Food is vital to individuals, communities, businesses and the economy.  This section describes the elements of the ‘food environment’ that influence individual and community food choices, with a particular focus on how this impacts on population health.  Dietary behaviours are described in more detail in the ‘Lifestyle and behaviour’ JSNA chapter.

There are many important drivers influencing people’s food choices.  The current food system promotes poor dietary choices, over-eating and ultra-processed foods (such as sugar-sweetened drinks, fast food and confectionery).  There is growing recognition that improving people’s diets requires more than working at an individual level (for example to improve knowledge and practical skills) and that where we live and how we interact with our food environment has a strong impact on our choices and our health. ref]C. E. Caspi, G. Sorensen and S. V. Subramanian, “Food environment and diet: A systematic review,” The Local Health Place, vol. 18, no. https://dx.doi.org/10.1016%2Fj.healthplace.2012.05.006, pp. 1172-1187, 2012[/ref] 1 2

There is no common definition of the ‘food environment’, but for the purposes of this assessment it is described as the factors that influence people’s behaviour when it comes to choices over what they eat (see Box 1).  Key elements of the food environment relevant to health and wellbeing include the availability and accessibility of affordable, healthy, good-quality food.

‘Food poverty’ and ‘food insecurity’ (see Box 1) are growing problems in developed economies.  In the UK, a combination of changes to the welfare system, rising food prices and high living costs are contributing to widening inequalities, (see the ‘Living standards’ and ‘Housing and homelessness’ sections of this chapter) with serious consequences for the quality of people’s diets and, ultimately, for their health and wellbeing. This growth in food poverty is reflected in increased use of foodbanks across the country and in London. 3

Food prices have been unstable since the global recession in 2008 and with the influence of climate change. 4 In the UK, there has been a pattern of rising prices of healthy foods and lowering of prices of unhealthy foods. 5  The increased cost of healthier foods has the effect of widening inequalities.  However, most income groups have changed their food-buying patterns and there has been a pattern in the UK towards purchasing cheaper foods with more calories that are less healthy.  Food expenditure as a proportion of income has reduced in all income groups in the UK. 6

People’s perceptions of food are also a key driver of their eating patterns and these perceptions, in turn, are swayed by wider influences of culture, media and advertising.

Figure 1 provides a simplified overview of the mechanism by which aspects of the food environment impact on individual food choices and behaviours.  Some of these factors can be influenced at local level, while others are driven by industry behaviour and national government policy.

Figure 1: The food environment – wider influences on individual food choices

A variety of factors including affordability,availability and desirability affect food choices
Figure 1: The food environment – wider influences on individual food choices

Source: Adapted from National Obesity Observatory 7

Box 1 Definitions used in this section

Healthy diet – In the UK, the components of a recommended healthy diet are described in the Eatwell Guide. 8  A healthy diet is one that balances calorie intake with activity levels, incorporating a wide variety of foods with an emphasis on vegetables, whole fruits, starchy carbohydrates and wholegrains.

Food environment – Wider influences on people’s choices over the food they buy, prepare and eat.  These influences include cost, availability, media and culture.

Availability – The types of food outlets and number of healthy, good-quality food options in a local area.

Food security – Exists when all people, at all times, have physical and economic access to sufficient, safe and nutritious food to meet their dietary needs and food preferences for an active and healthy life. 9

Food poverty – Food poverty is the inability of individuals and households to obtain an adequate and nutritious diet, often because they cannot afford or easily access healthy food.A

Notes

  1. Food Poverty definition from https://www.food.gov.uk/northern-ireland/nutritionni/ninutritionhomeless

References

  1. T. L. Penney, H. Brown and E. Maguire, “Local food environment interventions to improve healthy food choice in adults: a systematic review and realist synthesis protocol.,” BMJ Open, vol. 5, no. 0.1136/bmjopen-2014-007161, 2015
  2. National Obesity Observatory, “Data Sources: Environmental influences on physical activity and diet.,” 2011
  3. N. Cooper, S. Purcell and R. Jackson, “Below the Breadline: The Relentless Rise of Food Poverty in Britain.,” Church Action on Poverty and Oxfam, 2014
  4. R. Griffith, M. O. Connell and K. Smith, “Food expenditure and nutritional quality over the Great Recession,” Institute for Fiscal Studies, 2013
  5. J. Nicholas, A. J. Conkiln and M. Suhrcke, “The Growing Price Gap between More and Less Healthy Foods: Analysis of a Novel Longitudinal UK Dataset,” Plos One, no. http://dx.doi.org/10.1371/journal.pone.0109343, 2014
  6. R. Griffith, M. O. Connell and K. Smith, “Food expenditure and nutritional quality over the Great Recession,” Institute for Fiscal Studies, 2013
  7. National Obesity Observatory, “Data Sources: Environmental influences on physical activity and diet.,” 2011
  8. Public Health England, “Eat Well Guide,” 2016. [Online]. Available: https://www.gov.uk/government/publications/the-eatwell-guide. [Accessed November 2016]
  9. EC-FAO Food and Security Programme, “An Introduction to the Basic Concepts of Food Security,” 2008. [Online]. Available: http://www.fao.org/docrep/013/al936e/al936e00.pdf (PDF document). [Accessed November 2016]