Access to healthy, affordable food is one of the most pressing challenges facing our society today. At the Sustainable Food Trust, we believe that everyone should have the freedom and dignity to make positive food choices, yet millions are held back by a distorted pricing system that makes fresh, healthy foods more expensive than processed and ultra-processed options. Here, food policy expert, Honor May Eldridge, explores the history and politics of food vouchers, the growing potential of social prescribing, and the role farming can play in improving public health and wellbeing.
Fresh fruit and vegetables are not affordable for those who would most benefit from it. Healthy foods are nearly three times as expensive per calorie as less healthy foods. Often, processed foods are the most affordable and accessible foods for low-income communities to purchase while fresh produce is too expensive. In the Global North, healthy foods cost, on average, twice as much per 1000 calories than processed food. For many with limited resources to purchase food and other everyday items, price rapidly becomes the deciding factor and processed (and ultra-processed) foods are cheaper. According to an analysis by the Office for National Statistics’ Consumer Price Index, conducted by the University of Cambridge, the poorest fifth of UK households would need to spend 47% of their disposable income on food to meet the cost of the Government recommended ‘healthy diet’. For households with children in the poorest fifth of the population, 70% of their disposable income would be needed to achieve a healthy diet. This has significant knock-on impacts to public health, with healthy life expectancy in the most deprived tenth of the population, 20 years less for women and 18 years less for men, than in the least deprived tenth. It also has an economic impact since it leads to higher rates of sickness and inability to work, further compounding poverty.
Food vouchers as a tool for change
All citizens should have the freedom to choose what they want to eat and experience the dignity that comes with empowered food choices. There are two key approaches to making healthy food more affordable to low-income consumers. The first approach is food vouchers. Food vouchers have a long history as a policy tool to address hunger, malnutrition and food insecurity by giving targeted groups access to essential goods. Early versions appeared in wartime economies. For example, during the Second World War, ration coupons entitled households to limited amounts of butter, meat and sugar. Outside of wartime, voucher schemes evolved toward supporting vulnerable populations rather than managing scarcity. They became a common feature of welfare systems, used to provide nutritionally important foods like milk, bread or infant formula. In the UK, the Welfare Food Scheme (1940s–2006) provided subsidised milk and vitamins to pregnant women and young children. This was later replaced by the Healthy Start voucher programme that supports low-income pregnant women or families with children under four to purchase healthy foods, such as fresh, frozen and tinned fruit, vegetables and pulses, as well as milk and formula.
In the UK, one of the leading examples of food vouchers today is Rose Vouchers. Run by the Alexandra Rose Charity, it provides families with £4 per child (or £6 for children under one year old) each week, redeemable at local markets and greengrocers. This initiative operates in various locations, but in Tower Hamlets in London, they are committing additional resources to pilot how an increase to £8 per week with an additional £2 per household member, impacts the success of the scheme. Results after eight months showed that 90% of participants experienced improved physical health, GP visits were nearly halved and adherence to the ‘five-a-day’ guideline increased from below 30% to nearly 80%. Additionally, 75% of participants lost or maintained their weight, and over half reported improved mental health.
The politics of food vouchers
The history of food vouchers shows them as tools issued by the state or municipal government to low-income individuals, designed to alleviate poverty by tackling the hunger that stems from it. From their inception, they have been embedded in social welfare policy and are often associated with the political left, which tends to favour redistributive measures to support vulnerable populations.
Nowhere is this more visible than in the United States, which operates the world’s most prominent food voucher scheme. Food stamps were first introduced in the 1930s under Franklin D. Roosevelt’s New Deal but in 1964, they became known as the Supplemental Nutrition Assistance Program (SNAP), which has since become a cornerstone of US welfare policy. Yet, more recently, SNAP has also become a lightning rod for political debate: advocates on the left point to its proven role in reducing food insecurity, improving health outcomes and stimulating local economies, while critics – particularly on the right – frame it as an unsustainable government handout that fosters dependency. This tension highlights the way food vouchers have become contested symbols of the over-reach of social welfare programmes and the role of government in addressing poverty.
Social prescribing: food as medicine
Increasingly, the preferred model of making healthy food more affordable and accessible to low-income communities is through social prescribing. This positions food as medicine, as opposed to a social welfare concern – citizens access to healthy food as a healthcare-based intervention that recognises the link between diet and health outcomes. In this approach, medical professionals, GPs, community carers, midwives and other frontline staff, are able to distribute vouchers specifically for fresh fruit and vegetables to individuals whose poor health is linked to diet-related conditions. The prescription is based on medical need, as opposed to income. The idea is that, just as a doctor might prescribe medication, they can also prescribe access to nutritious food, helping patients take practical steps toward better health.
The framing of subsidising access to fresh produce as a medical intervention, rather than as a traditional social welfare programme, makes the idea of social prescribing more politically palatable. By locating the intervention within the healthcare system, it is presented not as a handout or redistribution of resources, but as a preventative health measure designed to reduce long-term costs to the state and improve public wellbeing. This reframing is important because welfare-based food vouchers often carry the weight of political baggage: they are associated with the legacy of social assistance, poverty relief and debates around dependency. Social prescribing, by contrast, situates the intervention in a clinical context, where doctors are empowered to act directly on the social determinants of health. The outcome, however, is broadly the same as voucher schemes: both models aim to increase access to healthy food among low-income groups, thereby reducing diet-related illness and inequality. Yet, because social prescribing lacks the long and often polarised history of food voucher programmes, it appears less ideologically charged. This makes it a more approachable option for policymakers across the political spectrum, including those on the right, who may resist welfare expansion but can support interventions framed as targeted, evidence-based healthcare solutions.
Green social prescribing and the role of farms
The SFT is taking this framing even further, acting as a catalyst to inspire change. Since 2022, the SFT, in partnership with the College of Medicine and the University of Bristol, have run a pilot project to connect GP practices with nearby working farms, inspired by the belief that engagement with nature and food production can support health and healing. Framed as ‘green social prescribing’, the project uses nature-based interventions, like gardening or farming, to improve wellbeing.
Now in its third year, the project continues to work with several farms in the Bristol and Gloucestershire area, with six-week programmes in the spring, summer and autumn aimed at local residents from urban and other more deprived areas. Activities typically include farm walks, interaction with animals, foraging, wildlife identification, harvesting and quiet reflection in nature. The results continue to be positive, with participants reporting better mental health, reduced isolation and high enjoyment, especially from animal contact.
The project highlights the potential of farm-based social prescribing to improve public health and wellbeing while supporting sustainable farming. Given the proven health gains and wider social value, the next step must be to expand this model across the country, ensuring that communities everywhere can benefit from the healing power of farming and nature.
To find out more about the SFT’s green social prescribing project, click here.
