Household Food Insecurity in Canada: Time for Action!

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Household Food Insecurity in Canada: Time for Action! McGill Conference on Global Food Security October 29, 2014 Naomi Dachner PROOF Research Manager Department of Nutritional Sciences University of Toronto Acknowledgement: This research is funded by a Canadian Institutes of Health Research programmatic grant in Health and Health Equity. This presentation draws on the work of PROOF http://nutritionalsciences.lamp.utoronto.ca/

Defining the problem Household food insecurity: insecure or inadequate access to food due to financial constraints - popularly termed hunger

Household Food Security Survey Module (administered on the Canadian Community Health Survey since 2004) 18 questions, differentiating adults and children s experiences over the last 12 months: Worry about not having enough food Reliance on low-cost foods Not being able to afford balanced meals Adults/children skip meals Adults/children cut size of meals Adults/children not having enough to eat Adults/children not eating for whole day because there wasn t enough money to buy food?

Household Food Insecurity in Canada 2007-2012 1800 1600 Number of households (000s) 1400 1200 1000 800 600 400 Marginal food insecurity Moderate food insecurity 200 Severe food insecurity 0 2007 2008 2011 2012 Data Source: Statistics Canada, Canadian Community Health Survey (CCHS), 2007, 2008, 2011 and 2012.

Household Food Insecurity in Canada 2007-2012 1800 Number of households (000s) 1600 1400 1200 1000 800 600 400 12.6% of households or 4 million people including 1.15 million children. Marginal food insecurity Moderate food insecurity 200 Severe food insecurity 0 2007 2008 2011 2012 Data Source: Statistics Canada, Canadian Community Health Survey (CCHS), 2007, 2008, 2011 and 2012.

Household food insecurity, by province and Territory, 2012 Canada 12.6% Newfoundland and Labrador Prince Edward Island Nova Scotia New Brunswick Quebec Ontario 13.4% 16.2% 17.5% 15.6% 13.5% 11.7% Severe Moderate Marginal Manitoba 12.1% Saskatchewan Alberta British Columbia Yukon 12.5% 11.5% 12.7% 17.1% Northwest Territories 20.4% Nunavut 45.2% 0% 5% 10% 15% 20% 25% 30% 35% 40% 45% 50% Data Source: Statistics Canada, Canadian Community Health Survey (CCHS), 2012.

84% of the food insecure population is in our four largest provinces Number of Food Insecure Households by Province and Territory NL 27,600 PEI MS NB 9,200 47,000 67,800 QC ON 437,700 571,300 MB SK 55,800 50,700 AB BC YT NWT NU 2,500 3,100 3,200 164,700 225,600 0 100,000 200,000 300,000 400,000 500,000 600,000 (Tarasuk, Mitchell & Dachner, Household Food Insecurity in Canada, 2012. 2014.)

Food insecurity is inextricably linked to health Average per capita health care costs 1 over 12 months for Ontario residents, 12 yr and older, by household food security status, CCHS 2005, 2007-10 4500 4000 $3930 3500 3000 $2806 $ 2500 2000 1500 1000 500 $1608 $2161 0 secure marginally insecure moderately insecure severely insecure 1 including emergency, physician services, inpatient, same day surgery, homecare services, and prescription drug costs 8 (J Cheng, work in progress)

Single best predictor of food insecurity = household income Percent Insecure (%) Prevalence of food insecurity by household income (CCHS 2011) 50.0 45.0 40.0 35.0 30.0 25.0 20.0 15.0 10.0 5.0 0.0 46.2 14.8 6.4 3.3 2.0 0.9 Food insecurity captures material deprivation. the product of income (size, security, stability) assets, savings access to credit shelter costs other expenses (food, medications, debt, etc) Household income, adjusted for household size

The social policy underpinnings of food insecurity 62% are reliant on employment incomes low wages; short-term, part-time employment; single vs dual earner households inadequate income transfers to offset low earnings. Seniors are protected 7% are food insecure (versus 11% of working households) guaranteed annual incomes, indexed to inflation. drug coverage, transit subsidies, seniors days, (Emery et al. SPP Research Papers 2013; Emery et al. Prev Med 2013)

Prevalence of food insecurity among households whose main source of income was social assistance, by province/territory, 2012 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% 46.2% 78.7% Data Source: CCHS 2011-12 Note: PEI and Northwest Territories have been omitted because of the small size of the samples there. (Tarasuk, Mitchell & Dachner, Household Food Insecurity in Canada, 2012. 2014.)

Prevalence of food insecurity among households in Newfoundland and Labrador receiving social assistance, 2007-2012 80% 70% 60% 50% 40% 30% 20% 10% income support rates indexed rates to inflation earning exemptions health benefits low-income tax threshold affordable housing liquid asset limits 0% 2007 2008 2009 2010 2011 2012 Loopstra, Dachner and Tarasuk, under review.

Despite promising effects of policy, charitable food assistance remains the primary response

Other community-based food programs Community kitchens Community gardens Farmers markets Good Food Boxes Nutrition education and budgeting School meal programs

Effectiveness? Less than one-quarter of food insecure use food banks and participation is much lower for community kitchens and gardens. (McIntyre et al. Can J Public Health 2012; Loopstra & Tarasuk, Can Public Policy 2012; Can J Public Health 2013) Food needs among participants are not addressed, even in the short term. (Hamelin et al. Health Educ Res 2010; Loopstra & Tarasuk, Can Public Policy, 2012; Can J Public Health 2013 Loopstra & Tarasuk, J Nutr 2013; Kirkpatrick & Tarasuk, Can J Public Health 2009) Community based programs do not address the root causes of food insecurity.

http://nutritionalsciences.lamp.utoronto.ca PROOF TEAM Valerie Tarasuk NPI, University of Toronto Craig Gundersen Co-PI, University of Illinois Naomi Dachner Research Manager, U of T Lynn McIntyre University of Calgary Herb Emery University of Calgary Catherine Mah Memorial University Jurgen Rehm CAMH Paul Kurdyak CAMH