New Research – Maternal Food Insecurity is Positively Associated with Postpartum Mental Disorders in Ontario, Canada


Household food insecurity has been associated with pregnancy complications and poorer birth outcomes in the United States and with maternal mental disorders in the United Kingdom, but there has been little investigation of the effects of food insecurity during this life stage in Canada.


Our objective was to examine the relationship between the food insecurity status of women during pregnancy and maternal and birth outcomes and health in infancy in Canada.


We drew on data from 1998 women in Ontario, Canada, whose food insecurity was assessed using the Household Food Security Survey Module on the Canadian Community Health Survey, cycles 2005 to 2011–2012. These records were linked to multiple health administrative databases to identify indications of adverse health outcomes during pregnancy, at birth, and during children’s first year of life. We included women who gave birth between 9 months prior and 6 months after their interview date, and for whom infant outcome data were available. Multivariable Poisson regression models were used to compare outcomes by maternal food security status, expressed as adjusted relative risks (aRR) with 95% CIs.


While pregnant, 5.6% of women were marginally food insecure and 10.0% were moderately or severely food insecure. Food insecurity was unrelated to pregnancy complications and adverse birth outcomes, but 26.8% of women with moderate or severe food insecurity had treatment for postpartum mental disorders in the 6-month postpartum period, compared to 13.9% of food-secure women (aRR, 1.86; 95% CI, 1.40–2.46). Children born to food-insecure mothers were at elevated risk of being treated in an emergency department in the first year of life (aRR, 1.18; 95% CI, 1.01–1.38).


Maternal food insecurity during pregnancy in Ontario, Canada, is associated with postpartum mental disorders and a greater likelihood of infants being treated in an emergency department.

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New Research – Who Is Food Insecure? Political Storytelling on Hunger, Household Food Choices, and the Construction of Archetypal Populations

Food insecurity, inadequate access to adequate food due to economic constraints, affects one in eight households. Food insecurity is a serious structural problem affecting health, but dedicated policy action has been limited. In this study, we analyzed causal stories in Canadian political discussion about household food insecurity in provincial and federal Hansard records over two decades. Specifically, we examined patterns of archetypes – dominant characterizations of individuals and populations who experience food insecurity – and how these were used to convey a collective consciousness about ‘model’ food-insecure persons or groups. Archetypes aligned only with selected evidence of populations actually experiencing food insecurity.

New Research – Food Insecurity Is Associated With Higher Health Care Use And Costs Among Canadian Adults

Description: Food insecurity predicts poorer health, yet how it relates to health care use and costs in Canada remains understudied. Linking data from the Canadian Community Health Survey to hospital records and health care expenditure data, we examined the association of food insecurity with acute care hospitalization, same-day surgery, and acute care costs among Canadian adults, adjusting for sociodemographic characteristics.
Compared with fully food-secure adults, marginally, moderately, and severely food-insecure adults presented 26 percent, 41 percent, and 69 percent higher odds of acute care admission and 15 percent, 15 percent, and 24 percent higher odds of having same-day surgery, respectively.
Conditional on acute care admission, food-insecure adults stayed from 1.48 to 2.08 more days in the hospital and incurred $400–$565 more per person-year in acute care costs than their food-secure counterparts, with this excess cost representing 4.4 percent of total acute care costs. Programs reducing food insecurity, such as child benefits and public pensions, and policies enhancing access to outpatient care may lower health care use and costs.

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Food banks can’t adequately address COVID-19 food insecurity

A basic income, not expanded food charity, is critical as the pandemic plunges more Canadians into deprivation.

By Valerie Tarasuk, Lynn McIntyre

When the Prime Minister announced $100 million to support food banks and other community food programs during COVID-19, he was throwing aside everything we know about food insecurity in Canada. We know it is a large and very serious public health problem rooted in inadequate, insecure incomes. It cannot be solved by charitable food assistance. But in the announcement on April 3, which came after a series of innovative, generous and timely income support announcements for workers and businesses, Justin Trudeau called upon food charity volunteers and encouraged an expansion of programs that provide food rather than income for Canadians facing arguably the most extreme financial hardship during the pandemic.

Canada’s COVID-19 response has emphasized the importance of science in directing decision making.  Yet, food charity, an old idea that has never been able to adequately respond to food insecurity in Canada, has been brought to the fore as a sound solution. The evidence-based alternative to food charity is basic income, and this is the time for its implementation.

Food insecurity was bad before COVID-19. It is unquestionably worse now, as it will be in the post-COVID-19 recessionary future. Through national monitoring we know that in 2017-18, more than 4.4 million people were living in food-insecure households – the highest estimate to date. Food insecurity is a measure of people’s abilities to afford the food they need. It indicates a serious level of material deprivation. Food-insecure households struggle to cover the costs of all kinds of basic needs including rent, utilities, and prescription medications, day in and day out. Food insecurity is already a serious public health problem. Food-insecure Canadians are much more likely than others to have serious physical and mental health problems, and they are less able to manage these conditions. In the course of a year, severely food-insecure adults burn up more than double the health care dollars of the rest of us. They also die earlier – we estimated that severe food insecurity shaves 9 years off the life of adults in this country.

Without effective responses to the additional hardships brought on by COVID-19, the number of people affected by food insecurity and the levels of deprivation they face are going to get a whole lot worse. And the health implications of being food-insecure will become even more dire. So, mounting an effective response now is critical.

Over the last two decades, we and others have done a lot of research to figure out who is most at risk of food insecurity in Canada and why. This problem has nothing to do with food skills or shopping behaviours. Food insecurity is the product of inadequate, insecure incomes and a lack of assets. Prior to the pandemic, almost two-thirds of food-insecure households in Canada were reliant on income from employment. Many were in low-wage, short-term, part-time, precarious work. Any loss of income or rise in expenses for these workers and their families will make their situations worse. At the same time, job losses will plunge more people into food insecurity, as those with limited resources are unable to buffer this income shock.

We have also studied policy interventions that reduce food insecurity through deliberate poverty-reduction programming and the examination of food insecurity before and after policy changes. What moves the needle on food insecurity in Canada is interventions that a) reach low-income households whatever their income source, and b) improve their financial resources in an ongoing way. Examples include our public old-age pensions, the Canada Child Benefit, and Newfoundland and Labrador’s poverty reduction strategy.

Before COVID-19, the number of food-insecure people in Canada (4.4 million) was four times the number being helped by food banks. Seeking food charity is a strategy of last resort, most commonly used by people struggling to cope with severe levels of deprivation, but even among this group, most do not use food banksNor has food bank use risen as a strategy of choice over time.

Concerns about the institutionalization of food banks and their lack of effectiveness as a solution to food insecurity have been written about for decades. While the widespread public perception is that they must do some good, we have no evidence to suggest that the people who use food banks are better off than those who don’t. There are many reasons for this, only one of which is the limited assistance food banks can provide. Importantly, the needs of people who can’t afford enough to eat go way beyond food. Help from food banks has never been enough to fully meet the needs of those who use them, and this imbalance can only be intensifying now.

Image of skyscrapers with words "food insecurity" on them. A small truck with a short ladder labelled "food bank" is on the road, representing the disconnect between food insecurity and food bank use.
PHOTO CREDIT: Courtesy of Sarah Anne Charlebois, Canadian Observatory on Homelessness (Hub Solutions)

The newly announced Canada Emergency Response Benefit (CERB) will offer income support for up to 16 weeks to some of those who lose pay because of the pandemic. But its coverage and impact for households at risk of food insecurity are questionable. Calculations of basic living costs (in Alberta or Nova Scotia, for example) suggest that $2,000 may be insufficient to cover food, shelter, prescription medications, and other necessities for a month. This will matter less to recipients in households with other resources (the income of a spouse or parent, for example). But as a sole source of sustenance, the CERB is dangerously small.

People who are forced to turn to social assistance because they fail to qualify for CERB or any other income support program will find themselves in even more perilous situations. Pre-COVID-19, almost two-thirds of households reliant on social assistance were food insecure. The gross inadequacies of social assistance programs in Canada will spiral upwards now as basic living costs rise – even as more people are forced to apply for this assistance.

We are focusing on income support programs of last resort – CERB and social assistance – because that is what matters now for people who are unable to make ends meet through employment, savings, or other resources. There have been several initiatives announced under the federal government’s COVID-19 Economic Response Plan to support individuals who have been temporarily displaced from the workforce and to assist businesses and non-profits directly and indirectly, through tax postponement and wage subsidies. These levers are designed to sustain and eventually stimulate the economy in the relaunch phase post-pandemic. They must not be confused with the measure required to enable people to meet basic needs, namely a stable, adequate income.

As conditions worsen for the most vulnerable people in this country, we badly need effective responses. This means enabling those on the margins to meet their basic needs by ensuring that they have adequate, secure incomes – not trying to patch together these needs through haphazard charitable gestures and wage subsidies and emergency benefits implemented to address other objectives. Such efforts will not be enough to manage the escalating vulnerability of the millions of Canadians facing food insecurity. Now is surely the time to implement a basic income that is available to all. This means setting an income floor that is sufficient to meet basic needs and below which no one is allowed to fall. It’s the only way to ensure that no one is left behind.

This article was first published in Policy Options (April 28, 2020).

More Canadians are food insecure than ever before – and the problem is only getting worse

Today, PROOF, an interdisciplinary research program investigating household food insecurity in Canada, provides a long-awaited look into the current state of food insecurity in this country.

Drawing on data for 103,500 households from Statistics Canada’s 2017-18 Canadian Community Health Survey, we found that 1 in 8 households were food insecure. This represents 4.4 million people, the largest number recorded since Canada began monitoring food insecurity. And this number is an underestimate. The survey sample does not include people living on First Nations reserves, people in some remote northern areas, or people who are homeless – i.e., three groups at high risk of food insecurity.


What is food insecurity?

Household food insecurity refers to the inadequate or insecure access to food due to financial constraints. The experiences assessed to determine a household’s ‘food security status’ range from concerns about running out of food before there is more money to buy more, to the inability to afford a balanced diet, to going hungry, missing meals, and in extreme cases, not eating for whole days because of a lack of food and money for food.

Taken at face value, these questions suggest that food insecurity is a food problem – resolvable by programs that provide food for free or make it more accessible and affordable. But this misses the bigger picture. The deprivation experienced by food-insecure households is not limited to food. By the time people are struggling to put food on the table because of a lack of money, they are having trouble meeting all kinds of other expenses. Food-insecure households compromise spending on all kinds of necessities, including housing and prescription medications.

Who is food insecure?

Those most at risk are households with low incomes and limited assets (indicated on this survey by renting rather than owning your housing). Indigenous and Black households are disproportionately impacted by food insecurity, a finding reflective of the potent effects of colonialism and structural racism in Canada.

About 60% of households who report their main source of income as social assistance were food insecure. While not new, the finding is a stark reminder of the inadequacy of our ‘income support program of last resort’. Many of those who manage to qualify for income assistance cannot meet their basic needs. Almost one-third of those households reliant on Employment Insurance (EI) or Workers’ Compensation were also food-insecure, raising questions about the adequacy of these supports.

While the risk of food insecurity is greatest for households reliant on social assistance, EI or Workers’ Compensation, it is important to note that two-thirds of the households reported their main source of income as salaries or wages. Food insecurity is a serious problem for working Canadians.

Food-insecure households’ main source of income

Although 84% of people affected by food insecurity live in either Ontario, Quebec, Alberta, or British Columbia, there are clear geographic disparities in food insecurity rates. Food insecurity is much more prevalent in Nunavut than any other part of Canada. 57% of households in Nunavut reported some level of food insecurity and almost half of these households were severely food insecure (meaning that members experienced absolute food deprivation). The lowest prevalence of household food insecurity was 11% in Quebec. In fact, Quebec was the only place in Canada where the prevalence of food insecurity fell significantly between 2015-16 and 2017-18.

Household Food Insecurity by Province and Territory

Data source: Statistics Canada, Canadian Community Health Survey (CCHS), 2017-18.

Food insecurity is more common among households with children than those without. 17% of children under 18, or more than 1 in 6, lived in a family that experienced food insecurity. Across Canada, this rate ranged from a low of 15% in British Columbia to a high of 79% in Nunavut. The families most at risk were those headed by lone-parent women; one-third were food-insecure.

Food insecurity is a health problem.

It matters that 1 in 8 Canadian households were food-insecure in 2017-18 because such deprivation has profound negative effects on people’s health. The research on the relationship between food insecurity and health is unequivocal. Among children, exposure to severe food insecurity has been linked to the subsequent development of a variety of chronic health conditions, including asthma and depression. Adults in food-insecure households have higher rates of a wide variety of chronic diseases, including mental health problems, arthritis, asthma, and diabetes. They are also more likely to die prematurely. By our best estimate, adults in severely food-insecure households in Canada die 9 years sooner than the rest of us.

Because of its toxic effects on health, household food insecurity also places a substantial burden on our health care system.

How can we solve this problem?

  1. We must address its root causes – food programs are not the solution.

The persistently high prevalence of household food insecurity across Canada highlights the need for more effective, evidence-based responses. To date, there have been lots of federal, provincial, territorial, and local initiatives to support community food programs, including the federal government’s Local Food Infrastructure Fund launched last year. But food programs can’t fix the problem of household food insecurity that has been documented in this report.

  1. Governments must re-evaluate the adequacy of income supports and protections for low-income Canadians.

Tackling the conditions that give rise to food insecurity means re-evaluating the adequacy of the income supports and protections that are currently provided to very low-income, working-aged Canadians and their families. For example, our recent study of the Canada Child Benefit suggests that this new federal benefit reduced severe food insecurity among low-income families with children, but it did not make them food-secure. The high rate of food insecurity among families with children points to a need to review the benefit amounts for low-income families (i.e., those most vulnerable to food insecurity) to ensure that they are adequately supported to meet basic needs. Other federal programs like the Canada Workers Benefit also need to be reviewed to ensure that they are as effective as they can be in protecting low-income Canadians from food insecurity.

  1. Governments must design programs and policies in ways that ensure that vulnerable, low-income households have sufficient funds to make ends meet.

While federal leadership is imperative, provincial and territorial governments’ engagement in policies to reduce food insecurity is also critical. Given that the provinces and territories are responsible for health care, they bear the costs of food insecurity insofar as it increases people’s needs for health services. There are clear differences in food insecurity prevalence across the provinces and territories and within some jurisdictions (notably Quebec) over time. The effects of specific provincial/territorial policies on food insecurity rates warrant much more evaluation. What is known suggests that provincial and territorial government actions matter. Many important policy levers rest with the provinces and territories. They are responsible for social assistance, they set minimum wages and employment standards, they deliver social housing programs, they levy taxes and deliver tax credits, and many provide child benefits.

It’s time to recognize food insecurity is a serious public health problem in Canada, a problem that is only getting worse. Without deliberate, evidence-based policy interventions by federal, provincial and territorial governments, this problem will continue to fester.

For more information, see the Food Insecurity in Canada, 2017-18 report

New Research – Homeownership status and risk of food insecurity: examining the role of housing debt, housing expenditure and housing asset using a cross-sectional population-based survey of Canadian households

Studies have repeatedly found a strong, independent relationship between owning a home and lower vulnerability to food insecurity in Canada and elsewhere, but the reasons for this relationship are poorly understood. This aimed to examine the influence of housing asset, housing debt and housing expenditure on the relationship between homeownership status and food insecurity in Canada through examining cross-sectional data on food insecurity, housing tenure and expenditures, home value, income and sociodemographic characteristics derived from the 2010 Survey of Household Spending. Food insecurity prevalence was highest among market renters, followed by homeowners with a mortgage and mortgage-free homeowners. Substantial disparities in food insecurity exist between households with different homeownership status and housing asset level. Housing policies that support homeownership while ensuring affordable mortgages may be important to mitigate food insecurity, but policy actions are required to address renters’ high vulnerability to food insecurity.

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New Research – Association between household food insecurity and mortality in Canada: a population-based retrospective cohort study

Research drawing on a population-based sample of Canadian adults showed that those living in food-insecure households were more likely to die prematurely than their food-secure counterparts across all causes of death. Among adults who died prematurely, those experiencing severe food insecurity died nine years earlier than their food-secure counterparts. There is a graded positive association between household food insecurity status and hazard of premature mortality. This research shows that the markedly higher mortality hazard of severe food insecurity highlights the importance of policy interventions that protect households from extreme deprivation.

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New Research – Money speaks: Reductions in severe food insecurity follow the Canada Child Benefit

The rate of severe food insecurity dropped by one-third among low-income families after the introduction of the Canada Child Benefit (CCB) in 2016, researchers from the University of Toronto have found.

The study is the first to look at the CCB’s impact on food insecurity, defined as the inadequate or insecure access to food due to financial constraint.

“Our study results are yet another piece of evidence that improving household incomes reduces food insecurity,” says Valerie Tarasuk, a researcher at U of T’s Joannah & Brian Lawson Centre for Child Nutrition and the senior author on the study.

“If you give poor families more money, they spend it on basic necessities like food – and the more desperate they are, the more likely they are to do this.”

The journal Preventive Medicine published the results, which also reveal that while the benefit disproportionately affected low-income families, it did little to eradicate food insecurity altogether.

The muted effect is not surprising, the researchers say.

“I think the impact on family food insecurity was limited because the benefit was not designed with this outcome in mind,” says Tarasuk, a professor in the department of nutritional sciences in the Faculty of Medicine who is cross-appointed to the Dalla Lana School of Public Health. “To have a stronger impact on food insecurity, the government would need to put more money in the hands of the lowest-income families, which would be completely consistent with the intent of their federal poverty reduction strategy.”

Continue reading the U of T News article

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New Research – Prescription medication nonadherence associated with food insecurity: a population-based cross-sectional study

Household food insecurity, the inadequate access to food due to financial constraints, affects 4 million Canadians and is closely linked to poor health.

Almost half of adults who report not following drug prescriptions because of the cost are food insecure. The more severe their household food insecurity is, the greater the probability that adults will fail to take medications as prescribed because of the cost. This may lead to worsening health and greater use of health care services. Measures to reduce or eliminate out-of-pocket costs for prescription medications, while not a solution to household food insecurity, could improve food-insecure adults’ adherence to drug prescriptions.

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