Levelling Up on Regional Dietary Inequalities: A Data Story

The Government’s agenda on levelling up has an overarching mission to address stark geographical inequalities, ensuring equal opportunity across the UK. 
The white paper sets out 12 missions to achieved this. Food has a critical role in several of these missions including:

• increasing pay, employment and productivity
• increasing educational achievement 
• raising healthy life expectancy
• improving well-being
• increasing “pride in place”

Here we explore the links between these missions and regional disparities in dietary inequalities, and why government’s future work on levelling up must recognise the vital importance of dietary inequalities, and take further action to improve local food environments and combat food insecurity levels to reduce existing regional inequality on diets.

Regional Inequalities in Health

One of the Government’s levelling up missions is to reduce the gap in life expectancy between local areas and increase average healthy life expectancy.

Michael Marmot’s Build Back Fairer report shows large inequalities in health and life expectancy across regions of the UK(1)

Healthy Life Expectancy in the North-East is 6 years less for men and 7 years less for women than in the South-East(2).

The Government-commissioned National Food Strategy found that diet is the leading cause of avoidable harm to our health(3).

Regional patterns in obesity levels for adults and children follow the same pattern - generally higher in the North than the South.

Adult(4) and child obesity(5) levels are one of the metrics being used to assess the mission on improving life expectancy

Another important marker of poor nutrition is short stature - an indicator of suboptimal development and growth.

Children aged 4-5 are more likely to have short stature in the North than the South(6).

The geographical variation in diet-related health that is seen here is likely to be the result of geographical variation in economic disparities and in local food environments.

Regional Inequalities in Living Standards

Regional economic inequalities are seen across England with lower average household incomes(7) in the South and more households reliant on social security(8) in the North (excluding London).

With the exception of London, the gap between the North and the South is also seen in poverty levels(9).

And food poverty levels(10)

The Levelling Up White Paper commits to boosting productivity, pay and jobs but does not commit to reducing food insecurity rates.

Food insecurity is an important measure of severe material deprivation. It contributes not only to health inequalities and healthy life expectancy, but also social wellbeing.

A comprehensive approach to levelling up would directly aim to tackle food insecurity. Reducing overall food insecurity levels (particularly tackling high levels in the North of the country) will be integral to achieving the levelling up white paper’s missions on health and life expectancy. Government should measure its success (or failure) using this measure.

In addition to tackling food insecurity by increasing incomes, a complementary approach is to strengthen nutritional safety nets for the most at risk groups. Eligibility for Government schemes providing a nutritional safety net to children from low-income families (such as Free School Meals(11) and Healthy Start(12)) are another area where we see geographical patterns.

Part of the ambition of levelling up is tackling gaps in educational achievement across the country. High quality Free School Meals are an essential part of ensuring that children eat well in school, aren’t too hungry to learn and maintain a healthy weight.

In addition, the white paper commits to expand monitoring of school food. Developing an effective accountability mechanism around school food, to include mandatory reporting and piloting of a quality assurance role for the Food Standards Agency, is essential to ensure that there is healthy food available at school to all children.

Regional Inequalities in Dietary Intake

We also see regional patterns in quality of diets mirroring income and health inequalities.

People on lower incomes have to rely on cheaper foods, which are often more energy dense and less nutritious(13).

In the north, on average people buy fewer healthy foods such as fruit and vegetables(14).

And more purchasing of less healthy foods like chips and pizza(15).

Regional Inequalities in Local Food Environments

Poorer diets in the North are likely contributed to by the higher proportion of food outlets that are fast food outlets than in the South(16).

Evidence shows that local environments can influence dietary behaviour(17). For example, higher numbers of takeaways in neighbourhoods is associated with higher weight(18).

Part of the Government’s levelling up agenda is to increase investment in towns and cities, improve “pride in place” and people’s satisfaction with their town centre and community.

Transforming high streets to create better communities to live in across all areas of the country should include enforcing stricter regulations on fast food outlet locations to transform areas with wall-to-wall takeaways that are not only damaging health but create undesirable places for people to be living.

We particularly need to protect children by enforcing restrictions on fast food around schools to also have the benefit of tackling child obesity.

There are currently policies which give potential for local planners to regulate takeaways but a number of barriers to implementing them(19). The High Streets Task Force needs to make it easier for local authorities to do this.

Levelling up is an opportunity for government to set out a clear agenda to tackle regional disparities in dietary health and food insecurity. 

Diet is the most important factor shaping health outcomes in the UK, and therefore, tackling regional dietary inequalities is essential if we are to reduce regional health inequalities.

Government need to pro-actively set out a plan to reduce food insecurity including: tackling income inequalities through increasing wages, benefit levels and nutritional safety nets, and setting targets to improve food insecurity. 

We also need to see government transform the places we live to create local environments that facilitate better health and better settings for people to live in, and promote local procurement to simultaneously boost the local economy and health. 

See here for The Food Foundation’s response to the White Paper on Levelling Up. 

See here for more on levelling up local food environments.