In this Dispatches post, Centre Director, Professor Corinna Hawkes, reflects on the recent City Food Symposium and the importance of citizen-generated evidence.
You can find the slides of her opening presentation here.

 

The first project I ever did on food policy – 20 years ago now – was on food poverty in the UK. Since then, food banks have become institutionialised as the prevalence of food insecurity has risen. I then moved onto international work, focusing on the prevention of obesity and diet-related non-communicable diseases. In that time, both have also inexorably risen around the world.

So it is on a daily basis that I ask myself: why are we not managing to effect more change? It is easy to point fingers – and we should, sometimes at ourselves. Governments are not taking a hard enough line; food companies are hedging their bets; advocacy by NGOs is too weak; academics are working in silos. All of these things are true. But there is another aspect that has been troubling me for some time: that collectively, we are not doing enough to understand how people – citizens, communities – are experiencing the problems we are seeking to address. And this means that even when actions are being taken – and there is a lot of action being taken – we are not taking into account how people will respond to them. This means we are missing opportunities to design them better.  A simple example comes from Hugh Fearnley-Whittingstall’s TV programme last week. Hugh, with the best of intentions, drove into a deprived neighourhood in Newcastle, UK, with a fruit and veg van. Did people come? Well, yes, some did, but most did not. He realised he was going to have to understand the community better before cooking up solutions from the outside and parachuting in (it was to his credit that he realised this).

I have been sharing these concerns for a while now. Some have brushed them away, saying that the real problem is the systems that create food-related challenges. I agree. My point is that in designing solutions, we cannot ignore the fact that people are not separate from the systems that shape their everyday lives. And people respond to their circumstances – and the policies and actions designed to change them – in ways which are difficult for an external “expert” fully to understand. People, in other words, have evidence that emanates from their “lived experience”. This is knowledge that is impossible to obtain only from the outside. People’s experiences do reflect many things that outsiders can count – how much a farmer is paid for their crop, how many fast food stores there are, how much income someone has. But how people – and that means us all – respond to problems also reflects our feelings and human frailty. Feelings around identity, powerlessness, anger, shame, prejudice, vulnerability, exclusion, desire, hopefulness may not be “rational” but are a human reality that influence how we respond to our circumstances – and are shaped by them. Obtaining evidence of this “lived experience” is thus a starting point for exploring systemic issues that lie beneath people’s perspective on their own realities.

In the first instance, this simply means listening to people about their experiences. In the second, it means involving people in co-designing solutions and having a voice in demanding change. In the third, it means doing something with this – making sure what is learned feeds into what actions are taken, and how they are designed and implemented.

On April 25 2018, the Centre for Food Policy hosted our annual City Food Symposium dedicated to this topic. It explored how we can gather evidence of lived experience and how we can translate it into more effective and equitable action. It brought together people who are way ahead of me in their understanding of these issues. For there are indeed many in advocacy, policy and research who have been grappling with these issues for a good while, and even more who are coming into it. We welcomed Cristina Perez Parsons to talk about the NCD Alliance’s Our Views Our Voices global advocacy programme, and Alejandro Guarin and Natalie Lartey on what the International Institute for Environment and Development, Hivos and their Ugandan partner are learning from people’s experiences of their own diets in Western Uganda. We heard from Francesca Sanders from the UK’s Food for Life programme about their user-centred approach to designing food services for older people, and from Professor Wendy Wills about what she learned from listening to teenagers about their experience of school lunch. We heard from Elise Wach about an Institute of Development Studies project on transitions to agroecology with farmer participation in rural areas of Africa and Latin America, and from Anna-Maria Volkmann about what the Cities Changing Diabetes programme is learning about the factors that lie beneath food-diabetes in Houston, Mexico City, Johannesburg and Vancouver. Matthew Thomson of the Cornwall Food Foundation talked to us about the value of drawing on stories of people who experience food poverty, and Tianna Gaines-Turner and Sherita Mouzon shared with us how the Witness to Hunger programme in Philadelphia had given them a voice in talking about what hunger had done to them. Alexandra Wanjiku Kelbert shared with us the difference listening to people who had experienced food price volatility in a range of low/middle income countries had made in how they understood its effects – and Janette Lowe from rural Victoria, Australia, on how involving the local community in designing solutions to obesity has led to greater action to effect change (and declines in obesity). And we heard from national governments too – the work the Canadians are doing to consult their communities as they develop a Food Policy for Canada, and the work the UK Food Standards Agency are doing to understand trust in the food system.

There is a lot of exciting work going on. These talks  –  and the afternoon workshops hosted by The Leadership Centre, Shift Design, Nourish Scotland, the RSA Food, Farming and Countryside Commission,  Food Power, the Healthy Hoods project, and the Food Standards Agency – produced a lot of learnings for moving forward. These learnings will be captured in our report from the Symposium.

 

 

One message came through loud and clear: reality is messy and food policy needs to accept that reality. And, as highlighted by my colleague Claire Marris in her reflections on the day, reality can be uncomfortable. When we are listening, then, judgment needs to leave the room.

But hard as it is, engaging with lived experience emerged as not a “nice to” but a “need to.” It’s not the fluffy stuff we do on the side while the big guys get on with the important things. It may have a touch of touchy-feely about it, but at its heart, it is a very pragmatic agenda. Thus I very much welcomed Bill Vorley’s closing remarks –  that one of our first jobs is to change the view that citizen-generated evidence (the subject of an excellent IIED report released on the day of the Symposium) is not worthy of attention by the policy community. It is. Let’s embrace real life to drive forward real change.

 

 

This month we are sharing a guest post from Nicholas Freudenberg,  Distinguished Professor of Public Health at the City University of New York School of Public Health and Director of the CUNY Urban Food Policy Institute. 

 

For more than a century, New York City has used the authority of municipal government to make healthy food, that most basic of human needs, more available for all city residents. In the last decade, the city’s Mayors and City Council have launched dozens of new initiatives to prevent diet-related diseases, reduce food insecurity and create a more sustainable urban food system.   In a new report from the City University of New York Urban Food Policy Institute, my colleagues and I ask what New York has accomplished in food policy in the last decade and analyze the lessons for urban food policy in the coming decade.

Our report Food Policy in New York City Since 2008: Lessons for the Next Decade is based on our analyses of four sources:  20 major reports on food policy prepared by New York City and State public officials between 2008 and 2017;  six annual Food Metrics Reports produced by the Mayor’s Office of Food Policy between 2012 and 2017; a review of evidence on implementation and impact of 40 major city and state food policies from the last decade; and  an examination  of 10-year city  trends on key health and social outcomes including fruit and vegetable and sugary beverage consumption, rates of obesity and overweight, diagnoses of diabetes, and the number of food insecure individuals.

We found that the food policies of the last decade sought to achieve six goals: (1) improve nutritional well-being; (2) promote food security; (3) create food systems that support economic and community development; (4) ensure sustainable food systems; (5) protect food workers; and (6) strengthen food governance and food democracy. Our review identified policy successes and disappointments.

Food Policy Successes

Perhaps the most impressive accomplishment is that food policy is now squarely on the municipal agenda.  Two Mayors and City Councils have launched new food policies, created and expanded the Mayor’s Office of Food Policy, and included food goals in major strategic plans for the city. Although there are some differences in emphasis over the years, we noted the consistency of food policy and the commitment to making it an intersectoral priority.

Second, over the decade city government and civil society groups have acted to enhance the power of municipal government to improve local food environments.  Since 2008, New York City has improved the city’s institutional food programs through which 11 city agencies serve about 240 million meals and snacks a year.  The city has simplified enrollment and expanded outreach for the Supplemental Nutrition Assistance Program(SNAP), a public food assistance program that in 2017 provided food benefits for 1.7 million food insecure New Yorkers.  The city has supported dozens of new farmers markets, subsidized grocery stores in under-served neighborhoods, and made fruits and vegetables more available. This emerging public sector in food has the potential to serve as an alternative and catalyst for change to the private sector, which still prospers by making unhealthy food cheap and ubiquitous.

Obstacles to a Healthier Food System

These successes are tempered by significant shortcomings.  New York City still lacks a coherent comprehensive food plan with specific measurable goals.  In the 20 public reports we reviewed, elected officials made 420 specific recommendations for improvements in food policy, far too many for anyone to monitor.

While advocates are campaigning vigorously to make progress on each of the six food policy goals, their work is usually siloed.  Neither leaders nor a policy agenda that speaks for the millions of New Yorkers most harmed by our current inequitable food system has emerged.  Despite new governance mechanisms that improve coordination on food policy among city agencies, most New Yorkers still lack any voice in shaping their local food environment, a gap that leaves many policy decisions in the hands of real estate developers, supermarket companies or fast food chains.

Of greatest concern, critical health and social outcomes have barely budged in the last decade and the class and racial/ethnic gaps have persisted.  While soda consumption has declined among adults, fruit and vegetable consumption has not increased.  Modest declines in food insecurity are probably the result of improvement in the local economy.  As in 2007, about 55% of New York City adults are overweight or obese and the prevalence of diabetes has increased slightly.  These findings suggest that if we simply keep on doing what we’re doing, New York’s most serious food problems will persist.

Recommendations

To avoid this fate, we recommend five actions:

1. With multi-sector participation, create a New York City Food Plan that charts 5 to 10-year food policy goals.
2. Identify key outcomes and metrics for these goals that can be used to monitor the food plan.
3. Focus New York City food policies and programs more explicitly on reducing socioeconomic and racial inequities in food outcomes.
4. Strengthen New York City’s public sector in food to better achieve food policy goals.
5. Create new democratic and governance processes that offer New Yorkers a greater voice in shaping their food environments.

With these steps, New York City can translate the new attention on municipal food policy into measurable improvements in the well-being of its residents.  Read the full report here.

Nicholas Freudenberg is Distinguished Professor of Public Health at the City University of New York School of Public Health and Director of the CUNY Urban Food Policy Institute.  Co-authors of the report are Nevin Cohen, Jan Poppendieck and Craig Willingham.