1. 58% OF HOUSEHOLDS WITH CHILDREN EXPERIENCED FOOD INSECURITY IN NORTHERN MANITOBA IN 2008-09 Shirley Thompson, Mariah Mailman, Asfia Gulrukh Kamal University of Manitoba, Natural Resources Institute s_thompson@umanitoba.ca 12 November 2009 Figure 3. Percent of households with children that were moderately (red) and severely (purple) food insecure with 95% confidence (weighted by sample size of communities) in households with children compared by road access. The number of communities in each grouping is indicated in brackets. BACKGROUND Families in northern Manitoba lack access to affordable nutritious foods, particularly perishables such as fruits and vegetables, due to limited food selections, high food prices, and poor quality of fresh produce. Expensive transport costs and difficult logistics (e.g. airfreight charges, and uncertainty of travel on winter roads, high poverty rates, and a continuing decline in the use of country foods (Northern Food Prices Steering Committee, 2003) result in high prices and few healthy choices for vegetables. This household food security survey provides the first quantified data on the food security status in northern Manitoba. OBJECTIVES We explored the food security status of households of children and asked if in the last 12 months financial constraints affected the quality and quantity of food available to and consumed by children under 18 years. To measure the food security status of households in communities, a simple and scientifically grounded measurement tool (modified from the US Food Security Survey Module, Bickell, Nord, Price et al. 2000) was used, applying the version that was adapted for Canada (Health Canada, 2007, pp. 45-49). The survey uses a validated set of 18 questions about food security as experienced and reported by household members, of which eight questions consider children’s food security and the other ten questions are directed toward measuring adult food security. METHODS The following steps to determine child food security status were taken 1.A survey of 534 households, of which 463 had children, in northern Manitoba was undertaken in the summer of 2009 in 14 communities. In most of these 14 communities we surveyed 50 homes. Many communities had small sample sizes because the population was limited, which resulted in the entire population being sampled in Granville Lake, Ilford, Thicket Portage and War Lake. However, for Wasagamack the sample is small and unrelated to the population size and caution should be taken in interpreting the results for this community. 2.The survey was analyzed using excel and SPSS for children in households for each of the eight child-referenced items. Each question in the survey asked the household about a food insecurity issue that occurred or did not occur within the past 12 months due to financial resources. “Depending on the question, a response was considered affirmative if the respondent indicated (i) “yes”; (ii) “often” or “sometimes”; or (iii) “almost every month” or “some months but not every month” (Health Canada, 2007, p. 11). The response is calculated according to the equation: Percent of households with food insecurity issue = number of affirmative responses/total number of households responding. “Households for which the item was “not applicable” were excluded from the denominator (Health Canada, 2007, p. 79)” as well as items for which the participant’s response was “no answer” or “I don’t know”. Blank responses were treated as “no answer”. 3.The level of food insecurity for northern Manitoba was determined with confidence intervals. Out of the eight child-related questions, if three were answered affirmatively the household was considered moderately food insecure and four or more were considered severely food insecure. Table: Food Insecurity Ratings from Answers to Household Food Security Survey. The more times affirmative responses were made indicated a greater degree of food insecurity. Overall, households were moderately food insecure if either adults or children or both adults and children were moderately food insecure and neither were severely food insecure. If either adults or children were severely food insecure, the household was severely food insecure (Health Canada, 2007 p. 10). In households that were moderately food insecure the quality and/or quantity of food consumed was compromised. Households that were severely food insecure had reduced food intake and disrupted food patterns. FINDINGS Almost two-thirds of children at 58% +/- 2% in northern Manitoba households were food insecure (n=463, 34% moderately and 24% severely equals 58% total with 2% confidence intervals) (Figure 1). All households (not shown) were more moderately and severely food insecure than households with children, and it appears that households that were moderately food insecure were better able to privilege children’s eating needs than households that were severely food insecure. Across communities the total rate of food insecurity of households with children ranged from 10% in Ilford to 88% in Granville Lake (Figure 2). Households with severely food insecure rates were lowest, at zero, in Ilford and Thicket Portage and highest in South Indian Lake (53%). Household with children were greater than 40% severely food insecure in: Brochet/Barrens Land First Nation, Garden Hill First Nation, Red Sucker Lake First Nation and South Indian Lake First Nation. In households with children, the percentage of food insecurity was greater in communities that lacked road access compared with those with road access (Figure 3). Lack of road access seems to elevate the rate of overall food insecurity by 20% in households with children. The responses for the individual questions were summarized for the 14 communities. Households that responded to a question asking whether “your household relied on only a few kinds of low-cost food to feed the children because you were running out of money to buy food” had 62% of people answering yes, with 21% often and 41% sometimes = 62%. In household with children meals did not always contain all of the food groups (often 19% and sometimes 44% = 63%) (Figure 4). Children were not able to eat enough because households couldn’t afford to buy enough food (17% often and 44% sometimes = 61%) (Figure 5). The survey also showed that household with children that showed a lack of food, and a lack of money to buy more food, caused parents to cut the size of children’s meals (36%). Further, households with children skipped meals (34%), and of the 34% that skipped meals, 11% did so often, 11% skipped meals some but not every month, and 13% skipped meals only one or two months in the last 12 months. The survey revealed that household with children not eating for a whole day were approximately one in five (19%), and for going hungry were more than one in four (26%). CONCLUSIONS The quality and quantity of healthy food is lacking in 58% +/- 2% of households with children in northern Manitoba due to high food prices. More than half of households with children in northern Manitoba had either reduced food intake and disrupted food patterns or reduced quality or quantity of food. These rates show a food security crisis in Manitoba’s Aboriginal communities (First Nation and Northern Affairs communities) that needs immediate attention and dedicated resources. Long-term solutions are required and immediate action should be taken. Road access is an important factor contributing to the rates of food insecurity. Communities without road access have greater levels of food insecurity than those with road access. ACKNOWLEDGMENTS This study was funded by CIHR. We extend deep thanks to all of the people in these northern First Nation communities, including War Lake FN, South Indian Lake FN, Nelson House FN, Berens River FN, Red Sucker Lake FN, Garden Hill FN, Wasagamack FN, St. Theresa Point FN and Northern Affairs communities including Ilford, Cormorant, Wabowden, Leaf Rapids, Lynn Lake and Thicket- Portage. Figure 2. Percent of households with children that were moderately (red) and severely (purple) food insecure compared by communities. Numbers in brackets represent sample size, the number of households that were interviewed in each community. Figure 1. Percent of households with children that were food security (black), moderately food insecure (red) and severely food insecure (purple) with 95% confidence intervals and weighted by sample size of communities. Figure 5. Percent of households where children’s meals were restricted in size (blue), skipped (red), children didn’t eat for a whole day (purple) and children were hungry (yellow). Figure 4. Percent of households where adults relied on a few kinds of low-cost food to feed children (blue), couldn’t afford to feed children balanced meals (red) and children weren’t able to eat enough because households couldn’t afford to buy enough food (purple). Granville Lake children are planting tomatoes at a gardening party. Keith Anderson and his niece plant vegetables in Leaf Rapids. A youth said, “Lynn Lake gives us food. Whenever we want, we catch fish”. In Nelson House, Bella and her family get eggs from her chickens. Someone from Thicket Portage said, “Children are not getting enough healthy options. They can’t recognize common fruits and veggies because they never have been exposed to these kinds of food. They mostly eat Kraft dinner and chicken nuggets”. An elder from Ilford said, “The young generations do not have the knowledge. We need someone to teach them how to garden”.