Vitamin D is important but Healthy Start is more than a Vitamin D intervention programme
By Georgia Machell, Apr 13 2015 04:46PM
Healthy Start beneficiaries can access free vitamins through the programme for both mums and children. The Healthy Start maternal vitamins contain vitamins D, C and folic acid, the children’s vitamins contain vitamins A, C and D, Vitamin D is the vitamin that has received most attention in recent years, andthe CMO even made a statement encouraging Healthy Start vitamin promotion and take-up to specifically address concerns around growing levels of vitamin D deficiencies.
NICE are conducting an economic analysis examining the cost effectiveness of moving the Healthy Start Vitamin programme from a targeted to a universal approach. Although growing numbers of local areas are choosing to make Healthy Start vitamins universal, this analysis will assess whether there is an economic case to change the policy centrally, making it mandatory that all women and young children receive Healthy Start vitamins.
The discussions around vitamin D and Healthy Start raise issues about who Healthy Start is for. It is not only low-income women and their young children at risk of vitamin D insufficiencies, also people with dark skin, those who cover-up and the elderly are at risk. If Healthy Start vitamins do become universally available, the nature of one aspect of the nutritional safety net will change from one which originally had a targeted approach to address health risks in low-income communities, to a general population approach. This may positively impact population averages for nutrient intakes, but will not necessarily impact the health of vulnerable populations or address health inequalities. Thus, as the shifting history of welfare foods has illustrated and the changing policy context for Healthy Start indicates, the focus and shape of welfare food provision may continually change in response to new evidence and concerns. The benefit of having vague objectives, is that the policy can be manoeuvered to fit as a policy response to a range of issues.
The focus on vitamin D as an area of policy concern and Healthy Start vitamins being hailed as a solution, highlights the fluidity of welfare food policy. Healthy Start, which began as a scheme to promote breastfeeding and counteract the negative connotations with the Welfare Food Scheme, today appears to be largely regarded as a system for distributing vitamin D. The recommendation from the CMO and the economic assessment being undertaken by NICE are valuable, however the food aspect of Healthy Start is getting overshadowed, perhaps because it is unclear what the impact of the food vouchers is intended to be and the lack of data collection or monitoring on how families choose to spend their Healthy Start vouchers.