Drivers of Healthy Start uptake across England and Liverpool

Recent data in the UK reveal a concerning increase in food insecurity, affecting 25% of households with children in September 2022, up from 10% in January 2021. This surge has disproportionately impacted households with children and may affect their access to fresh fruits and vegetables, as many low-income families struggle to afford these nutritious options.
The Healthy Start (HS) program in England, offering financial assistance for the purchase of fruit, vegetables, and milk may be crucial for low-income families. However, its uptake remains relatively low. Lack of awareness of the programme and barriers to uptake have been identified. Feeding Liverpool conducted a pilot study in 2021 to understand the perspectives of HS beneficiaries, which suggested that families struggled to make applications.
In response to low HS uptake rates, many local authorities and local food alliances have made the promotion of HS a central pillar of their public health and food strategies. However, the extent to which these promotion strategies have had an impact remains unexamined. Potential disparities in uptake have not been explored either, and significant variations in uptake rates can exist within city regions. A more comprehensive understanding of the local factors contributing to these variations is crucial.
This project, in collaboration with Feeding Liverpool, seeks to investigate the drivers of HS uptake at the individual, area, and within-area levels. The methodology for this project takes a mixed methods approach, addressing four main research objectives:
1. Investigate household and individual factors associated with HS voucher receipt, including food insecurity, English as a Second Language (ESL), time constraints and disability.
2. Analyse area-level factors affecting HS uptake across England, such as local spending, retail accessibility, and policy strategies.
3. Examine ward-level uptake rates in Liverpool, linking quantitative data to qualitative case studies in selected areas.
4. Explore facilitators and barriers to HS uptake through interviews with stakeholders and potential beneficiaries.
The project's findings will be disseminated through three journal articles and a student-led report in collaboration with Feeding Liverpool. These insights are anticipated to inform local area strategies to promote the HS program, enabling them to target specific factors associated with lower uptake rates. This research will benefit not only Feeding Liverpool but also various local authorities focusing on HS uptake, with potential for wider dissemination through Feeding Liverpool's membership in the Feeding Britain network. Moreover, the project has the potential to enhance the quality of life for low-income families and their young children by facilitating better promotion and uptake of the HS program and improving access to nutritious foods.
In summary, this project addresses the pressing issue of rising food insecurity in the UK, with a specific focus on Healthy Start program uptake. Its comprehensive approach, combining quantitative and qualitative methods, has the potential to drive evidence-based strategies to improve the uptake of this programme.