Tackling food and fuel insecurity in Scotland: a comparative interpretive policy analysis

Abstract Food and fuel insecurity have been rising in Scotland since 2021, yet very little exists on the dual burden of these poverties. This study, by way of a qualitative interpretative health policy analysis, seeks to better understand the policies and programmes available to mitigate food and fuel insecurity and the associated health burdens in Scotland. Thirty semi-structured key informant interviews were undertaken between April and December 2023 with policy experts in these fields. Interviews were transcribed, abductively coded, analysed, and triangulated with academic, policy and grey literature to compare and contrast policy responses. Given the importance of income when discussing multidimensional poverty, it is unsurprising that a major intervention towards ending food and fuel insecurity is the benefit system at large, which was overall described as insufficient and poorly organised. A cash first approach has been identified as paramount to address food insecurity and take over the ever-growing charity efforts (food bank larders, cooked meals, etc), which are largely considered “sticking plasters” by stakeholders. Fuel insecurity has been increasingly modelling food insecurity tactics - growing charity sector led approach such as introducing fuel banks and warm spaces. While these efforts are often similarly described as “sticking plasters,” many experts report that given the complexity of the issue - poor housing stock, unfair payment systems, lack of trained personnel, and market mis-regulation - increased income alone is insufficient to tackle fuel insecurity, stressing the need for a multidimensional approach to poverty. The health system, while increasingly burdened by both dimensions, was described as having little bandwidth for prevention and saw the role instead up to government and charities. Working with health systems may, however, help to identify those most impacted by food and fuel insecurity such as people with kidney failure.