Household Food Insecurity in Canada: An Examination of Nutrition Implications and Factors Associated with Vulnerability

Household food insecurity, defined as "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”, affected almost one in ten Canadian households in 2004. Responses have been dominated by community-based food initiatives with little attention paid to potential policy directions to alleviate this problem. The lack of impetus for policy responses may stem from the paucity of evidence documenting the nutrition implications of household food insecurity. Further, the development of policy interventions is hindered by a lack of understanding of the factors that influence vulnerability to food insecurity. This thesis comprises three studies aimed at providing stimulus and directions for policy responses to household food insecurity in Canada. The first study, an analysis of data from the 2004 Canadian Community Health Survey, documents poorer dietary intakes and heightened risk of nutrient inadequacies among adults and adolescents in food-insecure households, providing evidence of the public health implications and public policy relevance of household food insecurity. The second and third studies are examinations of household-level factors associated with vulnerability to household food insecurity. Analysis of data from the 2001 Survey of Household Spending demonstrates the relevance of housing costs to household food access. Among lower-income households, as the proportion of income allocated to housing costs increased, the adequacy of household food spending declined significantly. Receipt of a housing subsidy was associated with an improvement in food spending but mean food spending adequacy fell below the cost of a basic nutritious diet even among subsidized households. The final study comprises a cross-sectional survey of 464 low-income Toronto families, two-thirds of whom were food insecure over the preceding 12 months. Analysis of predictors of severe food insecurity highlights the centrality of income and housing costs and raises serious questions about current definitions of housing affordability and the adequacy of current housing subsidy levels. This work provides a public health imperative for action and points to the urgent need for social policy reform to ameliorate problems of household food insecurity in Canada.Ph