Is the Healthy Start scheme associated with increased food expenditure in low-income families with young children in the United Kingdom?

Abstract

Introduction: Healthy Start is a food assistance programme in the United Kingdom (UK) which aims to enable low-income families on welfare benefits to access a healthier diet through the provision of food vouchers. Healthy Start was launched in 2006 but remains under-evaluated. This study aims to determine whether participation in the Healthy Start scheme is associated with differences in food expenditure in a nationally representative sample of households in the UK. Methods: Cross-sectional analyses of the Living Costs and Food Survey dataset (2010-2017). All households with a child (0-3 years) or pregnant woman were included in the analysis (n=4,869). Multivariable quantile regression compared the expenditure and quantity of fruit and vegetables (FV), infant formula and total food purchases. Four exposure groups were defined based on eligibility, participation and income (Healthy Start Participating, Eligible Non-participating, Nearly Eligible low-income and Ineligible high-income households). Results: Of 876 eligible households, 54% participated in Healthy Start. No significant differences were found in FV or total food purchases between participating and eligible non-participating households, but infant formula purchases were lower in Healthy Start participating households. Ineligible higher-income households had higher purchases of FV. Conclusion: This study did not find evidence of an association between Healthy Start participation and FV expenditure. Moreover, inequalities in FV purchasing persist in the UK. Higher participation and increased voucher value may be needed to improve programme performance and counteract the harmful effects of poverty on diet.

An exploration of the statutory Healthy Start vitamin supplementation scheme in North West England

“…While the food voucher works better than a cashequivalent benefit [9,41], and its subversion [42] is probably uncommon [43], its monetary value has progressively lagged food costs [12,25]. From April 2021, the weekly food voucher increased from £3.10p (since 2009) to £4.25p (matching Scotland) [44].…”

“…The food vouchers may have improved maternal nutrition more than Welfare Foods [7][8][9]. They may well promote fruit and vegetable consumption [10,11] although evidence is conflicting [12]. Additional 'vitamin vouchers' were exchanged for Government-commissioned children's drops (6-48 months: vitamins A, C, D) and pregnant and lactating women's tablets (folic acid; vitamins C, D).…”

An exploration of the statutory Healthy Start vitamin supplementation scheme in North West England

“…While the food voucher works better than a cash-equivalent bene t 9, , and its subversion is probably uncommon, its monetary value has progressively lagged food costs 12,25 . From April 2021, the weekly food voucher increased from £3.10p (since 2009) to £4.25p (matching Scotland).…”

Maternal and Child Health Network Policy Briefing 1: Welfare Grants in Pregnancy and Early Childhood

“…Improving the material circumstances of parents and in particular mothers, is key to improving child and maternal health. • Existing evidence suggests that welfare grants provided during pregnancy and early childhood are important for child and maternal health outcomes [2][3][4]. • Increasing household income positively affects children's social-behavioural development and their health, as well as improving maternal mental health, parenting and the home environment [5], especially for low-income households.…”