Health and the “Heating or Eating” Dilemma

Health 	and the Heating or Eating Dilemma

Prof. Euan Phimister of Stellenbosch Business School,  together with  researchers Sarah N. Champagne, Aravinda Meera Guntupalli, Jennie I. Macdiarmid and Omotayo Olusola, share their research into how the UK media portrays food and fuel poverty and the realities behind the "heating or eating" dilemma.

By CoBS Editor Antonin Delobre. Based on the research: Heating or eating? The framing of food and fuel poverty in UK news media, Sarah N. Champagne, Jennie I. Macdiarmid, Omotayo Olusola, Euan Phimister, and Aravinda Meera Guntupalli, Social Science & Medicine, 2024.

Note: This insight reflects the author-editor’s interpretations of the research paper rather than those of the original researchers. 

Research findings suggest that UK news media coverage has contributed to public sense-making around the intersection of food and fuel deprivation, increasing the visibility of the “heating or eating” dilemma, although discussion of longer-term structural responses appears to be less prominent.

While the discourse has brought previously separate issues together within a broader cost-of-living narrative, media coverage often relies on illustrative examples of lived experience rather than exploring potential policy responses in depth. The study also identifies relatively limited engagement with the public health dimensions of deprivation, despite evidence linking food and fuel insecurity to wider health outcomes.

Here are a few key points raised by the issue:

  • Frequency of framing: The “heat or eat” trade-off dominates 71% of media discourse, functioning as a rhyming, reductive heuristic that prioritizes emotional resonance over a more nuanced understanding of mutual rationing.
  • Although 59% of coverage assigns responsibility to the government, often identifying specific political actors such as Boris Johnson and Rishi Sunak, the narrative includes relatively limited discussion of specific policy responses, resulting in a less clearly defined account of how responsibility might be addressed.
  • The public health paradox: A stark disconnect exists where 29% of articles acknowledge individual health consequences, yet 0% frame the crisis as a collective public health issue, thereby erasing the potential for health-system-led advocacy.

The contemporary UK media landscape has witnessed the emergence of Food and Fuel Poverty (FFP) as a unified phenomenon, a significant departure from historical policy responses that treated these deprivations as distinct, segregated dimensions of poverty.

This narrative fusion was catalysed by a series of systemic shocks, including a decade of government austerity, the economic disruptions of the COVID-19 pandemic, and the 2022 spike in volatility exacerbated by the Russian invasion of Ukraine.

Food poverty is analytically defined as the inability to acquire nutritionally adequate food in socially acceptable ways, while fuel poverty encompasses the inability to maintain decent living standards through adequate domestic heating or cooling. In a high-income nation like the UK, the simultaneous occurrence of these deprivations exposes deep-seated societal inequalities and a failure of the social security safety net.

To analyse how the media shapes public perception and conditions policy responses, we must look to framing theory, which explores how news organisations promote specific aspects of a phenomenon to organize meaning. Frames act as heuristics – cognitive shortcuts – that allow the public to diagnose, judge, and assign responsibility for complex social issues.

This analysis identifies a critical division between “Descriptive Frames,” which define the nature of the lived experience, and “Prescriptive Frames,” which identify the actors possessing the culpability or capacity to remedy the situation. By emphasizing the immediate realities of the “heat or eat” dilemma while giving less attention to the broader policy context, media coverage tends to foreground individual experiences of hardship. As a result, discussion may focus more on describing the impacts of deprivation than on examining its structural causes or potential policy responses.

The media primarily utilises three lenses to articulate the experience of FFP, with a heavy emphasis on binary decision-making. The Trade-Off frame is the most pervasive, utilising the evocative “heat or eat” phrase as a widely recognised shorthand for the broader challenges associated with inadequate income.

This frame simplifies a complex reality where many individuals do not choose one over the other, but rather attempt a precarious “balancing act” characterised by the “Mutual Cutback” frame.

The rarest framing is “Just Poverty,” which criticises the very separation of these dimensions, arguing that the focus on food and fuel prices is a distraction from the fundamental issue of insufficient wages and benefits.

UK media coverage of the Eat or Heat dilemma and actual lived experience.
Health 	and the Heating or Eating Dilemma

Prof. Euan Phimister of Stellenbosch Business School,  together with  researchers Sarah N. Champagne, Aravinda Meera Guntupalli, Jennie I. Macdiarmid and Omotayo Olusola, share their research into how the UK media portrays food and fuel poverty and the realities behind the "heating or eating" dilemma.

Responsibility for the FFP crisis is ostensibly projected onto the state, with 59% of articles centring on government responsibility. Former high-level officials, specifically Prime Ministers Boris Johnson and David Cameron alongside Chancellor Rishi Sunak, are frequently cited as the primary stakeholders of this discourse.

However, this assignment of responsibility remains vague, as the media rarely calls upon specific ministerial bodies – such as the Department for Work and Pensions – to exercise stewardship over the intersecting issue. This relative lack of ownership suggests that FFP is viewed as an important issue by some stakeholders, while receiving less attention from others, particularly given the complexities of devolution between Westminster and Holyrood.

While the energy industry is occasionally criticised for “profiteering” (13%), a significant portion of the “positive prescription” is deferred to community and charity action (12%). A marginal 3% of the discourse retains a neoliberal individual-responsibility frame, attributing poverty to failures in personal budgeting or culinary skills.

A critical failure of media discourse is the absolute absence of a public health frame (0%), even when articles frequently list the harrowing health consequences of deprivation. While 29% of reports mention impacts such as respiratory disorders, cardiovascular disease, and excess winter mortality, these are treated as descriptive outcomes of individual suffering rather than as a systemic burden on the national health system.

A public health frame argues that the health of a population depends on collective action beyond individual choices, emphasising that the policy environment and the environment in which a person lives matter deeply for health outcomes. The media’s tendency to avoid framing FFP as a public health concern prevents the involvement of public health experts as trusted communication partners who could advocate for evidence-based, structural solutions. By treating malnutrition and mental health struggles as isolated symptoms of personal poverty, the media obscures the state’s responsibility to prevent these systemic hazards to the nation’s health.

Geographic analysis reveals that Scotland accounts for 30% of FFP coverage, a disproportionately high volume that suggests the region is a critical trial site for intervention and a strong proponent of a rights-based approach to social security. In terms of organisational prominence, the Trussell Trust – an NGO supporting a network of food banks throughout the UK – emerges as the most cited stakeholder.

While media coverage gives considerable visibility to charitable responses, it places comparatively less emphasis on permanent, state-led approaches. This framing may contribute to greater public attention being directed towards immediate relief measures than towards longer-term structural solutions. Furthermore, the current narrative focuses heavily on young families and children, resulting in a “one-size-fits-all” rhetoric that erases the specific needs of vulnerable cohorts – such as older adults, those with disabilities or ethnic minorities – who face higher energy requirements and specific dietary hurdles.

The “heating or eating” narrative has reached a plateau where its evocative power no longer translates into specific legislative action. To bridge the gap between “describing the pain” and “prescribing the cure,” the discourse must transition toward a unified public health lens.

This shift would redefine FFP not as a series of individual trade-offs, but as a structural hazard that requires clear ministerial stewardship and the engagement of health systems as advocacy partners.

Moving beyond the rhyming heuristics of deprivation is essential to ensure that the media serves as more than a witness to suffering, and rather as a catalyst for a more robust and equitable social security architecture. Only through this reframing can the UK move from the rhetoric of deprivation to a genuine remedy for poverty.

Euan Phimister, Sarah N. Champagne, Aravinda Meera Guntupalli, Jennie I. Macdiarmid, and Omotayo Olusola
Euan Phimister, Sarah N. Champagne, Aravinda Meera Guntupalli, Jennie I. Macdiarmid, and Omotayo Olusola

The Council on Business & Society (CoBS), visionary in its conception and purpose, was created in 2011, and is dedicated to promoting responsible leadership and tackling issues at the crossroads of business, society, and planet including the dimensions of sustainability, diversity, social impact, social enterprise, employee wellbeing, ethical finance, ethical leadership and the place responsible business has to play in contributing to the common good.  

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