Is food insecurity the issue, or is it discrimination?

Community food security means always having access to a safe, nutritious diet through a sustainable system that promotes healthy choices, self-reliance, and equal access.[1] Food insecurity is “the inability to acquire or consume an adequate diet quality or sufficient quantity of food in socially acceptable ways, or the uncertainty that one will be able to do so.”[2] Understanding community food security is essential, because its impacts on health, economics, and social equity are profound and far-reaching.

Food insecurity is about health. Food insecurity is correlated with poor health, functional limitations, and chronic conditions.[3,4] It’s linked to childhood asthma, depression, obesity, and academic performance.[4,5] Food-insecure individuals experience higher rates of anxiety, hopelessness, and depression, with limited social support.[4]

Food insecurity is costly. Health care spending is 23% higher for working-age adults with marginal food insecurity, increasing to 121% when food insecurity is severe.[6] In 2011, 12.3% of Canadians were considered food insecure; by 2022, this had increased to 17.8%.[7,8]

Food insecurity is ageist. One in four Canadian children faces food insecurity, with 1.2 million children affected in 2022, impacting lifelong health and economic outcomes.[7]

Food insecurity is racial. People who identify as Black or Indigenous experience disproportionate rates of food insecurity (39.2% and 33.4%, respectively), compared with those who identify as White (15.3%).[7] Indigenous people are more likely to live in rural areas, with high food costs and challenging transportation networks. Colonization has disrupted both traditional passing down of cultural knowledge and traditional food systems.[9]

Food insecurity is sexist and ableist. Households headed by single women are more likely to be food insecure, and people with disabilities have 3 times higher rates of food insecurity.[10]

Food insecurity is about government policy. BC has the second-lowest provincial rate of food insecurity, after Quebec.[7] BC’s minimum wage has increased from $10.25 in 2013 to $16.75 now, contributing to its improved standing among provinces regarding food insecurity.[11]

Food insecurity is about income. Food insecurity rates halve at age 65, when individuals gain access to the Canada Pension Plan and Old Age Security.[7] Access to reliable, adequate funds that are adjusted based on inflation has been proven to decrease food insecurity.

Food insecurity is about climate change. Extreme weather events such as heat waves, heavy rain, and droughts hinder food production. Ironically, global food production contributes to one-third of the world’s greenhouse gases and significantly impacts biodiversity loss.[9]

Canadian policies often address food insecurity through food banks, meal programs, and food prescriptions; however, they do not address food security. Policies targeting social determinants provide the largest sustained improvements. Evidence supports a higher minimum wage, a guaranteed basic income, meaningful employment opportunities, and addressing systemic inequities.[13]

Reducing disparities in food insecurity, prejudice, and poverty offers clear benefits. As physicians, we see the impacts on our patients and the health care system. We must advocate for social and climate policies for the long-term health of all.
—Selena Lawrie, CCFP
COHP Member
—Jennifer M. Phillips, CCFP
COHP Member

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This article is the opinion of the authors and not necessarily the Council on Health Promotion or Doctors of BC. This article has not been peer reviewed by the BCMJ Editorial Board.

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

References

1.    Bellows AC, Hamm MW. International effects on and inspiration for community food security policies and practices in the USA. Crit Public Health 2003;13:107-123.

2.    BC Centre for Disease Control. Defining food security and food insecurity in British Columbia. Accessed 23 April 2024. www.bccdc.ca/Documents/FoodSecurity_FoodInsecurity_Definitions_FINAL.pdf.

3.    Che J, Chen J. Food insecurity in Canadian households. Health Rep 2001;12:11-22.

4.    Vozoris NT, Tarasuk VS. Household food insufficiency is associated with poorer health. J Nutr 2003;133:120-126.

5.    Alaimo K, Olson CM, Frongillo EA Jr. Food insufficiency and American school-aged children’s cognitive, academic, and psychosocial development. Pediatrics 2001;108:44-53.

6.    Tarasuk V, Cheng J, de Oliveira C, et al. Association between household food insecurity and annual health care costs. CMAJ 2015;187:E429-E436.

7.    Li T, Fafard St-Germain AA, Tarasuk V. Household food insecurity in Canada, 2022. PROOF. 19 November 2023. Accessed 23 April 2024. https://proof.utoronto.ca/resource/household-food-insecurity-in-canada-2022.

8.    Tarasuk V, Mitchell A, Dachner N. Household food insecurity in Canada, 2011. PROOF. Last updated 12 May 2017. Accessed 23 April 2024. https://proof.utoronto.ca/wp-content/uploads/2014/01/foodinsecurity2011_final.pdf.

9.    Alderhill Planning Inc. Indigenous food sovereignty and food security in a changing climate: What was heard from Indigenous engagements. 2022. Accessed 23 April 2024. www2.gov.bc.ca/assets/gov/environment/climate-change/adaptation/indigenous/food_security_report_-_2023.pdf.

10.    PROOF. Who are most at risk of household food insecurity? Accessed 23 April 2024. https://proof.utoronto.ca/food-insecurity/who-are-most-at-risk-of-household-food-insecurity.

11.    Ministry of Labour. Minimum wage increases to $17.40 an hour on June 1 [news release]. BC Gov News. 26 February 2024. Accessed 23 April 2024. https://news.gov.bc.ca/releases/2024LBR0006-000240.

12.    World Bank. What you need to know about food security and climate change. 17 October 2022. Accessed 23 April 2024. www.worldbank.org/en/news/feature/2022/10/17/what-you-need-to-know-about-food-security-and-climate-change.

13.    PROOF. What can be done to reduce food insecurity in Canada? Accessed 23 April 2024. https://proof.utoronto.ca/food-insecurity/what-can-be-done-to-reduce-food-insecurity-in-canada.