Parents adopt unhealthy food routines for family wellbeing in place of unaffordable activities

The study from the Centre for Food Policy at City, University of London sheds light on the food buying habits of low-income parents across England. It looked at how these families' food practices may be influenced by their 'food environment', i.e. where people can buy and eat food outside of the home, as well as advertising and promotions they come across, but also the wider socioeconomic factors in their lives that may be affecting their decision making.

The findings support the well-established view that a food environment where unhealthy foods are ubiquitous, cheap and heavily marketed, drives parents to feed their families on them. However, they further suggest that when parents are unable to afford social activities with their children, like visiting a 'soft play' centre or holidays even a short distance away, they are additionally driven to compensate with family 'treats' taking the form of unhealthy food routines.

Examples of such routines identified in the study include family visits to fast-food outlets like the local 'chippy' (fish and chips shop), kebab shop, or (famously branded) burger restaurant, or even food related events at home such as family snacks time in front of a movie or board game.

The study involved 60 parents on low incomes as participants, recruited equally from deprived neighbourhoods across three regions of England: Great Yarmouth, Stoke-on-Trent and the London Borough of Lewisham. Participants were aged over 18, a parent of a child in school of nursey and the primary shopper in the family. Reflecting the highly gendered nature of food work, 56 participants were women.

All participants took part in semi-structured interviews relating to practices of purchasing, preparing and consuming foods in the family, and the roles of different family members, including children, in enacting those practices. Fifty-eight of the participants took part in a photo elicitation exercise over a week where they took photos of things that made it harder or easier for them to buy the food they wanted for their families. Twenty-two of the participants also took part in a 'shop-along' interview where they guided the interviewing researcher around the shops of their choice, and what they bought.

The data from these sources were coded in a 'thematic analysis' to identify key themes which informed the interpretation of the findings, summarised overall as:

• low-income families use many tools to navigate food environments and feed families within budget.
• food environments push families to unhealthy foods but support other aspects of wellbeing.
• food practices shape how families engage with food environments.
• Food environment interventions must also address the broader aspects of people's lives

Based on the findings, the study authors' policy recommendations include removing unhealthy food promotions and food service outlets from the food environment, whilst crucially replacing them with healthier promotions and outlets to retain the opportunities for social wellbeing these provide for families.

Further recommendations include increasing the number of affordable, family activities available in deprived, local communities; making existing activities more affordable, such as through the availability of discounts; and addressing the broader social need to lift families out of financial insecurity, such as through more extensive benefit schemes, living wage policies, and action on insecure work provision.

Professor Corinna Hawkes is the Principal Investigator of the study, and Director of the Centre for Food Policy at City, University of London. She said:

Given the wonderful food available in this country, it's a travesty how many people's health is damaged by poor quality diets. This study shows that the pathway forward involves understanding how people experience food in their everyday realities. Policy to address inequalities will only work if it recognises that food is more than just nutrition and must meet a wider range of people's needs, such as social and economic well-being.

The study is published online in the journal, Health & Place.

The authors undertook this study as part of the National Institute for Health Research (NIHR) Obesity Policy Research Unit that conducts independent research to inform government policy.