Setting the Table Guidance: Fairer Scotland Duty Assessment

Stage 2 – evidence

Evidence Summary

There are a number of data sources and research findings that have informed the development of this FDSA. Whilst there is widespread recognition of the importance of early years exposure to food, the data and evidence on the provision of food in ELC settings is currently very limited. Instead, data and evidence on the benefits of early childhood education and care, the take-up of funded ELC, child poverty, food insecurity and health, and children’s views about food and food insecurity were considered.

• Scottish Government Early Learning and Childcare Census Data (2023) Early learning and childcare statistics - gov.scot (www.gov.scot)
• Improvement Service – Early learning and childcare delivery progress report (2023) Early Learning and Childcare Expansion Delivery Progress Report, February 2022 (improvementservice.org.uk)
• NHS Health Scotland – Evaluability assessment of the expansion of early learning and childcare (2017) NHS Health Scotland – Evaluability assessment of the expansion of early learning and childcare
• Scottish Government – Poverty and Income Inequality in Scotland (2022-23) Poverty and Income Inequality in Scotland 2020-23 (data.gov.scot)
• Scottish Government – Scottish Healthy Survey (2022) 8 Diet and Obesity - The Scottish Health Survey 2022 – volume 1: main report - gov.scot (www.gov.scot)
• Cambridge University Press - Food insecurity in children and young people (2024) Food insecurity in children and young people in Scotland | Proceedings of the Nutrition Society | Cambridge Core
• Nourish Scotland “Living is More Important than Just Surviving – Listening to what children think about food insecurity” report (2016) Living_more_important_than_surviving.pdf (nourishscotland.org)
• Children’s Parliament “What kind of Scotland?” report (2017) WhatKindofScotlandOnline2017.pdf (childrensparliament.org.uk)
• European Commission - Building a better understanding of the impact of early childhood education and care on medium- and long-term educational and labour market outcomes in Europe (2022) Building a better understanding of the impact of Early Childhood Education and Care on medium- and long-term educational and labour market outcomes in Europe
• CARE Project – review of research on the effects of Early Childhood Education and Care (ECEC) upon child development (2015) ‘A review of research on the effects of Early Childhood Education and Care (ECEC) upon child development’
• Organisation for Economic Co-operation and Development (OECD) – Starting Strong: Key OECD Indicators on Early Childhood Education and Care (2017) Starting Strong 2017: Key OECD Indicators on Early Childhood Education and Care

Data sources

Reports on the impact of early childhood education and care on positive life outcomes

The earliest years of life are crucial to a child’s development and have a lasting impact on outcomes and opportunities later in life. A number of reports explore the impact that Early Childhood Education and Care can have on building the foundations for future skills development, well-being and learning:

• European Commission - Building a better understanding of the impact of early childhood education and care on medium- and long-term educational and labour market outcomes in Europe (2022) Building a better understanding of the impact of Early Childhood Education and Care on medium- and long-term educational and labour market outcomes in Europe
• CARE Project – review of research on the effects of Early Childhood Education and Care (ECEC) upon child development (2015) ‘A review of research on the effects of Early Childhood Education and Care (ECEC) upon child development’
• Organisation for Economic Co-operation and Development (OECD) – Starting Strong: Key OECD Indicators on Early Childhood Education and Care (2017) Starting Strong 2017: Key OECD Indicators on Early Childhood Education and Care

The updated Setting the Table, including the revised nutritional standards, supports early intervention by educating ELC practitioners and children on the benefits of establishing healthy and nutritious diets prior to starting school.

Data on the take-up of funded ELC

The amended Children and Young People (Scotland) Act 2014 (the 2014 Act) meant that local authorities have a statutory duty to secure 1140 hours per year of funded ELC for each eligible young child belonging to (i.e. residing in) its area, irrespective of the child’s, or his or her parent’s or guardian’s, race, colour, sex, language, religion, political or other opinion, national, ethnic or social origin, property, disability, birth or other status. Further to this, the Scottish Government offers a universal entitlement of a free meal for all 3 and 4 year-old children and eligible 2-year-old children as part of their funded ELC day, including children from low socio-economic backgrounds or living in poverty.

The latest Scottish Government ELC census data showed near universal uptake of funded ELC by 3 and 4 year-olds in Scotland in September 2023. Additionally, around 13% of all 2 year-olds were registered for funded ELC, equating to around 50% of eligible 2 year-olds.

In addition, data published by the Improvement Service showed that in September 2023, 98% of children accessing funded ELC were reported to be accessing more than 600 funded hours. While 90% were reported to be accessing the full 1140 funded hours.

This indicates that a large, and increasing number of eligible children aged 0-5 in Scotland are benefiting from the 1,140 hours of Funded ELC offer, including the provision of a free healthy and nutritious meal as part of the ELC day.

NHS Health Scotland – Evaluability assessment of the expansion of early learning and childcare (2017)

The NHS Health Scotland – Evaluability assessment of the expansion of early learning and childcare developed a theory of change for the Scottish Government expansion to 1,140 hours of funded ELC in 2021. Whilst not evidential, the evaluation strategy provides an informed theory of how the impact is intended to be achieved. The Outcomes for children diagram within the report sets out how the expansion to 1,140 hours of funded ELC, including the provision of a free healthy and nutritious meal, is expected to support children to be healthy, active and nurtured, whilst wider family poverty and social inequalities. This expected positive impact will be strengthened through the update to the Setting the Table which includes revised nutritional standards and tailored advice on how best to meet the individual needs of all eligible children aged 0-5 in Scotland including those from low socio-economic backgrounds.

Statistics on poverty and food insecurity in Scotland

The most recent Scottish Government statistics on Poverty and Income Equality in Scotland (2020-23) present three-year averaged estimates of the proportion of people, including children, in Scotland living in poverty in addition to other statistics on household income and income equality which are used as estimates to monitor progress in reducing poverty, child poverty and income inequality.

They report that 24% of children were living in relative poverty after housing costs in 2020-23. Child poverty is broadly stable following a gradual rise in recent years. Children in some of the priority groups were more likely to be in relative poverty compared to all children (24%): this was particularly true for those in ethnic minority households (43% of children in relative poverty), single parent households (38%) and households with three or more children (38%).

The report also includes statistics on food insecurity. The questions ask about whether people were worried about running out of food, had to reduce meal sizes or skip meals. In 2020-23, 78% of children lived in households with high food security. This means that 22% of children lived in households with marginal, low or very low food security. Children in poverty were less likely to have high food security: just 58% of those in relative poverty.

This data provides a limited but important view on the intersectional relationship between food insecurity and the groups of children living in households with low incomes and/or in deprived areas.

Statistics on children’s diet and health

The Scottish Health Survey includes data on diet and obesity, including for children. The most recent report found that in 2022 22% of children aged 2-15 were eating five or more portions of fruit and vegetables a day, which was higher in 2021 and 2022 than in the rest of the time series (13% in 2008). In 2022, 64% of children were in the healthy weight category. This was at the same level as in 2021, which was the lowest since the start of the time series in 1998 (70%). One third of children aged 2-15 (33%) were at risk of overweight or obesity (29% among those aged 2-6 years). This was 5 percentage points higher than in 2021, and the highest level since 2011.

Research on food insecurity and children

Food insecurity in children and young people in Scotland (2024) reviews the key issues in relation to food insecurity among children and young people living in Scotland. Key points include:

• Being food insecure increases the likelihood that individuals will consume diets that are of a lower quality. Children living in food insecure households are at higher risk of having diets of poorer nutritional quality, with lower consumption of vegetables and higher consumption of nutrient poor highly processed foods.
• Inevitably if those experiencing food insecurity are not eating a diet in line with recommendations, there is a greater likelihood that their health will be negatively impacted. Evidence suggests that children experiencing food insecurity are more likely to report poorer health, more hospitalisations, under or overweight, developmental delays, and to be at greater risk of anaemia and asthma than children who are food secure.
• In children, an association has been identified between food insecurity and social and emotional wellbeing, with higher risk of behavioural problems, negative health perceptions, life dissatisfaction, anxiety and depression for the children affected.
• Across children’s age ranges, food insecurity has a negative impact on behavioural, academic and emotional outcomes.
• The introduction of school food and nutrient standards and food regulations have been shown to have improved the nutritional quality of school meals in England,^, but evidence is limited from Scotland.

Research on children’s views about food, nutrition and food insecurity

In 2016 Nourish Scotland published a report entitled “Living is More Important than Just Surviving – Listening to what children think about food insecurity”. The research involved four semi-structured sessions, in which researchers listened to 32 primary school aged children across Renfrewshire, Dundee, Glasgow and Edinburgh. The report also summarises existing research on food insecurity. The research provides insights into children’s views about food, nutrition and food insecurity:

• Children were confident in identifying the foods that children need, and recognised the importance of a healthy and balanced diet including the consequences of not having access to enough of those foods.
• Children were perceptive to how financial restraints could be a barrier to children being able to eat the foods they need and how that may make parents and children feel, including that children may feel that they should do something. Children understood that money would make a big difference to the amount and type of food eaten, what meal times are like and where families get food from.
• Children had well developed ideas around coping mechanisms and solutions to food insecurity, recognising the responsibilities of a range of people including politicians. Solutions included making healthy food more affordable, redistributing money, and supporting charitable solutions. When asked, all children agreed that children have a right to food, but they also recognised the barriers to realising this. Children often suggested rights-based solutions though they did not always identify them as such.

In 2017 the Children’s Parliament produced a report entitled “What kind of Scotland? Children influencing Scotland’s future”. The key finding from this report was children identifying poverty as the biggest barrier to quality of life, with children linking this poverty to not having enough food to eat. In this report the children went on to identify that in order for all children to have a ‘best start’ in life they needed healthy food to eat from pregnancy through to young adulthood, with a focus on the healthy food that toddlers need to eat. The children went on to identify that they like living in Scotland as it’s a safe place to live but they worry about their health, they worry about obesity, heart disease and cancer and they talk about poverty leaving children hungry.

What does the evidence suggest about possible impacts of the policy/programme/decision, as planned, on those inequalities of outcome?

The above evidence clearly outlines the risks associated with food insecurity and inequalities of outcome caused by socio-economic disadvantage, and the direct positive impact that a healthy and nutritious diet can provide for young children, including but not limited to improved physical health and mental wellbeing, and increased developmental outcomes in later life. The updated Setting the Table, including the revised nutritional standards, will help to alleviate this risk by ensuring that ELC providers and practitioners are appropriately equipped to provide all children aged 0-5 in funded or paid for ELC settings across Scotland, including those from low-socio economic backgrounds or living in poverty, with healthy and nutritious meals, snacks and drinks as part of their ELC day.

Is there evidence that suggests alternative approaches to the policy/programme/decision? For example, evidence from the UK or international evidence?

Scottish Government officials supporting the update to Setting the Table have liaised closely with UK Government officials to ensure alignment of approach, as much as possible.

What gaps are there in key evidence? Is it possible to collect new evidence quickly in other areas? For example, through consultation meetings, focus groups or surveys? How could you involve communities of interest (including those with lived experience of poverty and disadvantage) in this process? The voices of people and communities are likely to be important for identifying potential improvements to the programme/policy/decision.

Whilst there is widespread recognition of the importance of early years exposure to food, the data and evidence on the provision of food in ELC settings is currently very limited. Instead, data and evidence on the take-up of funded ELC, child poverty, food insecurity and health, and children’s views about food and food insecurity were considered. The Scottish Government is exploring a range of options for sourcing further data and feedback on the provision of a free healthy and nutritious meal as part of the funded ELC day.