Older people and rural places remain neglected subjects within the academic literature on food insecurity. In this paper, we investigate the relations between food insecurity and older people in rural England. We do this in a couple of ways. First, we utilise findings from an analysis of national survey data on food insecurity to examine levels of food insecurity and engagements with food assistance services amongst older people and those living in rural places. Second, we draw on materials from ethnographic research at a community food club in a rural district to explore older people's understandings of, and encounters with, food, food insecurity and community food provision. Three key findings emerge from our study. First, levels of food insecurity and engagements with food aid services are particularly low amongst older age groups and those living in rural places. Second, the relationship between older people and food insecurity in rural places is complex, bound up with cultures of denial, thriftiness, sharing and informal support. Third, community-based food provision can overcome some of the stigmatic aspects of food insecurity and food aid to provide meaningful social food experiences for older people in rural places.Food insecurity older people community food rural places UK.

Introduction:Tobacco and alcohol use are linked to health disparities. In recent years, food insecurity, an indicator of disparities, has increased in Great Britain. This study examined the associations between food insecurity and tobacco or alcohol use. Methods:Data were drawn from a representative cross-sectional study of people aged ≥16 years in Great Britain (N = 4,056), conducted in January‒February 2025. Food insecurity was measured with the 6-item Household Food Security Scale, divided into high/marginal, low, or very low food security. Logistic regression models with food insecurity (combining low and very low food insecurity) as the outcome and adjusted for age, gender, nation of residence, socioeconomic position, financial hardship and smoking or alcohol consumption (measured using AUDIT-C score), were used to derive odds ratios (ORadj). Results:Overall, 7.9 % (95 % CI: 6.9, 8.9) reported low and 9.6 % (8.6, 10.7) very low food security. Smoking was associated with food insecurity (ORadj = 1.75; 95 % CI: 1.32, 2.31). People who abstained from alcohol were more likely to be food insecure compared with those who drank at increasing (AUDIT-C 5: ORadj = 0.62; 0.41, 0.93) or higher risks of harm (AUDIT-C 8: ORadj = 0.63; 0.40, 0.97); however, this relationship was moderated by psychological distress. Conclusion:Food insecurity was associated with higher smoking prevalence. Among people experiencing distress, those abstaining from alcohol and at risk of dependence appeared more likely to experience food insecurity than those drinking at other levels. These findings suggest the need for interventions that offer support for smoking, alcohol and which address underlying stressors of food insecurity.

Abstract Background Households in areas of socio-economic deprivation are more likely to consume diets low in fruit and vegetables. Fresh Street is a place-based fruit and vegetable voucher scheme with vouchers redeemable with local independent (non-supermarket) vendors. Paper vouchers are offered to all households in a geographical area regardless of household type, size, or income with no requirement to demonstrate need. The regular shareable vouchers are combined with recipes and dietary information to increase exposure to healthy food prompts, reduce food insecurity, increase fruit and vegetable consumption, improve dietary quality, and support healthy dietary habits. This study aimed to inform a randomised controlled trial (RCT) to assess the impact of Fresh Street on a range of public health outcomes. Methods The pilot cluster RCT took place in three inner city areas of high socioeconomic deprivation in England (Tower Hamlets, Bradford, and Doncaster). New systems for managing vouchers and doorstep delivering weekly envelopes to households were developed. Weekly envelopes containing vouchers (5 x £1), a healthy seasonal recipe and brief nutritional information were offered to all households in nine intervention streets. Nine control streets received no intervention. Household surveys collected information on fruit and vegetable consumption, diet quality, and household characteristics. Results The household survey response rate was below the 50% target for progression to the main trial. Most local fruit and vegetable vendors accepted vouchers. Three quarters or more of households regularly accepted the envelopes. The scheme was well received by households, local vendors and local public health teams. Household uptake of the scheme was highest in Tower Hamlets (75%) and Bradford (83%). The mean weekly voucher redemption was highest in Tower Hamlets (£3.26) and Bradford (£2.82), where the scheme ran longest, and where vendors were nearby. Conclusions This was the first pilot RCT of a place-based, household voucher approach. The newly developed system for securely printing and redeeming the vouchers worked well and is potentially scalable. Future trials should consider alternative methods of assessing the impact on households and explore more efficient ways to deliver the intervention e.g. through collaborative working with local resources such as community centres.

Abstract Background Many UK communities experience food insecurity, and consume diets high in energy-dense, nutrient poor, processed foods and low in fruit and vegetables (FV). We explored a novel area-based approach to promote FV consumption and healthy eating in one such community. Methods We developed a weekly subsidy scheme for fresh FV with key local stakeholders in an area of socioeconomic deprivation in Northern England. The scheme (Fresh Street) offered five £1 vouchers to every household, regardless of income or household type. Vouchers were redeemable with local suppliers of fresh FV (not supermarkets). The feasibility of the scheme was assessed in four streets using rapid ethnographic assessment and voucher redemption information. Results Local councillors and public health teams were supportive of the scheme. Most eligible households joined the scheme (n = 80/97, 83%), and 89.3% (17 849/19 982) of vouchers issued were redeemed. Householders reported that the scheme made them think about what they were eating, and prompted them to buy and eat more FV. Conclusions This feasibility study reported high levels of acceptance for a place-based, household-level weekly FV subsidy scheme. Further research is required to evaluate the effectiveness of this approach to creating healthy diets, eating behaviours and food systems.

Many people in the UK have diets low in fresh fruit and vegetables and high in energy-dense, nutrient-poor, processed foods. There are multiple drivers of poor diet including living in a food desert which is characterised by inadequate access to transportation and a limited a number of food retailers providing fresh produce, including fruit and vegetables, for affordable prices. Recent studies suggest that opening new independent retail outlets, such as farmers markets and produce stands can increase access to and consumption of fruit and vegetables in the short-term. In terms of improving affordability of healthier foods, mounting evidence indicates that price discounts and subsidies (including vouchers) can effectively increase the purchase and consumption of fruit and vegetables, especially when combined with nutritional information. Given the importance of fruit and vegetables for health, interventions that help increase fruit and vegetable intake are warranted. The aim of this project was to feasibility test ‘Fresh Street’, an area-based approach to creating sustainable and healthy diets, eating behaviours and food systems in areas of high deprivation. This project was carried out in Sheffield. The results of the feasibility project are described in the report.

Drawing on research exploring food system change in a region in the North of England during the Covid-19 health pandemic, in this paper we explore how a "managerial" approach to food system governance and pro-visioning embedded in national food systems and international supply chains was suddenly supplanted by a more "open" approach. By enabling understanding of how food system change unfolded as a diverse range of hidden practices unexpectedly became visible, it contributes to food systems thinking through the development of a regional place-based perspective. We use this approach to understand the outcome of these processes and to investigate how embedding change across administrative and geographical boundaries can enable food system transformation to improve food security for future generations.

We all eat, but not all of us can access the food we need to live a healthy and active life. This is true for those in wealthy and emerging countries. In most instances, it is the most vulnerable who bear this burden disproportionately. This unit explores the scales, causes, and consequences of food insecurity and who is most likely to experience hunger and hardship. This module is divided into four sections. The first section focuses on the global scale of food insecurity and how we have sought to increase food production and distribution to meet the worldwide need and year-round demand. The section concludes with a discussion of the food insecurity of those who produce the food needed to meet this demand (lessons 1–4). The second section (lessons 5–7) introduces the causes and effects of household-scale food insecurity through the concepts of access, foodscape, food desert, and affordability. The section also investigates the social implications of food insecurity, such as the loss of commensality. The third section (lessons 8–9) highlights two areas linked to systematic and disproportionate food insecurity burden in order to explore how Sen’s concept of entitlement can explain this. The final section (lesson 10) introduces ways that we have sought to meet the needs of people at the household scale who are food insecure and seeks to provide a critical interrogation of the role of food aid as a mechanism for addressing food insecurity. By the end of this unit, students should be able to do the following: 1. Define food insecurity and describe how it manifests itself at multiple geographical scales (e.g., the region, nation, city, household, and individual); 2. Identify the causes and effects of food insecurity and how these interconnect and reinforce each other across geographical scale; 3. Contextualize how disadvantage linked to different forms of inequality disproportionately creates hunger and hardship for some groups more than others; 4. Critically evaluate and analyze the effectiveness of different solutions to address food insecurity at both the global and household scale.

The need for resilience thinking concerning food access became particularly stark during the COVID-19 pandemic. In March of 2020 rates of COVID infection in England rose to such an extent that the government took the step to put its population into lockdown. People were instructed to work from home and not to socialise with others. Business and community organisations were closed unless they were providing front line or essential services. While food retail remained open throughout the lockdown, food insecurity was both amplified and an effect of the lockdown (Loopstra 2020). While national government and local authorities scrambled to mitigate these effects, it quickly became apparent that if we are to build back better during and after the COVID crisis, a new understanding of food provision and support for those most vulnerable to food insecurity is needed. It also became clear that some localities were more resilient to food insecurity compared to others. In this chapter, I outline food insecurity and how it manifested itself during the initial lockdown period. I then turn to how local authorities and food providers responded to the crisis and their increasing realisation that a longer-term solution is needed. I propose the Food Ladders framework that mobilises resilience thinking as a way to evaluate food projects at the local scale as well as the food landscapes (foodscapes) they are part of and then build them better. The Food Ladders framework adopts a practice approach to understanding how food using activities enact resilience practice to achieve different outcomes concerning the availability and affordability of food as well as being a means to enable the social connectivity needed to provide mutual aid and support. While many localities are now adopting this framework to provide support within their communities, there remain structural barriers that pose a threat to the ability of these place-based interventions to succeed. The final section highlights some of these threats and suggests areas for further research and intervention to ease the way for local scale resilience to be enacted.

Background Healthy and sustainable dietary practices offer a possible solution to competing tensions between health and environmental sustainability, particularly as global food systems transition. To encourage such dietary practices, it is imperative to understand existing dietary practices and factors influencing these dietary practices. The aim of this study was to identify multi-level factors in lived rural and urban Ugandan food environments that influence existing dietary practices among women of reproductive age (WRA). Methods A mixed methods study was conducted. Multiple correspondence analysis followed by hierarchical cluster analysis were performed on dietary data collected among a sample (n = 73) of Ugandan WRA in Kampala (urban) and Wakiso (rural) districts to elicit dietary clusters. Dietary clusters, which were labelled as dietary typologies based on environmental impact and nutrition transition considerations, were reflective of dietary practices. Following this, a smaller sample of WRA (n = 18) participated in a Photovoice exercise and in-depth interviews to identify factors in their social, physical, socio-cultural and macro-level environments influencing their enactment of the identified dietary typologies, and therefore dietary practices. Results Four dietary typologies emerged: 'urban, low-impact, early-stage transitioners', 'urban, medium-impact, mid-stage transitioners', 'rural, low-impact, early-stage transitioners' and 'rural, low-impact, traditionalists'. Although experienced somewhat differently, the physical environment (access, availability and cost), social networks (parents, other family members and friends) and socio-cultural environment (dietary norms) were cross-cutting influences among both urban and rural dietary typologies. Seasonality (macro-environment) directly influenced consumption of healthier and lower environmental impact, plant-based foods among the two rural dietary typology participants, while seasonality and transportation intersected to influence consumption of healthier and lower environmental impact, plant-based foods among participants in the two urban dietary typologies. Conclusion Participants displayed a range of dietary typologies, and therefore dietary practices. Family provides an avenue through which interventions aimed at encouraging healthier and lower environmental impact dietary practices can be targeted. Home gardens, urban farming and improved transportation could address challenges in availability and access to healthier, lower environmental impact plant-based foods among urban WRA.

Uganda is undergoing dietary transition, with possible environmental sustainability and health implications, particularly for women. To explore evidence for dietary transitions and identify how environmentally sustainable women’s dietary patterns are, principal component analysis was performed on dietary data collected using a 24 h recall during the Uganda Food Consumption Survey (n = 957). Four dietary patterns explained 23.6% of the variance. The “traditional, high-fat, medium environmental impact” pattern was characterized by high intakes of nuts/seeds, fats, oils and spreads, fish and boiled vegetables. High intakes of bread and buns, rice and pasta, tea and sugar characterized the “transitioning, processed, low environmental impact’ pattern. The ‘plant-based, low environmental impact” pattern was associated with high intakes of legumes, boiled roots/tubers, boiled traditional vegetables, fresh fruit and fried traditional cereals. High intakes of red/organ meats, chicken, and soups characterized the “animal-based high environmental impact” pattern. Urban residence was positively associated with “transitioning, processed, low environmental impact” (β = 1.19; 1.06, 1.32) and “animal-based high environmental impact” (β = 0.45; 0.28, 0.61) patterns; but negatively associated with the “plant-based low environmental impact” pattern (β= −0.49; −0.62, −0.37). A traditional, high-fat dietary pattern with medium environmental impact persists in both contexts. These findings provide some evidence that urban women’s diets are transitioning.

Global estimates suggest that approximately one third of all food that is produced is wasted (Parfitt et al 2010, Gustavsson, et al. 2011). Alongside this, a myriad of concerns, not least a concern for people who struggle to access food that is safe and healthy, has given rise to a host of organizations operating across the world that seek to move food that otherwise would be wasted from the commercial supply chain to the not-for-profit sector. This short article seeks to lay bare an ontological transition in the fundamental qualities of food as it makes this shift from being commercial food loss and waste to food that feeds people and has the capacity to support social good. Drawing on Mol’s material multiple ontologies approach (Mol, 2002, 1999, also see Law 2009, Jackson, et al. 2019), the article argues that once food has left the commercial supply chain and enters the surplus distribution network it ceases to be food loss or waste. In the chain of practices that move food along, throughout each step, food becomes a new thing with new affordances for enacting new effects, which are fundamentally different from those that arose in the previous step. As such, this article is not concerned so much with how food becomes wasted, but instead with what it becomes and the effects of that becoming as it moves from the commercial supply chain into the non-commercial sphere of surplus redistribution.

The food ladders approach is a novel, evidence-based approach for creating and household and community resilience by capitalising on the capacity of food to bring people together. Food Ladders is not like existing household food insecurity approaches that focus on the lack of good food within households and then feeds that gap. Instead, Food Ladders activates food and its related practices progressively to reduce local vulnerability to food insecurity and its knock-on effects.At the core of Food Ladders is a conceptual framework of practices that can be used to evaluate, assess, and implement activities that enhance resilience. The framework is based on three levels. Level 1 focuses on activities that result in coping resilience. These activities act as a safety net and catch people when they are in crisis. Level 2 fosters adapting resilience and is produced by practices that are asset recognising and asset building. Level 3 enables transformation resilience, which reduces the vulnerabilities to existing mechanisms that cause shock. These activities are typically self-organised, build on existing assets, may have reach beyond the community itself. These are capacity mobilising activities. Evaluation should occur within the scale of the locality, rather than the organisational or household scale. One important dimension of this evaluation is in not just determining the levels that might be present within the locality, but also considering the degree to which they are connected to each other and enable a pathway for people. Food Ladders was developed through a series of research projects funded by the ESRC, MRC, and the N8 AgriFood Programme. This interdisciplinary work is a collaboration between Dr. Blake and a wide range of partners, including local authorities, food industry actors, national charities and community organisations across the UK.

This research considers the relationship between neoliberalism, poverty and food insecurity and how this impacts on the ability of a community to self-organise and become resilient. Specifically, it examines shocks imposed by the implementation of austerity policy and neoliberal welfare reform and the longer term individualisation that gives rise to greater vulnerability to such shocks and how community organisations encourage different levels of resilience in the face of this. Original findings from case study and qualitative analysis are twofold. Firstly, food insecurity effects are not only hunger and poor health experienced at the individual scale, but they also extend into places through the loss of social networks, erosion of community spaces, denigration of local foodscapes and collective de-skilling that limits the community resources needed for self-organising. Secondly, the ways in which food support is provided in communities has implications for how communities can regain the resources they need to be able to enact resilience in the face of trouble and difficulty. As such, the research demonstrates that self-organising is more than free-time activity; in these conditions, the capacity to self-organise is a vital community asset that is necessary for building resilience and social sustainability. As such, policy responses to poverty should take a multi-scale approach.

This paper's contribution to research on food and social justice or food justice is threefold. Firstly the paper considers how the processes that shape urban space also contribute to the production of food injustice. This intervention pushes the food justice literature to consider how contextual drivers linked to urban governance are key forces that shape access to food in cities. The second contribution critiques the current emphasis on race-based disadvantage and white privilege by considering how racism as an aspect of food injustice can have shifting influence. Finally, the vast majority of food justice research focuses on the United States, which goes some way towards explaining why race and white privilege play such an important role in current explanations. This paper draws on the context of Hong Kong to highlight the ways in which place-making projects shift over time and how these spatial projects impact on food injustice. These three research interventions extend the concept and applicability of food justice to make it a more international concept, while at the same time opening the concept out to new groups of people who also struggle to feed themselves.

This paper seeks to identify an important point of contact between the literature on inequalities in oral health and the sociology of power. The paper begins by exploring the problem of social inequalities in oral health from the point of view of human freedom. It then goes on to briefly consider why inequalities in oral health matter before providing a brief overview of current approaches to reducing inequalities in oral health. After this the paper briefly introduces the problem of power in sociology before going on to outline why the problem of power matters in the problem of inequalities in oral health. Here the paper discusses how two key principles associated with the social bond have become central to how we think about health related inequalities. These principles are the principle of treating everyone the same (the principle of autonomy) and the related principle of allowing everyone to pursue their own goals (the principle of intimacy). These principles are outlined and subsequently discussed in detail with application to debates about interventions to reduce oral health related inequalities including that of water fluoridation. The paper highlights how the 'Childsmile' programme in Scotland appears to successfully negotiate the tensions inherent in attempting to do something about inequalities in oral health. It then concludes by highlighting some of the tensions that remain in attempting to alleviate oral health related inequalities.