All UK women need to be able to buy a healthy diet before & during pregnancy to avoid low birthweight & the risk of the life time mental and physical ill health of their babies or infant deaths.

7 April 2019

THE SCIENCE OF MATERNAL NUTRITION AND THE LACK OF SOCIAL SECURITY

My point is quite a simple one. All women need to be able to buy a healthy diet before and during pregnancy to avoid low birthweight and the risk of the life time mental and physical ill health of their babies or infant deaths. To do that they need an adequate income and a truly affordable home both in work and unemployment.  I met Professor Michael Crawford, of the Institute of Brain Chemistry and Human Nutrition, in 1999  and he has written;     
  • The incidence of low birthweight a hall mark of future physical and mental ill health has risen since 1973 in the UK
  • In 1972 it was predicted that brain disorders would rise following on the rise in death from heart disease. The prediction was based on similar nutritional requirements for specialised dietary fatty acids and their associated nutrient cluster .  That prediction has now been realised.
  • Although the national diet improved during the last century, a fundamental flaw crept in the last 4 decades because of a lack of knowledge on the requirement of specialised fats for the development and health of the brain and arteries.
  • Several national and international expert committees on diet and health have commented on the flaw. However, little action has been taken because of want for of relevant knowledge.
  • The required recommendations have been voiced by the Black, Acheson, Wanless and Marmot reports with the exception of addressing fundamental flaws in the food chain.
  • What is not recognised is the pivotal role of the mother, her nutrition and health prior to conception and through pregnancy and lactation.
  • It now requires bold, interdepartmental initiatives by government and local governments on food production, distribution, public and school education, and investment in prevention by the NHS
  • In 2005 the EU published an audit of the cost of ill health. Brain disorders were found to have overtaken all other burdens of ill health at a cost of €386 billion. A review in 2010 put the cost at €789 billion. 
  • In 1990-91 The Winterton Commons Select Committee on Maternity Services requested action on low birthweight and the inequality of health; none was taken.r Jo Nurse at the DoH presented the UK cost of mental ill-health in 2007 at £77 billion – a cost greater than heart disease and cancer combined. A reassessment in 2010 found the cost to be £105 billion.
  • The Wellcome Trust then published a repeat in the UK of the estimate and mental ill health in the UK came out as £113 billion in 2013. The rise in mental ill-health is mainly amongst children. If it continued unabated, the end of humanity is a logical consequence. 
  • Malnutrition is present in the UK and affects over 3 million people with associated health costs exceeding £13 billion annually (BAPEN 2009). Added is the now rise in obesity and diabetes II which will inevitably affect mental development. 
In 1997 as Chair of Z2K I commissioned the 1998 Family Budget Unit to research Low Cost but Adequate, A minimum income standard for the UK, which went on to be used by UNISON and London Citizens to persuade Ken Livingstone to launch the London Living wage. The report had already made me concerned about the inadequacy of the singlea dult's unemployment benefit. 
 
After Meeting Michael Crawford in 1999 I became in ever more concerned that young single women reliant on the state for an income would not have an adequate diet before or during pregnancy. 
 
11 May 2009 I had written to The Guardian "...However, rights and responsibilities apply both ways. Since 1948, successive British governments have been signed up to the right to an adequate standard of living as detailed in the UN's convention on human rights, but have not honoured their side of the contract by implementing that right in adequate unemployment incomes. We hope peers debating the bill will understand that reducing with sanctions £50.95 a week adult unemployment benefit for 18-25-year-olds, or £64.30 thereafter, which is less than half the poverty threshold, can never be justified by a shallow appeal to an unjust social contract.
 
15th May 2009 Professor Jonathan Bradshaw's reply to my letter was also published by The Guardian "When unemployment benefit started in 1912 it was 7 shillings a week - about 22% of average male earnings in manufacturing. The percentage fluctuated over the succeeding decades, but by 1979 the benefit rate was still about 21% of average earnings (manual and non-manual, male and female). By 2008, however, as a result of the policy of tying benefits to the price index while real earnings increased, the renamed jobseeker's allowance had fallen to an all-time low of 10.5% of average earnings. This is not a policy justified by the need to maintain work incentives. It is just a dreadful record of neglect by governments since 1979."
 
In 2009 Gordon Brown saw the point and introduced the "Health in pregnancy grant" at the 25th week which, though a step in the right direction, was too late in a pregnancy. On which Professor Baroness Findlay told the House of Lords on the 25th January during the Child Poverty Bill. 
 

"In the time available, I could not do justice to the crucial importance of nutrition during pregnancy and infancy in tackling disadvantage. In brief, it is becoming apparent that low birth weights, of which Britain has the highest rate in western Europe, are associated with poor cognitive abilities and serious brain disorders such as cerebral palsy.

I remind the Committee that I come from south Wales, where we have the tragedy of the highest epidemic of spina bifida and anencephaly through folate deficiency. That was due to diet. Since folate supplements have come in, we have seen that drop dramatically. If you do not get diet right in pregnancy, you store up problems that will be there for the whole of the child's life, from the moment it is born.

In 2002, Sir Derek Wanless's report to the Department of Health, Securing Good Health for the Whole Population, expounded an egalitarian sentiment, harmonious with the spirit of Every Child Matters. He identified birth rate as a pivotal cause of a vicious cycle of poor health; he recognised that the cycle repeats itself from generation to generation and traps communities in poverty and health inequality. The cycle of poverty will remain repetitive and relentless unless we have the courage to tackle its very core and root that out. That is what the amendment seeks to do.

The Minister in another place reminded us that a health and pregnancy grant is available to women from the 25th week of pregnancy, but that is far too late. From the time of conception and in those early phases of cell division, long before you might say that the foetus is medically viable, is when the nutritional influences probably have their major effect. We have to get this dealt with pre-conception, let alone from birth."

in May 2010, immediately after the election, the Health in Pregnancy Grant was abolished by the coalition.

The neglect of women's need for a healthy diet before and during pregnancy was raised in amendments tabled and rejected by government in both the 2012 and 2016 Welfare Reform Bills. 

Since 2011 all unemployment benefits have been frozen. The single adult's Jobseekers Allowance(JSA) are stuck at £57.90pw up to age 25 and £73.10pw thereafter which equates to £317pm Universal Credit (UC), to both if which family, childrens, disabled people's, housing and council tax benefits are added.  JSA/UC It is paid to at least 3.6 million people a year (please see ONS BENO1). 
 
The minimum incomes standards MIS research for a healthy diet has been done at the University of York since Z2K began MIS in 1998. It starts with nutrition, moves on to weekly menus, which are checked with potential users and the wider public and then costed at supermarket prices. The April 2018 amount needed for a healthy diet by a single adult published by the Joseph Rowntree Foundation is £49.29 a week (see page 39), which takes a big slice out of JSA/UC of  £57.90pw up to age 25 and £73.10pw thereafter. 
 

DEVASTATING BLOWS TO A WOMAN BEFORE, DURING AND AFTER PREGNANCY

 
But the following austerity policies take even larger slices.
  • JSA/UC has to pay up to 30% of the council tax in 276 out of 326 English Councils. Non or late payment adds court costs and bailiffs fees to the arrears.
  • A three month sanction stops it. Debts, rent, council tax, gas, electricity and water arrears build up and have to be paid after the three month sanction ends out of the impossibly JSA/UC. A devastating blow to a pregnant woman. 
  • We are supporting a unemployed homeless family of five in temporary occupation who receive the benefit income for three. The mother does not have a British passport and the third child was born after April 2017. Neither of them receive benefits. The severely disabled first child now receives permanent DLA and the other son and the father receive the benefits to which they are entitled. 
  • All of the 82,000 homeless families in temporary accommodation in England are paying council rents. Councils can compel them to take permanent accommodation in the private sector.  In Tottenham council rents are for a two bed flat are £90pw and PRS rent are £300.  
  • The overall benefit cap cuts housing benefit leaving unpaid rent to be paid out of adult and childfren's shredded state benefits
  • Nothing has been done to ban ban compulsory zero hours contracts. 
  • The law is clear: it is illegal to make someone redundant due to pregnancy or maternity. But the TUC reports that 390,000 women a year are discriminated against in pregnancy yet only 1% take tribunal claim. Many are sacked to receive these austerity benefits. 

Under these circumstances buying a healthy diet both before and after conception becomes impossible for 100s of1000s of women in the UK. Three days food from a food bank does not cover a nine month pregnancy.
 
It is sadly not surprising that there has been an unprecedented increase in infant deaths among the babies of poor mothers since 2015. It seems likely that some of this is due to the lack of midwives as shown by Professor Danny Dorling but  much concern must also be focused on the inevitability of malnourished fetus and babies due to the dire lack of social security incomes before, during and after pregnancy 
 
The graph was prepared by Professor David Robinson-Taylor and published by the BMJ
 
BMJ.jpg

 

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