An evaluation of nutrition welfare policies for low-income children in the United Kingdom
File(s)
Author(s)
Parnham, Jennie
Type
Thesis
Abstract
Introduction
A child’s socioeconomic status is one factor determining their dietary quality. Food-assistance policies in the UK include Healthy Start and Universal Infant Free School Meals (UIFSM). Around 17% of the population are eligible for these policies, yet uptake can be as low as 55%. However, they are under-evaluated and consequently, not well-understood. This thesis aims to evaluate these nutrition welfare policies on measures of dietary intake in British children.
Methods
In this thesis, I quantitively analyse nationally representative datasets to evaluate a range of food assistance policies, including Healthy Start and UIFSM. Multivariable regression methods were used to test how programme participation impacted the dietary intake in UK children. Indicators used to describe the impact of the policies on dietary intake included household purchases, nutrient and food content and degree of industrial food processing in the diet.
Results
Overall, I demonstrated mixed impacts of the food-assistance policies on the dietary intake of children. For instance, I did not find evidence that Healthy Start participation was associated with increased fruit and vegetable expenditure. Yet, I found that UIFSM was associated with lower national intakes of ultra-processed foods associated with packed lunches, contributing to lower sodium and saturated fat intakes. Furthermore, UIFSM was associated with lower socioeconomic dietary inequities. However, although school meals were preferable to packed lunches in this analysis, they were not optimal, with high levels of processed and sugary items.
Conclusions
Food-assistance policies in the UK have the potential to improve the diet of not only low-income children, but all children through universal schemes. However, improvements need to be made to realise their full potential. Key recommendations include broadening the age and income eligibility criteria of Healthy Start and Free School Meal policies, so they reach more of the population and ensure continuity of assistance throughout childhood.
A child’s socioeconomic status is one factor determining their dietary quality. Food-assistance policies in the UK include Healthy Start and Universal Infant Free School Meals (UIFSM). Around 17% of the population are eligible for these policies, yet uptake can be as low as 55%. However, they are under-evaluated and consequently, not well-understood. This thesis aims to evaluate these nutrition welfare policies on measures of dietary intake in British children.
Methods
In this thesis, I quantitively analyse nationally representative datasets to evaluate a range of food assistance policies, including Healthy Start and UIFSM. Multivariable regression methods were used to test how programme participation impacted the dietary intake in UK children. Indicators used to describe the impact of the policies on dietary intake included household purchases, nutrient and food content and degree of industrial food processing in the diet.
Results
Overall, I demonstrated mixed impacts of the food-assistance policies on the dietary intake of children. For instance, I did not find evidence that Healthy Start participation was associated with increased fruit and vegetable expenditure. Yet, I found that UIFSM was associated with lower national intakes of ultra-processed foods associated with packed lunches, contributing to lower sodium and saturated fat intakes. Furthermore, UIFSM was associated with lower socioeconomic dietary inequities. However, although school meals were preferable to packed lunches in this analysis, they were not optimal, with high levels of processed and sugary items.
Conclusions
Food-assistance policies in the UK have the potential to improve the diet of not only low-income children, but all children through universal schemes. However, improvements need to be made to realise their full potential. Key recommendations include broadening the age and income eligibility criteria of Healthy Start and Free School Meal policies, so they reach more of the population and ensure continuity of assistance throughout childhood.
Version
Open Access
Date Issued
2021-09
Date Awarded
2022-02
Copyright Statement
Creative Commons Attribution NonCommercial Licence
License URL
Advisor
Vamos, Eszter
Millett, Christopher
Sponsor
National Institute for Health Research (Great Britain)
Grant Number
Grant Reference Number PD-SPH-2015
Publisher Department
School of Public Health
Publisher Institution
Imperial College London
Qualification Level
Doctoral
Qualification Name
Doctor of Philosophy (PhD)