Sharifah Sekalala, Kevin Hearty, and Hadijah Namyalo-Ganafa
Interspersed between headlines of multiple crises in the United Kingdom such as leaving the European Union, COVID-19, successive changes of government, the war in Ukraine, and public sector work strikes, has been a long-standing crisis around the cost of living. The cost-of-living crisis is about many things; high energy prices, high utility bills, unaffordable housing, but also fundamentally about increasing prices of food and groceries. The phrase ‘the cost of living crisis’ obscures the fact that in one of the richest countries in the world, three million people are relying on food banks for emergency food parcels with over a million of those parcels being given to children. There are fears this may be an underestimate as some towns do not have food banks, and some people are too ashamed to seek help.
In the UK, ‘food bank’ refers to initiatives which provide emergency parcels of food for people take away, prepare, and eat at home. They became prevalent in the UK after the 2007/08 financial crisis but the increased cost of living combined with inadequate wages has created soaring demand. Most food banks are ‘overwhelmed’ by increasing demand.
The right to health includes a complete state of physical and mental health, and social well-being and extends to the underlying determinants of health, such as an adequate supply of safe food and nutrition. States must ensure that everyone has physical and economic access to adequate food and the means for its procurement.
The resurgence of malnutrition and its health effects
Globally the number of malnourished people has been rising since 2015. An estimated 3 million people suffer from malnutrition in the UK and in 2021 it was estimated that 1 in every 10 people aged 65 years and above was either malnourished or at risk of malnutrition. Children have also been greatly affected with a recent international survey indicating that GPs in poorer areas of the country have reported a resurgence of rickets and scurvy due to severe nutritional deficiencies and NHS data shows that about 700 children are admitted to hospitals with these diseases every year in the UK.
Paradoxically while malnutrition is increasing, the UK is also facing an epidemic of obesity with 63.8% of adults aged 18 years and over estimated to be overweight or obese. The increased consumption of sweet and savoury processed food and less fruit and vegetables occurs during cost of living crises. These foods are cheaper, more calorific, need little cooking and are high in salt and sugar and this trend is reasonably expected to be repeated. Obesity is associated with reduced life expectancy and is a risk factor for a range of chronic diseases, and can also impact on mental health.
Long term food insecurity has physical and psychological impacts. Hunger especially in high income countries is stigmatising, and many who seek food banks feel ashamed of using them, as they have been labelled by some as feckless or irresponsible and unable to budget. We know from other diseases such as HIV/AIDS that stigma has a huge impact on mental health.
Additionally, there is increasing evidence from jurisdictions such as Canada that household food insecurity is independently associated with depression among adults. Recent data from the UK shows that, among 17- to 22-year- olds with a probable mental disorder, 14.8% reported living in a household that had experienced not being able to buy enough food or using a food bank in the past year, compared with 2.1% in young people unlikely to have a mental disorder.
Linking the rights to food and health
As with any social harm, it must be frankly acknowledged that lack of access to food is a harm that certain sections of the population experience ‘from cradle to grave’ – and there are, of course, gendered, racial, geographical and class-based determinants in how the harm is unevenly distributed across society. Trying to firefight the symptoms, rather than addressing the structural root causes in a human rights compliant manner, obscures how lack of access to food is a long-term social harm.
The right to food is recognized by international human rights law and the UK has ratified most international conventions protecting the enjoyment of this right. The government is obligated to protect its population from being unable to access adequate and nutritious food during the current cost-of-living crisis. The continuous supply of food by food banks should not shield the UK government from these obligations.
The UK government should implement the provisions of General Comments 12 and 14 and provide people in poverty with either food or resources for acquiring food. The consumption of low nutrient foods harms people’s health so the government must intervene and manage food prices so families can afford nutritious food.
The latest figures from Northern Ireland show the limitations of relying on short-term measures rather than longer-term structural and societal change; an increase in foodbank usage after March 2020 originally attributed to the pandemic has not only persisted but actually worsened in recent months.
The rise of food banks has led to governments deflecting from their human rights obligations which would involve moving beyond thinking about the right to access food as a negative obligation and address the structural causes and effects. This will entail reinstating proposals in the now abandoned National Food Strategy Plan: firstly, a recommitment to all social rights and increasing social protection so that citizens can afford nutritious food, reinstating social programs such as cash vouchers for free school meals which were introduced during the COVID-19 crisis, and encouraging doctors in to use measures such as social prescribing of nutritious food. Secondly, governments can use legislative and tax measures to promote sugar taxes on unhealthy food, raise revenue from businesses which are profiting from a food crisis, give tax incentives to farmers to grow and distribute food locally, encourage greater community involvement in food supply chains and food security decisions, and create a holistic food framework through encouraging sustainable food and agricultural practices.
Thirdly, the bulk of food production and supply is in the hands of transnational companies which have human rights obligations to protect, respect and fulfil. Private companies can respect health related norms by, for example, cutting down sugar and salt in food processing, avoiding marketing of sweetened products to children, and respecting biodiversity in their production, retail and supply processes. Governments also have an obligation to prevent transnational food companies from acting anti competitively through antitrust legislation to diversify the number of food manufacturers and retailers which would encourage competition.
Sharifah Sekalala is a Professor of Global Health Law at the University of Warwick, UK.
Kevin Hearty is a lecturer at the Queens University Belfast, UK.
Hadijah Namyalo-Ganafa is a PhD student at the University of Warwick, UK.