“It ripples through, it's like a dropping stone into a pond…the ripple effect is huge”: Food insecurity and health: Insights from women, children, and frontline workers

Abstract

This doctoral study is set within the context of a global financial crisis and a pandemic within which food insecurity and the parallel landscape of emergency food aid have expanded. Food security is built on four pillars: access, availability, utilisation, and stability. This doctoral study aimed to explore food insecurity and its health impacts amongst women and children; groups more vulnerable to experiencing food insecurity. Multiple qualitative methods were used including a researcher-in-residence model within a local authority’s public health team in North East England, a meta ethnography of European studies and longitudinal serial interviews. Across qualitative methods, I explored: (1) using a partnership approach in public health research; (2) the experiences of food insecure European women and children and their nutritional health and wellbeing, and (3) the emergency food aid landscape as it navigated a rapidly changing public policy landscape during a pandemic through the experiences of frontline workers. The critical syntheses presented uncover lives that are fraught with negotiating access to food daily, accompanied by adverse physical, psychological, and social experiences. The voices missing are those of pregnant women who are experiencing food insecurity. Underpinning these experiences was inadequate income and a lack of a sufficient ‘safety net’ to meet basic cost of living needs, thus resulting in reliance on food aid. Further, the COVID-19 pandemic accelerated and diversified the need for food aid whilst also exposing the food aid system’s fragilities, raising questions of whether it is ‘fit’ for purpose. Findings emphasised a social dimension to the experience of food insecurity. Therefore, this thesis puts forward a fifth pillar to the concept of food insecurity – social acceptability. Policy and practice recommendations outlined prioritise social acceptability to improve access to healthy food for women and children.