to Food Insecurity Presented by: Mary Ellen Prange, City of - PowerPoint PPT Presentation

OSNPPH Food Security Workgroup Responses to Food Insecurity Sub-group Position Statement on Responses to Food Insecurity Presented by: Mary Ellen Prange, City of Hamilton Public Health Services Tracy Woloshyn, York Region Public Health June 2, 2016

About OSNPPH info@osnpph.on.ca www.osnpph.on.ca @RDspubhealthON

Overview • Household food insecurity: def’n , measurement, relevance to PH practice • Nutritious Food Basket recommendations • Food insecurity: a serious PH problem • Food insecurity: community responses • Development of OSHPPH Position Statement • Actions & outcomes to date and next steps • Aspirations and strategies for PH in the 21 st century

Definitions Household Food Security Food security exists in a household when all people, at all times, have physical and economic access to sufficient, safe and nutritious food to meet their dietary needs and food preferences for an active and healthy life.

Definitions Household Food Insecurity inadequate or insecure access to food because of financial constraints Hunger an individual-level physiological condition that may result from severe food insecurity with a high level of food deprivation Individuals who experience food insecurity may not experience hunger

How is food insecurity measured? Household Food Security Survey Module (HFSSM) • 18 questions • Part of Canadian Community Health Survey • Reports produced by Food Insecurity Policy Research (PROOF) http://proof.utoronto.ca/resources/ proof-annual-reports/

How many Ontarians are affected by food insecurity? Prevalence of Household Food Insecurity 25 20 15 10 5 0 2005 2007 2008 2009 2010 2011 2012 2013 2014 Reference: Tarasuk V, Mitchell A, Dachner N. 2016. Household food insecurity in Canada, 2014. Toronto: Research to identify policy options to reduce food insecurity (PROOF). Retrieved from: http://proof.utoronto.ca.

How is food insecurity relevant to public health practice? • Application of Nutritious Food Basket data • Determinants of health and reducing health inequities

NFB Scenarios Spreadsheet Single parent, Family of 4 Family of 4 Family of 4 One person One person One person 2 children Family / Old Age Income Ontario Full-Time Security + Scenarios Ontario Median ON Ontario Ontario Disability minimum Guaranteed Works income Works Works Support wage Income Program Supplement Monthly $2196 $2882 $6952 $1988 $740 $1193 $1544 Income Average $1030 $1030 $1030 $889 $582 $744 $744 Monthly Rent Monthly cost $827 $827 $827 $624 $279 $279 $202 of food Funds $339 $1025 $5095 $475 -$121 $170 $598 remaining % income for 47% 36% 15% 45% 79% 62% 48% rent % income for 38% 29% 12% 31% 38% 23% 13% food

NFB Education & Advocacy • Reports to Boards of Health on results of NFB costing with recommendations for provincial and/or federal gov’t action • Public education • Media communication • Participation on local coalitions (e.g., basic income, poverty-reduction)

Relationship between food insecurity and health • Health and well-being are closely linked to household food security • Food insecurity can both an outcome and cause of poor health Food Poor insecurity health • High odds of becoming a high-cost user of health care

Food insecurity: Community responses • Food charity • Food banks • Community meals • Programs for children • Coupons/vouchers • Community food programs • Community gardens • Collective kitchens • Good Food Boxes

Food banks...solving hunger? • False impression that people receive enough from food banks • Defines ‘hunger’ as the problem and charity as the solution

What does the literature say? Less than 25% of those experiencing food insecurity use food banks Accessing food banks can be challenging Food banks often do not reach the population that is the most severely food insecure Stigmas and social exclusion surround food insecurity and food bank use Food banks typically not able to meet clients’ food and nutrient needs Food banks are inherently reliant on donors and volunteers

What does the literature say? Food banks, the media, and public support of the charitable model alleviate pressure on government to provide adequate income As registered charities , food banks have limited advocacy opportunities Food banks do not address the underlying root cause of hunger – POVERTY Food banks are not reducing food insecurity Food banks were intended to be emergency relief in the face of a recession and have since been institutionalized – food banks are not a valid long-term solution

Food charity: An ineffective response to food insecurity • Food insecurity requires a paradigm shift from an individual/household problem to a system problem that requires intervention with public policy • Social justice issue: the right to food

Food charity: A counterproductive response to food insecurity From a systems-level perspective, the existence of food banks • creates the illusion that food insecurity is being taken care of in the community • allows the state to neglect its obligation to ensure income security for all Canadians

Food charity: A counterproductive response to food insecurity

Why no effective action? • Knowledge limited to researchers, public health professionals, policy makers • Citizens generally unaware of the problem • Minimal government intervention in capitalist economy is generally seen as a good thing • Governments not pressured enough to take action Adapted with permission from: “ Placing the Social Determinants of Health on the Public Policy Agenda” presentation by Dennis Raphael and Toba Bryant at the Annual Meeting of the Canadian Public Health Association. Toronto, June 14, 2016.

What is the solution? • Build social and political movement – “nutcracker effect” • Raise awareness, educate • Recognize barriers: political, social, economic Adapted with permission from: “ Placing the Social Determinants of Health on the Public Policy Agenda” Baum, F. (2007) Cracking the nut of health presentation by Dennis Raphael and Toba Bryant at the equity: Top down and bottom up pressure for Annual Meeting of the Canadian Public Health action on the social determinants of health. Association. Toronto, June 14, 2016. Promotion & Education, 14(2), 90-95. See more at: http://nccdh.ca/resources/entry/cracking- the-nut-of-health-equity

Basic Income Guarantee: an effective response to food insecurity • Dramatic reduction in poverty rates of Canadians after age 65 • Rate of food insecurity among Canadian aged 65- 69yrs is half of that among those 60-64yrs Emery H, Fleisch V and McIntyre L. How a guaranteed annual income could put food banks out of business. The School of Public Health Policy SPP Research Papers. 2013; 6(37): 1-20. http://policyschool.ucalgary.ca/sites/default/files/research/emery-foodbankfinal.pdf • Endorsement of the concept by experts (e.g., Tarasuk, Power, McIntyre, Riches) • Addresses concerns with charity and social assistance re: dignity and security

Position Statement http://www.osnpph.on.ca/

Position Statement key messages • Food insecurity is an urgent human rights and social justice issue for local, provincial, and federal public policy agendas • Food charity is an ineffective and counterproductive response to food insecurity; it does not address root cause – poverty • An income response is required to effectively address food insecurity

Position Statement calls on • Ontario PHUs • Ontario Boards of Health • Municipal governments • Individuals • Schools, faith-based organizations, emergency services, local businesses and community organizations • Media • Federal and provincial governments

Additional Resources http://www.osnpph.on.ca

Outputs and outcomes to date • 130 endorsements from individuals and organizations including: • 9 Boards of Health/Health Units • OPHA • alPHa • Community Food Centres Canada • Health Providers Against Poverty – Ontario • Ontario Network of Injured Workers • Freedom 90 (Association of Food Bank volunteers) • The Ontario Association of Public Health Nursing Leaders • Ontario Healthy Communities Coalition

Outputs and outcomes to date • Liaison with alPHa/OPHA Health Equity Workgroup • Letter to Premier/Deputy Premier/Minister of Community and Social Services http://tinyurl.com/hsfqxzr • International interest from the U.K. https://seekingsitopia.wordpress.com/ • NCCDH call for examples of advocacy and health equity in Canada

What’s next? • Continue to seek endorsements; to endorse, go to: http://tinyurl.com/zjt5mkz • PowerPoint for Health Units • Put forward a submission for PROOF conference – Nov. 2016

Application of Position Statement to public health practice • Avoid perpetuating the message that charity or community food programs are effective responses to food insecurity • Encourage municipalities to not support tax credits for donation of ‘edible waste’ to food charities ( see OSNPPH’s letter to federal Minister of Finance at: http://tinyurl.com/hdzbjot ) • F ocus on ‘upstream’ or systems efforts when possible (e.g., advocacy for a basic income)