The prevalence of food insecurity in an inner-city London borough between 2021 and 2023: evidence from annual cross-sectional surveys

Background: The prevalence of food insecurity in the UK has risen; this is likely to continue given the increasing cost of living. Addressing food insecurity is a key focus for Lambeth Council (an inner-city London borough). This study aimed to estimate the prevalence of food insecurity among residents and identify sociodemographic risk factors. Methods: Three convenience sampling cross-sectional surveys were conducted in 2021, 2022, and 2023. Prevalence by year and sociodemographic characteristics were calculated for food insecurity, receipt of food assistance, and perception of access to affordable, healthy, and culturally appropriate food. Risk factors were identified using multivariable logistic regression modelling. Results: There were 1,679 respondents in total. Overall, 14.0% and 17.3% experienced low or very low food security, respectively, and 13.7% received food assistance. The prevalence of food insecurity remained approximately static by year. Prevalence of receipt of food assistance decreased from 16.7% in 2021 to 12.3% in 2022 and 12.5% in 2023. Whilst several characteristics were associated with food insecurity in univariable analyses (including age and ethnicity), disability (aOR 2.48, 95% CI 1.60–3.84), employment (unemployed versus full time work: aOR 5.31, 95% CI 3.05–9.42), housing (council/housing association versus homeowners: aOR 7.00, 95% CI 4.68–10.70), and living with children (aOR 1.56, 95% CI 1.15–2.11) had the largest effects following adjustment. The proportion who perceived food to be affordable, healthy, and culturally appropriate decreased (65.6% in 2021, 51.2% in 2022, 52.5% in 2023) and increased with increasing food insecurity (37.5% very low security, 48.1% low security, and 62.4% high security). Conclusions: There is a high prevalence and unequal distribution of food insecurity in Lambeth. The most important risk factors reflect financial security. This analysis informed Lambeth’s ‘Food Justice Action Plan’ by focusing on individuals more likely to experience food insecurity.