Intended for healthcare professionals

Rapid response to:


Austerity, sanctions, and the rise of food banks in the UK

BMJ 2015; 350 doi: (Published 08 April 2015) Cite this as: BMJ 2015;350:h1775

Rapid Response:

Re: Austerity, sanctions, and the rise of food banks in the UK

Loopstra et al’s paper is an important analysis of the unacceptable phenomenon of acute hunger in modern Britain. 1 Emergency food aid is an extreme manifestation of food poverty. The rise in food prices, the rise in energy costs and the fall in real wages until last year has meant that perhaps 13 million people cannot afford a healthy nutritious diet. This is a much greater proportion of the UK population than before. For the poorest in our society, up to 35% of disposable income will now be needed for food, compared to less than 9% for the more wealthy. This will increase reliance on cheap, highly processed, high fat, high sugar, high salt, and calorie dense, unhealthy foods. 2 Re-emerging problems of poor public health nutrition such as rickets and malnutrition in the elderly are also causes for concern.3

The authors are also correct in saying that other factors such as food and energy price, levels of food poverty relative to real wages need to be look at it in the complex of factors leading to extreme food poverty and acute hunger. A national living wage policy is also urgently needed, or a minimum wage which reflects the real needs of people to benefit from a healthy diet, as we suggest in the Faculty’s manifesto, Start well, live better.4

We also agree with the authors that a national surveillance system for emergency food aid is needed. Furthermore, we believe that public health nutrition has been a neglected area for far too long. A much greater emphasis should be placed on surveillance of public health nutritional deficiencies and populations at risk of food poverty. A national food policy is needed. This should place a greater emphasis on healthy nutrition, restrict marketing of processed foods to children, and provide stronger regulatory and fiscal policies to discourage consumption of junk food and sugary drinks.

The work of Boyd-Orr 5 and Dugald Baird 6 showed how national food policy in the World Wars powerfully contributed to better public health outcomes, particularly for pregnant women and young children. It is time for us to relearn the lessons of history and not tolerate the presence of hunger and poor nutrition in British society.

John Ashton President UK Faculty of Public Health

John Middleton Vice President, UK Faculty of Public Health

Simon Capewell, Vice President elect, UK Faculty of Public Health

1. Loopstra R Reeves A, Taylor-Robinson D, Barr B, McKee M, Stuckler D. Austerity, sanctions, and the rise of food banks in the UK. BMJ 2015; 350:h1775
2. Ashton JR, Middleton J, Lang T. Open letter to Prime Minister David Cameron on food poverty in the UK. Lancet 2014; 383:1631
3. Middleton J why we should be concerned about Victorian diseases. Guardian healthcare online network, august 8th 2014. (accessed April 17th 2015)
4. Stewart L, Skinner L, Weiss M, Middleton J. Start well, live better a manifesto for the public’s health. J Public Health 2015; 37 no.1: 3-5. (accessed April 17th 2015)
5. Horton R. Economic austerity, food poverty, and health. Lancet 2014;383:1609.
DOI: (accessed April 17th 2015)
6. Baird D. Social and economic factors affecting the mother and child.
Am J Public Health 1952; 42: 516-520.

Competing interests: No competing interests

17 April 2015
John D Middleton
Vice president
John R Ashton, Simon Capewell
Faculty of Public Health
4 St Andrews Place