Case Study: Empowerment Approaches to Food Poverty in NE Scotland

This case study examines empowerment approaches for people living in food poverty in the City of Aberdeen in the North East (NE) of Scotland. Food poverty in Scotland is a public health problem that disproportionately affects poor people. Its extent is not well measured, but in Scotland 18% of the population are estimated to live in relative income poverty. Three main groups are at risk: people who are ‘working poor’, people who are unemployed and dependent on state welfare, and people who are homeless. These groups overlap and people move between them. Neither local authorities nor health authorities directly provide or fund services related to food poverty. They collaborate with the voluntary sector to do so. Health authorities provide evidence on reducing health inequalities, and local authorities support services delivered by the voluntary sector. This case study is part of a wider international programme coordinated by Training and Research Support Centre entitled ‘Learning from international experience on approaches to community power, participation and decision-making in health’. The study includes five sites in the USA and case studies from twelve sites in selected high-, middle- and low-income countries, with support from the Robert Wood Johnson Foundation Global Ideas Fund at CAF America. As one of the six deep scan case studies in the project, we describe promising practices in, and models of, community participation, power and decision-making in the local health system. With a focus on food poverty in deprived and marginalised communities, we reviewed approaches and practices for building social power and involving communities in efforts to address population health in relation to food poverty, within and between communities, government agencies, nongovernmental and community initiatives in the site. The scan case study involves four agencies, two statutory - Aberdeen City Council (ACC) and National Health Service (NHS) Grampian - and two non-governmental enterprises - Social Bite and Community Food Initiatives North East (CFINE). Three practices are examined: i. opening pathways to employment, financial capability and housing (Social Bite); ii. supporting poor households to move sustainably out of food poverty (CFINE); and iii. making community grants in low-income urban areas through Participatory Budgeting (ACC). Social Bite and CFINE both provide emergency food aid, develop employment capabilities and opportunities and provide education, skills development and training. Social Bite provides food to homeless people, and through this process facilitates access to housing, healthcare and employment within its broader business. It is a dynamic national group with a strong social media presence. Its activities humanise hunger and homelessness, building self-worth, confidence and opportunities to overcome situations of hardship. It is a social enterprise mainly funding activities from its commercial business, a chain of sandwich shops. CFINE is a local organisation that aims to empower people and communities by promoting the consumption of healthy food, building financial capabilities and building confidence through supported volunteering and employment. It is a charity funded by a mix of government grants, charitable funding and the profits from the sale of fruit and vegetables to the commercial sector. While CFINE does provide food aid, it views food banks as creating dependency and eroding dignity rather than tackling the root causes of food poverty. CFINE leads the Food Poverty Action Partnership, bringing together more than 60 agencies for a political response. As a practice with potential linkages in supporting actions on food poverty, ACC has introduced Participatory Budgeting (PB), engaging people living in deprived urban areas in resource allocation for community-based projects. PB has accelerated community participation in the site and nationally, because of the 2015 Community Empowerment Act. To date, two rounds of PB have been held in which community-based groups organise, develop and submit bids, which communities then vote on. The first PB rounds have been successful, with a high degree of engagement. Future rounds plan to go beyond voting, to develop deliberative processes, trust and transparent decision-making and to foster relationships among officers, elected members, partner organisations and communities. In a setting where it has not existed before, PB has included shared learning and capacity building for community members and professionals involved. None of the agencies have yet conducted outcome evaluations to assess the impact and effectiveness of the activities described in the case study. However, a wide range of information and evidence was identified on outputs (activities and services), processes (specific steps that lead to outcomes) and perceived impacts (narratives and anecdotal evidence). Legislation on Participation Requests published in 2017 requires that projects funded by community grants (PB) be subject to an evaluation of outcomes, and both CFINE and Social Bite recognise the importance of evaluating the impact of their activities. The case study raises various insights for wider exchange: a. The dependency on non-governmental enterprises to provide services for those living in food poverty in the site is not matched by the mandate or resources to meet the needs of all those in need. In a context of austerity, public services are also limited in what can be done outside their statutory responsibilities. This results in small-scale, variable and unregulated practices and a lack of obligation to ensure equitable population-based access and impact. b. The non-governmental enterprises are able to respond to the needs of specific, often disadvantaged groups. They have a deep commitment to support the development of knowledge, skills and confidence in those involved, to overcome harsh situations through people-centred approaches that prioritise dignity and trust. However, their actions often target individuals rather than collective action and empowerment. c. A reliance on unpredictable external funding limits the time and resources available for developing such collective action in a context of rapidly expanding social needs. d. PB, in contrast, reflects a state commitment to the inclusion of communities in decision making for public services and resources. It is backed by policy in Scotland and supported by a range of operational tools and resources, such as the National Standards for Community Engagement (Appendix 7). With the PB undertaken to date focusing on modest community grant-making, its expansion into mainstream funding will call for re-orienting the relationships between communities, political actors, civil society and the state. This will take time, commitment and leadership. It does, however, open important opportunities for nongovernmental organisations to work with communities to support these processes and build shared learning on the nature and purpose of their participation. While noting the specific contexts and differences across the organisations, there is potential for translation of approaches and learning in other settings: a. Food can be an effective, accessible way to engage people in activities and develop capabilities that improve their quality of life, such as when food-related activities provide an entry point for health and social service referrals, for training, supported volunteering and employment. b. Practices that are humanising and processes that build respect, dignity and trust are necessary to overcome situations of hardship. c. While it is possible to fund such activities from commercial food ventures in social enterprises, unpredictable funding can limit the collective scale of power and action. PB provides a wider social process when backed by law and policy covering public inclusion in democratic processes on the organisation and use of public funding. The PB process in Scotland has yielded a range of PB-related resources outlined in the appendices of this report that may be of use elsewhere. All four agencies included in this case study are interested in learning from other sites about carrying out impact evaluation to provide more robust evidence on the effectiveness and efficiency of their programmes. Scotland is at an important juncture in regard to opening up spaces for broader deliberation with an explicit focus on tackling inequalities.