Social Determinants of Health

After working with over 5,000 participants, we have an exceptional insight into the underlying reasons are for why people make the poor food choices they do.

It is commonly believed that the reason is a lack of cooking skills. In reality, research shows that people in poverty have similar cooking skills to the rest of the population.  So this does not explain their significantly worse diet.  The explanation lies elsewhere.

The real reasons are encompassed in the challenges our participants face in all aspects of their daily lives. They can be broadly characterised as

  • Economic (what it costs) e.g.
    • cost of food, transport, equipment, energy, storage, data
  • Structural (things you can do nothing about) e.g.
    • takeaway density in your area
    • distance/transportation to and from shops
  • Psychological (how you feel about it) e.g.
    • confidence
    • mental health
    • food preferences, particularly of kids
  • Practical (skills, what you can learn)

These are the social determinants of health, the complex, interlinked, wider societal issues that influence our health.

Seeing the barriers in this way helps us to understand why cooking skills are just a small part of the reasons that people don’t cook.

Many of the cost related barriers are affected by the “Poverty Premium” – where people in poverty commonly pay more to access goods and services.

Understanding how many extra barriers affect those in poverty (most of the black and red ones), helps us to understand why some people see home cooking as an unachievable goal. It’s not “laziness”, it’s a sensible allocation of finite resources!

As the chart shows, the many more barriers that people in poverty face to improving their diets may seem insurmountable.  The Bags of Taste programme is designed to tackle all of these barriers, and we show impact in all areas.  This leads to dramatic change in our participants’ lives, including a typical 85% drop in takeaway consumption; £1,300 per annum savings on food bills and takeaways, and over half of our participants report improved health.

For a short presentation explaining the Social Determinants of Health, watch the video at the bottom of this page.

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Barrier: Mental health  around 50% of our participants suffer from poor mental health

  • Got me to forget about my self harm, death and stop thinking too much. Stress goes for a while.
  • I have gained confidence cooking from fresh, and overcome my fear of doing things in a group my mental health feels better on a daily basis and I have learn to shop better. I think all the staff have made my time here easier made me realise no question about cooking is daft question and who would have thought 38 years later it only takes three weeks to cook

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Barrier: Food preferences  children in poverty often have even more restrictive food preferences than others

  • My children enjoyed a few of the meals we have done at the classes and now buy more veg and have showed my partner some of recipes and she now trys them.

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Barrier: Skills deficit  for some, a lack of cooking skills is part of the problem

  • I’ve been bringing Paul who I care for and he’s really got some basic skills in cooking. He looks forward to coming each week.
  • Learning to cook new dishes with confidence and showing off my skills with friends and family. I feel this will definitely help with minimising the risk of me getting Type 2 diabetes. I personally feel that there should be more courses like this and 4 weeks is not enough, although I have learned so much in that short time.

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Barrier: Tasty and cheap alternatives there is a higher concentration of takeaways in poor areas

  • I’ve never cooked for myself and have always relied on takeaways and ready meals, my doctor told me I had to change. After coming to Bags of Taste, I have cooked everyday for myself and realised its not so hard. I feel better, have more energy and trying things I never thought I would!  I really enjoyed the classes.

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Barrier: Confidence  one of the most significant barriers, people in poverty have demonstrably lower
confidence, leading them to believe they cannot, even when they have the necessary skills.

  • [I have learned] healthy eating using less money on food and bills. I have learnt to prepare quality good foods that are rated in 5* hotels
  • Did try cooking at home with ingredients and recipes from course – was “Chuffed” with results – which has given me the confidence to try more – and turn it into a daily habit
  • I am really proud to have supported a young person and she then gave her dad the confidence to attend too. She was polite and listened really well.  It enabled them both to eat that day and a further 4 days with the ingredients.  It gave them (and me) new skills and confidence.  This has taught all 3 of us in so many ways.  Thank you from the bottom of my heart.
  • [I have learned] The gradual feel of confidence in coming on my own. Having more skills.
  • This course helped me with my confidence and I really enjoyed meeting new people. I suffer anxiety so I’m really proud of myself for sticking to the full four sessions

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Barrier: Social Isolation  poverty causes people to isolate themselves as social activities can be expensive; it may seem pointless cooking for one

  • I enjoyed the course. I feel much more confident to meet people and talk to them. I have learnt new cooking skills and I understand how to eat healthy. Thank you
  • I’m getting out socializing learning to cook. I’ve learned that cooking for myself is cheaper than takeaway. I love the student area on facebook as it has the video and pdf of instructions to help me at home. There’s lots of resources. I’ve enjoyed the class its helped me with my confidence. I’ve been talking to people and they’ve been talking back. It’s helped me to get out of the house.
  • I’ve improved my cooking. I am happy I’ve met new, kind people. I know where to buy cheaper food and I can invite my friends for a dinner now! Thank you 🙂

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 Barrier: Scarcity mindset only dealing with immediate issues & not planning ahead

  • Before Bags of Taste, I ate a lot of processed food and takeaways. Nowadays it’s all fresh fruit and veg and I enjoy cooking every day, unless I have cooked enough for 3 days.
  • I have 3 illnesses which affect my dexterity & mobility. I wanted to improve my dexterity. I find as I suffer from these chronic illnesses, when I fall ill I live on takeaways.  This course has encouraged me to make double portions & freeze half for when I am ill.  Also I can never know what to make as I am recovering from bouts of illness and I can now defrost one of my meals, without buying ready meals
  • I have had a great time. I had met lovely people from Hackney, it is very nice to meet people that live in my area.  I feel confident in trying new recipes, and think ahead before cooking a new dish, planning the ingredients to be used.  It is a great way to save money and waste less.

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Barrier: Up front cost of ingredients/bulk buying not having a well stocked larder means that trying a new recipe involves buying more ingredients e.g. sauces, than you need; typical cost £15 per recipe

  • … some of the new expenditure has been for overstock (large bags of rice, frozen spinach, bags of spuds etc.). It has transformed the way I look at food and feeding. I can now look at a greengrocers display and see meals rather than just a pile of pretty coloured decorations. I am a lot less chaotic in the shops now, most of what I buy is more relevant now.
  • To take the bag home and just have everything there, ready, simplifies things and gives you the opportunity to cook the things you already cooked on the course cheaply and conveniently
  • Given me a chance to think about how I might buy & cook things more cheaply.
  • I never considered before the simple trick of multiplying up quantities… because I cooked in such bulk, I now have 4 ready meals.

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Barrier: Energy participants are often concerned about oven usage and other energy costs

  • Refocused mind away from expensive Ready Meals as recipes are easy to follow. Quantities used are enough for 2-4 portions so can be frozen & used again later, saving energy (both electricity and personal) Met with some lovely people. Easily accessible motivated me to come to the class. An afternoon out of the house with friendly people (so not isolated)

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Barrier: Equipment & Storage  do they have the equipment needed to cook what is taught? 

  • Overall I’ve really enjoyed the course, I’ve learnt new skills and using my new knife [bought for £1 from us] has been fab and very helpful. I’ve even lost weight!  I’ve made all the recipes and cooked fish curry twice.  Staff and volunteers have been great and I’ve told all my friends about the course too.  I hope they will get a lot out of it like I have.  Thank you very much.
  • I love the recipes and the simplicity in cooking them – on one hob. Very well organised course.
  • I now enjoy cooking and spicing up my vegetables. I have less wasted food because I now freeze more.  My cooking is more organised and even my food cupboard is organised

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Barrier: Risk of waste  recipe wasn’t nice/didn’t work; kids won’t eat it; buying more than you need

  • The course definitely had an impact on me because, I am able to try new dishes on a very low cost. It help me to think about what I am going to eat rather than just eating anything
  • Its opened my eyes to healthy, nutritious food from scratch. I was always intimidated by cooking before but have become much more adventurous. The portion sizes were a revelation as well as they were much smaller than I would cook before so there is much, much less food waste in my house now.  Thank you!!

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Barrier: Food Access/Transport  do you have affordable shops nearby? Can you carry your groceries home?

  • …how to know what to look for when buying vegetables, local shops to get cheap ingredients…
  • Made me think more how to buy & what to buy & where… I like the preprepared bags …
  • The local tips re: best and cheapest shops particularly useful.
  • It’s helped to know where to save money, waste less food and make really lovely meals.
  • Alicia’s tips on how to freeze food and where to buy were very useful (as I can’t stand wasting it)
  • The instructor and volunteers are excellent at explaining how to cook – aside from the recipes info about purchasing cheap food.

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Barrier: Information deficit  hard to know where to buy cheapest products & what recipes to try

  • I now enjoy cooking much more than before. I know more products and have discovered some recipes that I know I will cook often and recommend.  This course is such a great project…
  • This has really been an eye opening course. I never thought I would be able to cook such interesting meals so easily.  The recipes are really great and I feel so much better and more confident cooking. It’s helped me experiment without spending too much money.
  • Bags of Taste was such a fantastic course. I learnt so much about where to budget shop locally and got some absolutely great tips, especially how to properly chop an onion and the super saving ginger peeling tip!  I had so much fun replicating the dishes we learnt at home and was so proud of my certificate of completion that I framed it J  Thank you to Savannah and all the fab volunteers and new friends I made.  Forever grateful.
  • It’s good to know where to get cheap ingredients for making low-cost meals. It’s also good to see them being used in the course.

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Barrier: Time deficit cooking, and associated research & shopping, can take a lot of time

  • A great impact. Learnt cooking tips and new recipes.  A very enjoyable and necessary course .  The course is really needed in communities especially with people living busy lives. Recipes were quick and easy to cook.

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Barrier: Perception of cost, time  people believe healthy food costs more

  • I’ve learnt that I can economise and eat well on a budget. The recipes are really healthy and very reasonable.
  • …discovered how simple it was preparing a healthy hot meal at reasonable cost…

This course has taught me delicious food isn’t hard or expensive to make.

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