1. proof.utoronto.ca
@proofcanada
Learning from population survey data on food insecurity: insights from Canada
Valerie Tarasuk
Professor, Department of Nutritional Sciences
Faculty of Medicine, University of Toronto
Acknowledgement: The research presented here was funded by a programmatic grant from the Canadian Institutes of Health Research.

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

3. Canadian Community Health Survey (CCHS):
Conducted annually by Statistics Canada to monitor the health of the population.
Surveys a nationally representative sample of approximately 65,000 Canadians, 12 years of age and older
Omits people living on reserves and in institutions, members of the Armed Forces, and people who are homeless.
Food security module is not always part of the common content, and on years when it has been optional, some provinces and territories have opted out.

4. (Tarasuk, Mitchell & Dachner, Household Food Insecurity in Canada, 2012. 2014.)

5. Number of people living in food-insecure households vs number reported to be helped by food banks in March of respective year.
Data Sources: Statistics Canada, Canadian Community Health Survey (CCHS), 2007, 2008, 2011 and 2012, and Food Banks Canada, HungerCount, 2007, 2008, 2011 and 2012.

6. Adults’ fruit and vegetable consumption, servings per day by food security status* * * * *
Food secure
Food insecure
# of servings
Age/sex group
Food insecurity here includes only moderate and severe food insecurity.
*Significant difference between food-secure & food-insecure subgroups, p<0.05
(Kirkpatrick & Tarasuk, J Nutr, 2008: 138: ) 6

7. The health effects of food insecurity in Canada
Children
Poorer development and learning
Impaired disease management
Increased likelihood of developing asthma, depression, other chronic conditions.
Adults
Poorer mental health
Increased probability of infectious and non-infectious diseases
Poor disease management and heightened odds of negative disease outcomes.
(Aibibula et al. AIDS Care Anema et al, AIDS Care Anema et al, PLoS One. 2013; Marjerrison et al, J Pediatrics, 2011;158:607-11; Gucciardi et al, Diabetes Care 2009; Gundersen et al, PloS One 2018; Jessiman-Perreault & McIntyre, SSM Pop Health 2017; Kirk et al, Public Health Nutr 2014; Kirkpatrick et al., Arch Pediatric Adol Med 2010; McIntyre et al., J Affective Disorders 2013, McIntyre et al. J Social Psych Psych Epid, 2017; Melchior et al, PloS One 2012; Tarasuk, Mitchell, McLaren & McIntyre, J Nutr, 2013; Tarasuk et al, Can J Psychiat 2018)

8. (Adapted from Tarasuk V, Mitchell A, McLaren L, & McIntyre L
(Adapted from Tarasuk V, Mitchell A, McLaren L, & McIntyre L. Chronic physical and mental health conditions among adults may increase vulnerability to household food insecurity. Journal of Nutrition. 143(11), )

9. (Adapted from Tarasuk V, Mitchell A, McLaren L, & McIntyre L
(Adapted from Tarasuk V, Mitchell A, McLaren L, & McIntyre L. Chronic physical and mental health conditions among adults may increase vulnerability to household food insecurity. Journal of Nutrition. 143(11), )

10. Average health care costs per person incurred over 12 months for Ontario adults (18-64 years of age), by household food insecurity status:
$2806 $
One window into the health impact = health care utilization (ON).
Slide also makes the business case for intervention
(Tarasuk et al, Canadian Medical Association Journal, 2015)

11. What predicts vulnerability to household food insecurity?
Findings from multivariable analyses of population surveys:
Increased odds:
Lower income
Reliance on social assistance, Employment Insurance or Workers’ Compensation
Renter (vs home owner)
Presence of children under 18 yr
One adult – single or lone parent
Aboriginal respondent
Education < university completion
Decreased odds:
Reliance on seniors’ pension or retirement income
Immigrant vs Canadian born
No evidence of association:
Food shopping/cooking skills
Use of home or community garden for food
Proximity to food retail (only small-scale studies)

13. 65% of food insecure households are renters.
After adjustment for income and other socio-demographic characteristics, renters still have 2-3 times the odds of food insecurity.
Homeownership reflects greater assets and access to credit  protection against income shocks.
(McIntyre et al, J Hous and the Built Environ, 2016)

14. Food insecure households spend less on everything, and prioritize spending on basic needs.
(Fafard-St Germain & Tarasuk, Public Health Nutrition 2018)

15. Policy insights arising from analyses of monitoring data

16. Prevalence of food insecurity by main source of income, 2012

17. Probability of moderate and severe food insecurity by age among low-income unattached adults

18. Probability of moderate and severe food insecurity by age among low-income unattached adults

19. Prevalence of food insecurity by main source of income, 2012
Low benefit levels + asset limits + restrictions on earnings = extreme vulnerability.

20. Data Source: CCHS
Note: PEI and Northwest Territories have been omitted because of the small size of the samples there.

21. NL’s Poverty Reduction Actions included: ↑ income support rates
indexed rates to inflation
↑ earning exemptions
↑ health benefits
↑ low-income tax threshold
↑ affordable housing
↑ liquid asset limits
(Loopstra, Dachner & Tarasuk, Canadian Public Policy, September, 2015)

22. 2012

23. Understanding of food insecurity that has emerged from our analyses of population data:
Food insecurity is a potent social determinant of health.
The deprivation experienced by food-insecure households is not limited to food. Their spending is compromised across a broad spectrum of goods and services.
Household food insecurity status is the product of
income - stability, security, and adequacy relative to expenses (e.g., shelter, food, medications, debt), and
assets - reflected in our data by home ownership.

24. OPPORTUNITY FOR ALL - CANADA’S FIRST POVERTY REDUCTION STRATEGY
August 21, 2018