question to Sadiq Khan, the Mayor of London, on behalf of Food Inequalities Rebellion:

One of the mayor’s strategic priorities is tackling child health inequalities and good nutrition is central to reducing such inequalities. Does the mayor therefore agree that as schools are hubs in all communities and central in providing food to children, UFSM for all children should be a pan-London strategic priority? If so, what is he doing?

The Mayor’s response:

Universal Free School Meal Provision

Answered By: The Mayor Date: Thursday, 19th December 2019

A whole school food approach plays a critical role in tackling health inequalities and I’m continuing to invest in the Healthy Schools London programme to improve children’s health and wellbeing and ensure schools are meeting the school food standards.

However, the free school meals eligibility criteria are not fit for purpose as they exclude some of the most vulnerable children in society whose families have ‘no recourse to public funds’, receive Universal Credit but have an annual household income above £7,400 or are experiencing in-work poverty.

In my London Food Strategy, I call on partners to join me in lobbying government to invest in universal free school meals and in November, I hosted a London School Food Conference to promote a whole school food approach and highlight the benefits a universal offer has had in Islington, Southwark and Newham.

Extend universal free school meals

06 February 2020

400,000 children in London have very low food security.  

166,512 Londoners received assistance from a Trussell Trust foodbank – just under 60,000 of recipients were children.

Today, the London Assembly called on the Mayor and the Chair of the London Assembly to jointly write to Secretary of State for Education to outline the case for extending the provision of universal free school meals. 

Fiona Twycross AM, who proposed the motion said:  

“Food insecurity blights the lives of hundreds of thousands of children in our capital, with many forced to go into school hungry and under-nourished. In one of the richest cities in the world, this is simply unacceptable.

“Foodbanks and other charities do an incredible job of providing emergency food parcels to those affected by food poverty, but the simple truth is they shouldn’t exist in the first place.

“Many of the solutions to tackling food insecurity lie in the hands of national Government. However, City Hall should also play its role and build the case for extending the provision for universal free school meals.”

Food Inequalities Rebellion ….

We thank Fiona and Sadiq’s GLA team for trying. We have no faith in this new right conservative government to look after our children and communities. We have to rely on ourselves. That is, collectively through our trade unions and communities. We have to organise politically for resources and legislation resources to feed our children.

.

General election and food inequalities: Changing the narrative from charity to a political project

By Sharon Noonan-Gunning, PhD, RD. Views my own

Ten million voted for the Corbyn and McDonnell project. The vast majority of young people voted for progressive policies that focus on tackling inequalities, including inequalities in child health, through providing social rights that would reduce food poverty, halve food banks in one year and introduce universal free school meals (primary age). And, this to be integrated with a sustainable food system. Labour was promising a manifesto that would change people’s lives for the better on a scale not seen in modern times. Their policies ‘corbynomics’ are supported. The ruling elites and their class were desperate to avoid a Corbyn government and for these policies to materialise. It would have signalled the beginning of the end of neoliberalism in UK and be an international inspiration, not least in Europe. So, the hope was stopped by an orchestrated, vicious and hugely resourced campaign by the elites and their class that included the demonisation of Corbyn and used media and social media to manipulate, and fuel fear and social division.

This is not to idealise the Corbyn and McDonnell project. I am on the left, a socialist. I now wonder whether following 2017 election, the left leaders, advisors and strategists, including Momentum and we in the broader left, were sufficiently organised and understood the stakes, to the same extent as the elites, and Boris Johnson’s circle around ‘Britannia Unchained’.

‘Brexit’ was made to dominate. The reality was that for Johnson and co., Brexit was always a smokescreen for an agenda to deliver the UK to unfettered market forces. The sharks that are currently basking around UK waters will soon start to ravage the NHS, food system and workforces. All of which, and more, will be opened up to US standards. Already their commitment to increasing the national minimum wage and protecting worker’s rights have been axed. The agenda is further privatisation, deregulation and selling UK public services, land, assets and workforces to the highest bidders. That is the companies, US or other, whose profits will be made by driving down working conditions, increasing poverty, inequalities and social division. Inevitably, amid fightbacks, the government will increase repression and use the additional 10,000 new prison ‘spaces’ promised by Priti Patel.

I voted for Brexit- left exit – for an internationalist Left socialist UK government. I asked myself, how could I trust the EU capitalist powers, a trade bloc, that amid talks of human rights turn the Mediterranean Sea into grave yard (where 18,000 refugees have lost their lives since 2014). Some of my friends and family who voted remain swung behind Labour as they saw and feared the real Conservative agenda. Not following the national data, I thought this might be happening elsewhere. Labour supporters in Bermondsey (where I live) who had voted Brexit in 2019 Euro-election said they would ‘always vote Labour in the GE’. I thought at best we’d have a hung Parliament but not a defeat on this scale.

It’s important to remember that it was the crisis in the Conservatives, articulated through Cameron and Osborne, that opened the Brexit floodgates. Brexit quickly became a metaphor for the discontent and anger that many felt following decades of deindustrialisation, losing out in globalisation, and in a financial crisis that was made by the banks and paid for by the working class through austerity and precarity dominating every day lives. This social depression was caused by the very same politicians who then turned to populism and its false promises.

This pattern of events is not unique to the UK. Similarities across Europe point to the rise of nationalism and populism amid deepening inequalities. For the UK, there is irony that the one-nation Toryism is driving a rise in English nationalism, potentially leading to the breaking-up of the UK. Going into 2020, nationalism and inequalities could be compounded by the precarious state of the world economy as described by the IMF . And in the UK, growth (GDP) is forecast to slow from 1.3% in 2019 to 1.0% in 2020. This is the weakest since 2009. So, as Brexit unfolds the economic conditions within which it sits, are likely to worsen the effects on British workers and working-class communities.

What are the consequences for food and health inequalities?

The effects of Food Brexit disrupting the logistics in multiple and complex global food supply chains could lead to food shortages, increased food insecurity alongside spikes in food prices. In a globalised world, the UK food system relies on importing about 40 per cent of all the food we eat – an increase from around 25 per cent two decades ago. More than 30% of all the food consumed in the UK comes from EU member states. In London around 10% of jobs are in the food sector which contributes around £20bn to the London economy. The value of the U.K. restaurant market could lose £5.4 billion in the event of a “disorderly” Brexit. With food sector reliant on a migrant workforce, over one quarter made up of EU citizens, there will be a skills gap and labour shortages which bosses may view as an opportunity to replace with automation rather than paid workforce. Workers and their families will suffer the effect of price rises, and increased lack of access to affordable foods of good nutritional quality. Public sector food provision such as in schools and hospitals will be vulnerable to decline in nutritional standards. The poorest families and their children will suffer most. And, its important that we understand that the Conservatives do not care. They believe poverty and inequalities are inevitable and necessary. The poor are so because of ‘personal failing’ whilst ‘the most talented’ can lift themselves out of poverty. So, it is no accident that Conservative leadership does not consider the effects of Brexit on food security. 

Continue reading

Continue reading “General election and food inequalities: Changing the narrative from charity to a political project”

Food labelling scandal – ‘with a stroke of a pen’

The struggle for our rights to have clear, transparent food labelling has been a battleground in England for many years. As ever, the interest and pockets of large food corporations are valued over the health and social rights of the many.

The latest scandal on food labels has been found in India. As the article below highlights, more than 70 million Indians suffer with diet-related chronic ill health, this is estimated to rise to 120 million.

Despite this, the government has opted to postpone its decision to put red warning labels on unhealthy packaged food proposals. Its proposal will be reviewed by The International Life Sciences Institute (ILSI)–  a controversial US non-profit organisation with a revolving door with food corporations including Coca-Cola. 

ILSI has branches in 17 countries and is funded by giants of the food and drug industries. 

This is further evidence that we need accountability and democratic control of the food system! Read on….

https://www.nytimes.com/2019/09/16/health/ilsi-food-policy-india-brazil-china.htm

Supermarket aisle
Photo by Fikri Rasyid on Unsplash.