14 This is in part due to the stigma associated with the targeted nature of the scheme. Although this programme increased spending on FV, 13 uptake is rapidly declining with less than half of those eligible in the programme.

Application to this programme is via healthcare providers, and vouchers are sent monthly.

This programme also targets individual low-income pregnant women and mothers with children under four in households on income support. In the UK, the Department of Health & Social Care ‘Healthy Start’ programme provides vouchers worth £3.10 per week for FV, milk and infant formula 12. In the USA, these programmes report significant increases in the intake of FV 10 and savings in food expenditure. However, the majority of programmes target individual families-mainly low-income women, infant and children. There is mounting evidence (mostly from USA) that price discounts are effective in increasing purchasing and consumption 8, 9 of healthier foods. 7 Targeted benefits such as vouchers and subsidies can be effective in increasing purchases of FV and improving the nutritional composition of food bought.

Price discounts applied at a population level have been associated with a positive shift in population level purchases of FV, with the effect persisting after removal of the discount. 4 This leads to an increase in all-cause mortality and cardiovascular mortality. Those on low incomes are more likely to have a higher intake of sugar and saturated fatty acids, and lower intake of FV and dietary fibre than recommended. 1, 2, 3, 5 These communities consume diets low in fruit and vegetables (FV) and high in energy-dense, nutrient-poor processed foods. Many communities in the UK cannot afford food to make up a healthy diet.

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