Child development impacts of targeted food payments

“The Healthy Start programme is one of the main ways that England supports low-income families with young children to eat healthier food. Using ECHILD data, we can provide some of the first large-scale evidence linking the provision of support to children’s outcomes.”
— Christine Farquharson, Associate Director at IFS

This study is part of a wider research project evaluating the effectiveness of the Healthy Start program. The research team consists of Dr Britta Augsburg, Christine Farquharson (Institute for Fiscal Studies), Prof Melanie Lührmann (Royal Holloway, IFS), Prof Stephanie von Hinke (University of Bristol, IFS), Dr Andrew McKendrick, Ludi Wang (IFS) and Prof Christina Vogel (City St George’s). The project is funded by NIHR and started in 2022, aiming to finish in 2026.

‍This project was reviewed and approved through ECHILD's data access process. Learn how ECHILD data is kept safe.‍

  • We want to understand the effects of the Healthy Start scheme which offers targeted payments for low-income pregnant women and families with young children to buy healthy food.

  • Early life conditions shape long-term health and education outcomes, yet we see nutritional inequalities emerging even before children start school, when most interventions begin. Understanding the impacts of targeted food payments helps us assess their effectiveness relative to other policy tools.

  • Using ECHILD, we compare the birth outcomes and other developmental outcomes of children born to eligible and ineligible families before and after the introduction of the Healthy Start scheme. These results are complemented by parallel analysis using consumer scanner data to evaluate changes in food purchases and nutrition.

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  • Why does this matter?

    Nutrition in early life has long-lasting impacts, yet we consistently see poorer children have worse nutrition to their richer counterparts from an early age. In England, Healthy Start is the principal program addressing these inequalities before children start school. Understanding its effectiveness will support better policy-making and communication with parents, local authorities and healthcare professionals.

    What do we want to find out?

    We want to evaluate the effect the Healthy Start program has on families’ food purchases, children’s birth outcomes (e.g. birth weight and gestational age) and later outcomes (‘Good Level of Development’ at age 5).

    What we will do

    We use health and education records from ECHILD of children born to families eligible for Healthy Start and families not eligible for it, before and after the introduction of the program, to see if it has made a difference to the birth and later outcomes of the children.

  • Background and aims

    Healthy Start is the primary public health intervention aimed at improving the diets of disadvantaged families during a critical developmental period. It is an important part of the nutritional safety net in early life and has been the subject of significant policy action, with an uplift to the voucher value announced in the recent NHS 10-year plan.  The scheme offers weekly payments (currently £4.65) to pregnant women, new mothers and families with children under four to purchase fruit, vegetables, milk, infant formula and pulses. Previous research has found that the introduction of the programme in 2006 increased spending on fruit and vegetables, and did so by more than an equivalent unconditional cash benefit would have done. This project will evaluate the impact of the introduction of Healthy Start vouchers in 2006 on the early health and educational outcomes of children in eligible families.

    Methods and analysis

    Using administrative linked health and education records from the ECHILD database, we estimate the impact of the introduction of the Healthy Start scheme on birth outcomes and early childhood development. We employ a Difference-in-Differences design that compares children from households predicted to be income-eligible and those predicted to be income-ineligible households, comparing children born before and after the program’s introduction in November 2006. We analyse the impact of the program on birth weight and other birth outcomes, as well as development at age 5.

    ECHILD data used

    • HES: Admitted Patient Care (2003/04-2010/11) + Mother-Baby Link

    • NPD: Spring Census data (2007/08-2020/21), Early Years Foundation Stage Profile (2007/08-2014/15)