This review builds on issues raised in the themed section relating to household level food insecurity, and the food charity response specifically. It looks at key elements in the development of this body of work and at some of the evidence gaps which remain. In particular, it engages with literature on determinants of household food insecurity with relevance to social policy (for example sufficiency of income), and on research which has examined charitable food responses through the lens of food insecurity. The review is necessarily limited in scope and therefore does not cover other elements of household food insecurity and food charity, including research on nutrition or food skills, or work on food charity operation, food sourcing and reach, for example.
Conceptualisations of the problem of constrained access to food do vary (as discussed in this article), but this review utilises the concept of ‘food insecurity’ to refer to the inability to access an adequate, healthy diet via socially acceptable means, or the uncertainty that one will be able to do so (see Anderson, Reference Anderson1990: 1560). The first part of the review outlines how issues of food insecurity and food charity have emerged in academic writing and some of the key findings of this evidence base, notably around, firstly, the structural determinants of food insecurity, and, secondly, the drivers of food charity use, and the potential impact of food charity on food insecurity. Following this, two key gaps in the evidence base are discussed: the lack of internationally accepted conceptual agreement on the issues under study (looking particularly at the utility of the concept of ‘household food insecurity’); and the lack of systematic measurement (of food insecurity and food charity usage). These are urgent issues to resolve, given the ways in which they preclude comparative social policy analysis.
The development and scope of food insecurity and food charity literature in the global North
There is a long history of academics (and of course activists and civil society organisations) working both on food and inequalities and on the relationship between low income and food outcomes (see, for instance, Boyd Orr, Reference Boyd Orr1936; Köhler et al., Reference Köhler, Feichtinger, Barlösius and Dowler1997; Dowler and Tansey, Reference Dowler, Tansey, Mosley and Dowler2003; among many). Some of the literature has emerged from social policy and some from those working within the framing of the structural determinants of inequalities in health (see, for instance, James et al., Reference James, Nelson, Ralph and Leather1997). It has also long been recognised that food patterns, nutrient intakes and body size outcomes vary by social and economic conditions, such that those who are better off are more likely to eat more healthily than those who are poorer, although the size of class differences varies by country (and indicator) (Roos and Prättälä, Reference Roos and Prättälä1999; Dowler, Reference Dowler2001; Crotty and Germov, Reference Crotty, Germov, Germov and Williams2004). The relationship with household level poverty (variously defined) and potential policy response has a less strong research history (with Department of Health, 1996; Köhler et al., Reference Köhler, Feichtinger, Barlösius and Dowler1997; Riches, Reference Riches1997, being notable exceptions).
Among the range of long-standing research on food insecurity in North America is work that has used the framing of loss of rights and entitlements in relation to food and social policy in their own countries (Poppendieck, Reference Poppendieck1994; Tarasuk and Davies, Reference Tarasuk and Davis1996; Riches, Reference Riches1997). This framing, and the challenge it poses to the growing assumptions about food charity as an appropriate response to household level food insecurity, have emerged more widely, as growing numbers are seeking such help (for example, Kjaernes, Reference Kjaernes, Köhler, Feichtinger, Barlösius and Dowler1997; Dowler and O’Connor, Reference Dowler and O’Connor2012). This is notwithstanding the recognition that many who had recourse to charitable food in the latter decades of the twentieth century were those who might be characterised as being in ‘special circumstances’, such as the ‘homeless’, refugees or those whose social security entitlements had been exhausted (Dehavenon, Reference Dehavenon, Köhler, Feichtinger, Barlösius and Dowler1997; Evans, Reference Evans, Köhler, Feichtinger, Barlösius and Dowler1997; Jordan and Kutsch, Reference Jordan, Kutsch, Köhler, Feichtinger, Barlösius and Dowler1997).
What has changed in the last seven to eight years is, as discussed in the Introduction and the individual articles in this themed section, the combination of policies of economic austerity and parallel rising food and fuel prices. These and other conditions have led to increasing numbers seeking charitable help, or reporting considerably worsening household food insecurity. In some countries, including Germany and the UK, specific government policies to reduce public expenditure by reshaping or cutting levels of, and entitlements to, social security have played an important part (see Pfeiffer et al., Reference Pfeiffer, Ritter and Hirseland2011; Dowler and Lambie-Mumford, Reference Dowler and Lambie-Mumford2015). This in turn seems to have triggered a much more organised and systematic charitable effort (Castetbon et al., Reference Castetbon, Me´ Jean, Deschamps, Bellin-Lestienne, Oleko, Darmon and Hercberg2011; Perez de Armino, Reference Pérez de Armiño, Riches and Silvasti2014; Silvasti, Reference Silvasti2015) in the absence of clear responses from governments at national and local levels.
Research on experiences of household food insecurity in the global North has addressed both its determinants and the ways in which individuals and households have attempted to cope with constrained food experiences. We here focus on research discussing food insecurity determinants of particular relevance to social policy analysis, notably the roles played by income, economic security and costs of living. By highlighting the impact of low and insecure incomes, high housing costs and reliance on social assistance, research shows how experiences of food insecurity are shaped by economic and policy determinants of household economic security and living costs (De Marco and Thorburn, Reference De Marco and Thorburn2009; Coleman-Jensen, Reference Coleman-Jensen2011; Kirkpatrick and Tarasuk, Reference Kirkpatrick and Tarasuk2011). The evidence presented in this themed section, and other recent research (Riches and Silvasti, Reference Riches and Silvasti2014), suggests that these economic and policy determinants may now be having more severe impacts at the household and individual level which are increasingly difficult to sustain. It is important to note, however, that it is difficult to be more precise about the relationship between macroeconomic conditions and social policies in different countries and the determinants of food insecurity because, outwith North American countries, there are few systematic indicators at the household level, which critically inhibits the ability to undertake cross-area comparative studies.
With a similar breadth to the food insecurity literature, the research on food charity covers a range of aspects of the provision of charitable food relief and the experiences of recipients. Research on food charity falls into a number of key categories including: the nutritional adequacy of food bank provision; human rights and the ethics of food charity; the operation, food sourcing and reach of food charity; the characteristics of food charity users; and the ability of food charity to address food insecurity. This part of the review focusses on the latter two categories in particular. North American research has observed how the proliferation of food charity took place in the 1980s during a ‘deep’ recession, when there were marked increases in unemployment and increasingly inadequate social security provisions (Tarasuk and Davis, Reference Tarasuk and Davis1996; Poppendieck, Reference Poppendieck1998; Riches, Reference Riches2002). More recent writing on the growth of such charitable responses and their increasing institutionalisation within European contexts, particularly in response to austerity, recession and shifting state welfare provision, indicates that there could be a similar story emerging of food charity in Europe, but comparative social policy analyses are hindered by the aforementioned lack of systematic food insecurity and food charity monitoring (Pffeifer et al., Reference Pfeiffer, Ritter and Hirseland2011; Silvasti and Karjalainen, Reference Silvasti, Karjalainen, Riches and Silvasti2014; Lambie-Mumford et al., Reference Lambie-Mumford, Crossley, Jensen, Verbeke and Dowler2014; Perez de Armino, Reference Pérez de Armiño, Riches and Silvasti2014).
Countries which have adopted a system for measuring household level food security on a consistent basis (largely Canada and the USA, although other countries, such as Brazil (Hackett et al., Reference Hackett, Melgar-QuiÑonez, Pe´rez-Escamilla and Segall-Correˆa2008), have also started using the same metrics) produce annual analyses of the numbers and conditions of such households, and offer an opportunity for in-depth research on practices used by household members to try and mitigate negative circumstances (see, for example, Coleman-Jensen et al., Reference Coleman-Jensen, Gregory and Singh2014b). Such practices include seeking out additional help, such as emergency food aid. The evidence which has emerged from investigations into the intersections between food insecurity and food charity use is that households which are more food insecure are, as might be supposed, those which are also more likely to seek out additional, external help, such as emergency food aid, and, indeed, that the likelihood of food charity usage increases with severity of food insecurity (Bhattatai et al., Reference Bhattarai, Duffy and Raymond2005; Loopstra and Tarasuk, Reference Loopstra and Tarasuk2012). It is also clear from this research that households in Canada and the USA, as elsewhere, employ a multiple range of strategies for trying to manage limitations to their food access. For example, people draw on social networks to borrow money or food, they eat less varied diets or they stagger the payment of bills so as to release money for food, among many other resourceful practices (Aluwalia et al., Reference Ahluwalia, Dodds and Baligh1998; Nnakwe, Reference Nnakwe2008). Indeed, asking for emergency food aid from a food charity is both a strategy of last resort for individuals and households (Aluwalia et al., Reference Ahluwalia, Dodds and Baligh1998; Loopstra and Tarasuk, Reference Loopstra and Tarasuk2012), and often only one of many strategies employed. Furthermore, the evidence also suggests that when households do turn to charitable food assistance, they are also likely to be drawing on multiple forms of food and other welfare support, where they exist (Berner and O’Brien, Reference Berner and O’Brien2004).
Nevertheless, it is important to emphasise that the literature also shows that, even in countries such as the USA and Canada, where food charity systems are widely established and extensive, uptake amongst food insecure households is still relatively low. Yu and colleagues (Reference Yu, Nebbitt and Von2010), for instance, showed that, in the USA, only around one in five food insecure households sought and received ‘informal food support’; these findings are echoed by Loopstra and Tarasuk (Reference Loopstra and Tarasuk2012) who showed that, in a survey of 371 low income families in Toronto, 75 per cent were judged food insecure, yet only 23 per cent had used a food bank. These and other authors document a range of reasons given to them as to why people do not take up food charity provision; these included a lack of access or insufficient information, different perceptions of food aid (who is it for and what it will provide) or household need (feeling that one was not in extreme need), and negative emotional experiences of indignity and stress (Ahluwalia et al., Reference Ahluwalia, Dodds and Baligh1998; Engler-Stringer and Berenbaum, Reference Engler-Stringer and Berenbaum2007; Loopstra and Tarasuk, Reference Loopstra and Tarasuk2012). Ultimately, however, even when food charity is accessed, research highlights that this provision cannot address the underlying causes of household food insecurity and thus has a limited impact on overall household food security status (see Poppendieck, Reference Poppendieck1994; Riches, Reference Riches2002; Yu et al., Reference Yu, Nebbitt and Von2010; Loopstra and Tarasuk, Reference Loopstra and Tarasuk2012).
Key challenges faced by the food insecurity and food charity literature
Many researchers in Europe, in particular, are looking to examine issues of household food insecurity, and to examine the roles and functions of charitable food systems. However, there are two key challenges which need to be addressed in the first instance. The first is the lack of internationally consistent conceptualisations of both the food insecurity problem and food charity response. And the second is a lack of consistent and comparable systematic measurement. These are both particularly important for social policy research as they currently form significant barriers to comparative social policy analysis and the identification of effective social policy responses.
Challenge 1: The lack of internationally consistent conceptualisations
Despite there being an internationally recognised concept and definition of household and individual food insecurity (FAO, 2006), the body of literature under consideration here includes varying conceptualisations and definitions of the problem of constrained food access. The concept of food insecurity at the household level is widely employed, and particularly used in domestic research in the USA and Canada (see Tarasuk, Reference Tarasuk2001; Daponte et al., Reference Daponte, Osborne, Haviland and Kadane2004; Coleman-Jensen et al., Reference Coleman-Jensen, Gregory and Singh2014a), following validation of quantitative indicators derived from qualitative work with low income mothers (Radimer et al., Reference Radimer, Olsen and Campbell1990). However in the UK, for example, the term ‘food poverty’ has quite wide purchase and seems to be intuitively understood (note there are at least two funded research projects addressing the need for formal definition and indicators at the time of writing; see also GLA, 2013). Having said this, a national survey of food and nutritional conditions in households living in multiple deprivation (Nelson et al., Reference Nelson, Ehrens, Bates, Church and Boshier2007), funded by the Food Standards Agency, employed a modified version of the US household food security index, and Defra has also funded research exploring the general public's understanding of ‘household food security’ (they were unfamiliar with the term, but understood the principles very well) (Dowler et al., Reference Dowler, Kneafsey, Lambie, Inman and Collier2011; Kneafsey et al., Reference Kneafsey, Dowler, Lambie-Mumford, Inman and Collier2013). It is also the case that some authors use the terminology of household food insecurity synonymously with ‘food poverty’ (for example, Dowler and O’Connor, Reference Dowler and O’Connor2012). In another example, Feichtinger (Reference Feichtinger, Köhler, Feichtinger, Barlösius and Dowler1997) and Pfeiffer et al. (Reference Pfeiffer, Ritter and Hirseland2011 and Reference Pfeiffer, Ritter and Oestreicher2015) have, in Germany, elaborated a concept of ‘alimentary participation’, which particularly emphasises the importance of the social function of food.
In the context of the growth of food charity, indications that food insecurity is worsening, and the high profile of the issue in policy and research circles, it is even more imperative that common conceptualisations and working definitions are agreed on a cross-country basis so that the experiences can be understood and, as will be discussed next, the concept operationalised. This may need to involve not just wider acceptance of an established conceptualisation (such as that of food security offered below), but also further theorising and developmental conceptualisation to ensure the effectiveness and adequacy of agreed-upon concepts.
Food insecurity at global, national, local and household levels has been the subject of considerable international research and discussion for several decades; there are numerous definitions which emphasise different elements, but there is broad agreement over the general concept, which is promoted by key international organisations, particularly the FAO (2006). More recent formulations by the WHO include nutritional wellbeing and the idea of ‘nutrition security’ (to emphasise quality as well as quantity of food) (Gross et al., Reference Gross, Schoeneberger, Pfeifer and Preuss2000). A particular focus in the operationalisation of the food insecurity concept by the US Department of Agriculture and Health Canada also emphasises a spectrum of vulnerability (mild, moderate and severe). One consequence is that such a conceptualisation firmly moves away from notions of ‘food crises’ at household levels, which have to some extent begun to emerge in Europe in recent years, for which usage of food charity has been adopted in some countries as a shorthand indicator for capturing or understanding household experiences.
As an example of a useful definition of household food security, that offered by Anderson (Reference Anderson1990: 1560) emphasises the importance of food for health, social participation and social justice:
access by all people at all times to enough food for an active, healthy life and includes at a minimum: a) the ready availability of nutritionally adequate and safe foods, and b) the assured ability to acquire acceptable foods in socially acceptable ways (e.g., without resorting to emergency food supplies, scavenging, stealing, and other coping strategies). Food insecurity exists whenever the availability of nutritionally adequate and safe foods or the ability to acquire acceptable foods in socially acceptable ways is limited or uncertain.
There are also conflicting understandings of food charity terminology. The conceptualisation of charitable emergency food provision itself is widely understood to refer to charitable initiatives which work in some way to provide food for people who are struggling to obtain enough food in the usual ways, and often conceptualised in an immediate and urgent sense, that is as ‘emergency’ provision (Poppendieck, Reference Poppendieck1994; Tarasuk, Reference Tarasuk2001; Lambie-Mumford et al., Reference Lambie-Mumford, Crossley, Jensen, Verbeke and Dowler2014). Importantly, this provision is distinct from formal state social protection or state-provided food welfare. Yet the terminology used to label particular types of projects within the charitable emergency food category may vary in different countries, as well as within countries. A good example of this is the idea of a ‘food bank’. Sometimes (but not always) in the US the term ‘food bank’ is used to refer to warehouses or centres which collect, store and redistribute food to charitable organisations who then pass on the food directly to beneficiaries (Berner and O’Brien, Reference Berner and O’Brien2004; Costello, Reference Costello2007). In this model, food banks effectively work as ‘middle men’, collecting and redistributing food, but they are not themselves recipient-facing. The food is distributed to charitable organisations which can be either ‘emergency’ food programmes or ‘non-emergency’ programmes (Mabli et al., Reference Mabli, Cohen, Potter and Zhao2010). Emergency providers include food pantries, soup kitchens and emergency shelters (Berner and O’Brien, Reference Berner and O’Brien2004; Mabli et al., Reference Mabli, Cohen, Potter and Zhao2010). This idea of a food bank is also found in many European countries (Perez de Armino, Reference Pérez de Armiño, Riches and Silvasti2014: 136). An exception is the UK, where a food bank is commonly understood to be a community project which provides parcels of food for people to take away, prepare and eat; so it is a direct provider (Lambie-Mumford, Reference Lambie-Mumford2013; Lambie-Mumford and Dowler, Reference Lambie-Mumford and Dowler2014). However, as in the United States, there are variations in how individual projects identify themselves; for example, the ‘Oxford Food Bank’Footnote 1 redistributes surplus food to local charities. In Canada, the food bank model also varies, and can include initiatives which give food to people directly (see Riches, Reference Riches2002; Tarasuk and Eakin, Reference Tarasuk and Eakin2003). This differing terminology, including within counties not just across them, is important to acknowledge, particularly for comparative social policy researchers, given the differences in various aspects, including the type of food provided and the scales at which projects work and their interaction (or lack thereof) with people in need. It is a particularly important issue to address, as, increasingly, comparisons are drawn cross-nationally without necessary regard for the differences which remain hidden between the provision under study (see, for example, Forsey, Reference Forsey2014).
Challenge 2: The lack of measurement
The second challenge that this research area faces is the lack of consistent, systematic measurement of food insecurity at the household level in different country contexts. Whilst in Canada and the USA household food insecurity is measured routinely (Coleman-Jensen et al., Reference Coleman-Jensen, Gregory and Singh2014a; Health Canada, n.d.), in other countries no formal monitoring is done, and where data may be available, they are cross sectional (for example, Holmes, Reference Holmes, Nelson, Erens, Bates, Church and Boshier2007, in the UK). Given the amount of research that has emerged across Europe over the last ten years in particular, which has highlighted the issues of food insecurity and, most recently, the impacts of austerity on different households’ abilities to access food, measurement is urgently required.
Specifically, what could be explored is the utility of more detailed survey modules, as used by the USDA and Health Canada, which provide insight into experiences of food insecurity. Currently there are a small number of food-related deprivation survey questions available to European countries and other countries which do not systematically measure food insecurity specifically; for example in EU statistics on income and living conditions (EU-SILC) and data collected by the OECD (Eurostat, 2014; OECD, 2014). These survey questions could be examined in relation to their utility for insights on food insecurity specifically, and if appropriate, the possibilities for strengthening or expanding their validity and applicability in this area could be explored. The lack of consistent systematic measurement is problematic because without it, it is impossible to get a reliable and representative measure of the extent and drivers of food insecurity across countries, or to understand similarities of experience, which precludes robust international comparative social policy analysis of food insecurity drivers, levels and possible interventions.
It is also worth mentioning that there is a lack of systematic data on charitable food systems, both their structures and practices, and how they are used, by whom, how often and under what conditions. The literature, particularly that which relates to the European experience, tends to use data collected by charities or churches themselves on provision, rather than more systematic data on overall food charity uptake and its drivers (see Pfeiffer et al., Reference Pfeiffer, Ritter and Hirseland2011; Lambie-Mumford et al., Reference Lambie-Mumford, Crossley, Jensen, Verbeke and Dowler2014; Perez de Armino, Reference Pérez de Armiño, Riches and Silvasti2014). These more informal data systems have usually been set up by the charities or church networks to monitor uptake and performance; they are not intended to provide systematic information for national or local social policy analysis. There are differences in the reliability of information collected, its breadth, depth of detail and interpretation (for instance, of recipient reasons for presentation), and in the training of those who complete and assimilate information from frontline forms.
Food insecurity surveys which also capture food charity use (see for Loopstra & Tarasuk Reference Loopstra and Tarasuk2012) could provide an important way forward for monitoring. This would provide a systematic, direct approach to measurement, as opposed to going through charities, and by not just sampling those who access food charity, these surveys also enable examinations of potential drivers of non-uptake, the food insecurity levels of those seeking charitable support and captures those attending projects which may not collect or report their own data on recipients.
Reflection
This review set out to convey the vibrant and evolving literature in the areas of food insecurity and food charity and this themed section provides another important step forward in its development, particularly for international social policy research. However, researchers looking to the next set of questions in this area need to be mindful of the two key challenges that this body of literature faces: the lack of agreed definition and conceptualisation; and the lack of systematic measurement in many countries. Particular urgency lies in establishing these for food insecurity in order to avoid an over-emphasis on the data provided by, or through, food charities which will not capture the wider food insecurity problem and determining factors in the population as a whole (Loopstra and Tarasuk, Reference Loopstra and Tarasuk2015). These two issues need to be addressed, so that we can get comparable international data on the drivers of food insecurity and food charity use and the social policy interventions most likely to succeed in ensuring food security for all.
