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Malnourishing Britain

Malnutrition cases have doubled since the start of Tory Party rule. That isn't an accident – it's the predictable consequence of policies designed to make people poorer.

Data compiled by the NHS shows that in 2020/21 there were 10,109 diagnoses of malnutrition, up from 4,657 in 2010/11. Credit: Getty Images

Poverty impacts people’s ability to consume a nutritious diet. When you lack the resources to shop for and cook food with enough protein, energy, or micronutrients, your health and wellbeing is damaged. In the extreme, this deficit is classed as malnutrition.

Those experiencing malnutrition have worse health outcomes and take longer to recover from illnesses. In children, malnutrition affects growth and cognitive function, leading to slower development and poorer education performance. These are some of the hidden costs of our cheap and unhealthy food system; for every £1 spent on food in the supermarket, we are paying an extra 39p in the costs of diet-related disease.

While commonly thought to be a problem restricted to developing countries in the Global South, in the UK cases of malnutrition have almost doubled in the decade since the Conservatives took office in 2010. Data compiled by the NHS shows that in 2020/21 there were 10,109 diagnoses of malnutrition, up from 4,657 in 2010/11.

The austerity regime pursued by the Tories has led to an increase in poverty and food insecurity in the most marginalised groups, largely as a result of the decimation of the welfare safety net. In the last decade, the Trussell Trust, the largest network of food banks in the UK, has seen a massive growth in demand for emergency food. In 2020/21, the network distributed 2.5 million food parcels, a 132% increase from 2014/15.

Earlier this year, the Department for Work and Pensions published data that showed 8% of all families in the UK had experienced food insecurity, with 43% of families in receipt of Universal Credit doing so, largely fuelled by poverty and low income. These figures make clear that Tory policy is responsible for the rise in malnutrition in the UK.

A  2020 parliamentary report on the failures of the food system explored the relationship between poverty and food insecurity, finding three broad barriers to accessing a healthy diet: the affordability of healthy food; practical considerations, such as infrastructure and amenities; and the stress and mental health implications of poverty and food insecurity.

The (Un)Affordability of Healthy Food

In 2021, the Food Foundation found that the poorest fifth of UK households would need to spend 40% of their disposable income on food to reach government healthy eating guidelines—compared to just 7% for the richest fifth. Additionally, healthier foods were found to be almost three times more expensive than less healthy foods.

This is particularly important as the implicit state response to food insecurity has been a reliance on charitable food provision, most notably through food banks where fresh food, including fruit and vegetables, are not available for recipients. That means those reliant on food banks are not able to access the nutrients required for a healthy diet.

Children’s lunches are also impacted by the costs of healthy food. Parents on a low income who are not eligible for free school meals face the choice between paying for a hot meal they can’t afford or sending their child to school with a packed lunch that doesn’t meet their nutritional needs.

In Wales, Welsh Labour and Plaid Cymru have recently committed to introduce universal free school meals for every primary aged pupil in the country. This is a positive step forward to ending childhood malnutrition, and improving children’s health and educational performance.

Practical Barriers to Health

The cost of a healthy diet does not begin and end at the supermarket checkout. The infrastructure in a community—the shops and transport options available—also impact the types of food that people consume.

Without a car, for example, shopping for a family for a week is almost impossible, meaning many have to make multiple trips for the food they need. This leaves them with the choice of spending more on public transport, travelling to further away shops with healthier options. or buying food at convenience shops, with less variety and higher prices. There is also the siren song of temptation coming from fast food takeaway shops to contend with, which are located in greater numbers in more deprived areas.

Buying vegetables is only one step in making a meal; you also need the time and resources to cook. The amenities in someone’s house, such as whether they have a fridge, freezer, or oven all impact on their ability to consume a nutritious diet and, as energy costs rise, campaigners voice concerns that those on low incomes are increasingly choosing between heating and eating. But this misses the fact that heating and eating are even more entwined than that: in order to eat, you also need the energy required to turn food from raw to cooked.

The Emotional Burden of Poverty

The stress of living in poverty does not produce conditions conducive to a healthy diet. Food insecurity only compounds this, with research finding an association between stress and food insecurity over and above socio-economic deprivation. When experiencing stress and anxiety, it is difficult to focus on anything but your immediate physical and emotional needs.

The last thing you want to do while worrying about your ability to heat your home or whether you can afford a new pair of shoes is to dissect the nutritional breakdown of your evening meal. To be able to comfort yourself with a cheap, nutritionally devoid takeaway is entirely reasonable.

While middle class moralisers such as Jamie Oliver blame the ill health of the country’s poor on their misguided dietary choices, they miss a crucial value of food: the way it makes us feel. As one commentator wrote, when you’re poor, ‘ninety-nine percent of what you need is answered “no” […] So, if the only indulgence that is viable, that is within budget, that will not mean you have to walk to work, is a Styrofoam container of cheesy chips, the answer is a thunderous “YES”. In a world of “no”, you are grateful for every “yes”, no matter how illogical or how unhealthy.’

The last decade of Tory rule has seen a devastating rise in malnutrition and food insecurity more broadly. The impact of poverty and the loss of the welfare safety net have left too many without the means to access a healthy diet, worsening their health and costing the NHS billions. Without action there will be no reversal in this trend. If anything, the recent cut to Universal Credit demonstrates a government unwilling to recognise its responsibility in creating this public health crisis.