Food insecurity: A problem of inadequate income, not solved by food

October 13, 2022

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Charitable food programs have been the primary response to household food insecurity in Canada since the 1980s. Yet, for as long as there has been systematic monitoring, there has been no meaningful decline in the prevalence of household food insecurity.

Based on the most recent data from Statistic Canada’s Canadian Income Survey, almost 1 in 6 people in the ten provinces lived in a food-insecure household in 2021.[1]* This amounts to 5.8 million Canadians, which is an underestimate considering that data on the territories are not yet available and the survey does not include people living on First Nations reserves, in some remote Northern areas, or who are homeless.[1]

Research into what it means to be food insecure helps explain why interventions centred around food have such limited impact — they fail to address the underlying problem of inadequate income. Food-insecure households do not only make compromises to food but also to other basic needs. The health consequences of food insecurity extend far beyond poor nutrition.

If the spotlight remains on the lack of food, it keeps the extensive compromises and health consequences these households face in the dark. It also leads us away from policy interventions that ensure wages and income supports are sufficient for them to meet their basic needs.

Illustration of helicopter shining light on can of food in the water with other basic needs sinking in the shadows, forming a dollar sign symbol

Compromises to food are only part of the pervasive deprivation food-insecure households face.

Food insecurity is an important marker of dietary compromise with food-insecure households spending less on food and having poorer quality diets, which decline with increasing severity of food insecurity.[2]

However, these compromises are part of a wider spectrum of trade-offs. Compared with food-secure households, food-insecure households spend substantially less on their essential needs such as housing, clothing, transportation, and personal care.[2][3] In addition, food-insecure adults may delay, reduce, or skip prescription medications because they can’t afford them. This cost-related medication nonadherence is associated with worsening health and greater use of health care services.[4]

Adults living in food-insecure households are more likely to delay, reduce, or skip prescription medication due to cost.

The breadth of health problems associated with food insecurity goes beyond diet-related conditions.

While food insecurity is associated with poor nutrition and diet-related diseases like diabetes,[3][5] its effects on health extend beyond conditions related to food and nutrition.

Food-insecure adults are at greater risk for a wide range of physical and mental health problems including mood and anxiety disorders,[6] depression,[7][8] infectious diseases,[9][10] chronic pain,[11] and poor oral health.[12] New research also shows that food-insecure adults and adolescents face greater risk of injury.[13]

This story continues to play out in the relationship between food insecurity and premature death (i.e., before the age of 83). While infectious-parasitic diseases, injuries, and suicides make up only a small proportion of premature deaths in Canada, the increase in risk of dying from these causes is especially great for severely food-insecure adults.[14] They are more than twice as likely to die from these causes than their food-secure counterparts.

The vast majority of premature deaths for both food-secure and food-insecure adults in Canada are caused by non-communicable diseases, but it is clear that these too take a much greater toll on the food-insecure.[14]

Adults living in food-insecure households are more likely to die prematurely.

Interventions that focus on food and not households’ financial circumstances miss the bigger picture.

Understanding food insecurity as a marker of a pervasive material deprivation and profound health inequity helps direct us to approaches to this problem that are effective.

The long history of food charity in Canada has produced a massive network of non-profit food providers,[15] but there has been no progress on food insecurity reduction because most food assistance programs provide, at most, temporary food relief.[16][17][18][19]

There is also no evidence that other food-based interventions, such as food literacy education, alternative food retail, or community gardens, can reduce food insecurity.[20][21][22][23][24][25][26] Ultimately, these approaches are unable to resolve the broader experiences of deprivation and the underlying inadequate financial circumstances.

On the other hand, income-based interventions treat the core problem rather than its symptoms. Research has repeatedly shown that policies that improve the financial situation of low-income households reduce their risk of food insecurity.[27][28][29][30][31][32][33]

Policies like minimum wage, social assistance, progressive taxation, child benefits, public pensions, and other income transfers must do more to support sufficient and stable incomes. It is also clear that systemic manifestations of racism and colonialism drive the high rates of food insecurity among Black and Indigenous households.[34][35] More attention must be paid to the socioeconomic and policy conditions that give rise to food insecurity.

Shifting the focus from food to income policies

Government response to food insecurity has continued to focus on food, with increased funding recently going towards charitable food initiatives.[36][37][38][39][40] This government response must end. The persistently high rates of food insecurity are a telling sign that there needs to be a concerted effort to restructure federal, provincial, and territorial policies to ensure Canadians have enough money for their basic needs.

Given the abundance of evidence on what it means to be food-insecure and the ability for income-based interventions to reduce food insecurity, the way forward lies in treating this problem as what it actually is — a problem of income inadequacy, not solved by food.


* Statistics for the territories in 2021 from the 2020 Canadian Income Survey (CIS) are not available at the time of this publication. Estimates from the 2018 and 2019 CIS show very high rates of food insecurity in the territories.

References

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  2. Fafard St-Germain AA, Tarasuk V. Prioritization of the essentials in the spending patterns of Canadian households experiencing food insecurity. Public Health Nutrition. 2018;21(11):2065-78.
  3. Hutchinson J, Tarasuk V. The relationship between diet quality and the severity of household food insecurity in Canada. Public Health Nutr. 2021:1-14.
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  7. Tarasuk V, Gundersen C, Wang X, et al. Maternal food insecurity is positively associated with postpartum mental disorders in Ontario, Canada. J Nutr. 2020;150(11):3033-40.
  8. Shafiee M, Vatanparast H, Janzen B, et al. Household food insecurity is associated with depressive symptoms in the Canadian adult population. Journal of Affective Disorders. 2021;279:563-71.
  9. Cox J, Hamelin AM, McLinden T, et al. Food insecurity in HIV-hepatitis C virus co-infected individuals in Canada: the importance of co-morbidities. AIDS and Behavior. 2016;21(3):792-802.
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  19. Tarasuk V, Fafard St-Germain AA, Loopstra R. The relationship between food banks and food insecurity: insights from Canada. Voluntas: International Journal of Voluntary and Nonprofit Organizations. 2019;31(5):841-52.
  20. Huisken A, Orr S, Tarasuk V. Adults’ food skills and use of gardens are not associated with household food insecurity in Canada. Canadian Journal of Public Health. 2016;107(6):e526–e32.
  21. Kirkpatrick S, Tarasuk V. Food insecurity and participation in community food programs among low-income Toronto families. Canadian Journal of Public Health. 2009;100(2):135-9.
  22. Loopstra R, Tarasuk V. Perspectives on community gardens, community kitchens and the Good Food Box program in a community-based sample of low-income families. Canadian Journal of Public Health. 2013;104(1):e55-e9.
  23. Blanchet R, Loewen OK, Godrich SL, et al. Exploring the association between food insecurity and food skills among school-aged children. Public Health Nutrition. 2020;23(11):2000-5.
  24. Pepetone A, Vanderlee L, White CM, et al. Food insecurity, food skills, health literacy and food preparation activities among young Canadian adults: a cross-sectional analysis. Public Health Nutr. 2021;24(9):2377-87.
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