Overview

Hounslow is a diverse London borough, with 188 spoken languages, a large south Asian population and one of the largest asylum seeker populations in London. Significantly almost 25% of jobs held by residents are “low paid”, with few Living Wage employers, and generally poor Public Transport Accessibility Levels. Hounslow suffers from high poverty rates, diabetes prevalence and poor oral health.

The London Borough of Hounslow (LBH), in particular Equality, Diversity & Inclusion (EDI) and Public Health teams have been using mapping and evidence to prioritise and drive effective change, including pioneering use of NHS England CORE20PLUS5 Framework to understand health inequalities in the 20% most deprived neighbourhoods, and underserved “PLUS” groups.

As part of the COVID19 response, LBH set up a Food Network and Food Action Plan (2021), and commissioned the Centre for Food Policy (CFP) to investigate the Cost-of-Living crisis through the “Feeding Our Families London Study” (2023).

Ambition: LBH’s Public Health department’s aim is to develop Hounslow’s first cross-cutting Food Strategy. They commissioned CFP to adopt a whole-systems, people-centred approach. Through embedding food across council priorities and streamlining policy coherence, whilst centring lived experience, the food strategy aims to address the systemic causes of poor food access.

Key actors

• London Borough of Hounslow’s Health Improvement Team led by Buvana Ailoo

• Liza Ctori, LBH’s key point of contact for CFP

• Food Network Coordinator and Third Sector Manager

• Dr Christopher Yap, Senior Research Fellow, Centre for Food Policy (CFP) 

• Chesta Tiwari, Research Assistant, led on stakeholder engagement, Centre for Food Policy

• Diverse communities engaged including Somali community member, refugees and asylum seekers, SEND adults & VCSE organisations 

• Council representatives from across different teams who we brought into a workshop alongside residents and VCSE organisations to co-create the Theory Of Change)

Alignment with the EAT-Lancet Commission 

By strengthening the voice of diverse consumers across Hounslow, we found:

• Culturally appropriate nutritional advice is key: authentic resources highlighting culturally-appropriate “swaps” and portion sizes for a healthier diet meet a gap in mainstream information (and misinformation).

• Unhealthy urban food environments require a whole-systems approach: the high prevalence of fast-food outlets on high streets was named as a contributing factor in the low amount of fruit and vegetables eaten.

• Hounslow’s Healthier Retail actions help to improve options within walking distance in otherwise “food deserts”, complimented by CFP recommendations to include health signposting information in these shops to help Make Every Contact Count.

Progress:

• Built a new trusted connection between public health and a key underserved refugee community, resulting in a community health champion, and regular access to health screening and dietary ill-health prevention services for the community.

• Identified a nutrition champion within an underserved refugee community to increase uptake of healthy diets in a culturally appropriate way.

• Identified & engaged 5 council green champions to act as a cross-council mechanism to help embed food across all strategies.

Lessons Learned

Conducting the enquiry with a focus on delivery over research outputs was key: this quickened the speed of trust in relationship building. Through prioritising meeting people where they were, using creative mixed methods approach including snowball sampling, multilingualism and avoiding recording; the researcher gained deeper understanding of the systemic issues from socio-economically vulnerable communities and residents in historically under-served areas.

Centering lived experience and eliciting proposals for improvements in an accessible way provided valuable insights to improve long-term policy outcomes.

Next steps

• Develop stronger links with Planning, Regeneration and Economic Growth teams for healthier food environments. Use improved connections to streamline and tailor communications about council services for different demographics, including youth, residents with Special Educational Needs and residents without English as their first language

• Quantify positive outcomes to demonstrate evidence for increasing funding and service provision where feasible. Co-develop Theory of Change to identify metrics for tracking success and ensuring progress.

• Develop a cross-cutting governance mechanism,  including dedicated resource and defined responsibility, to ensure accountability for food-related priorities.

• Build on non-profit sector skills and resilience, facilitating community participation in strategy implementation

For more information contact: Chesta Tiwari at Chesta.Tiwari@citystgeorges.ac.uk Or Christioher Yap at Christopher.yap@citystgeorges.ac.uK