December 2024 Board of Health Meeting - Addressing Household Food Insecurity Resolution

ISSUE

Food insecurity, defined as inadequate or insecure access to food due to financial constraints (Li et al., 2023), remains a significant public health issue in Windsor-Essex County (WEC). Locally, WEC had a 20.7% household food insecurity rate between 2021-2023, with a 24.1% rate in 2023 alone (PHO, 2024). The 2024 Real Cost of Eating Report demonstrates that income, particularly when dependent on social assistance, is not adequate for many WEC residents to afford basic needs. Even after adjusting for other well-established social determinants of health, such as education and income levels, food insecurity has been found to negatively impact people’s physical, mental, and social well-being. Food insecurity is a robust predictor of healthcare use and costs, resulting in considerable public spending on health care. Due to its impact on health, food insecurity is an urgent public health problem and upstream income-based solutions are needed to address poverty, income insecurity, and household food insecurity.

BACKGROUND

Income disparities: Income inequality has been recognized as one of the most significant social determinants contributing to poor population health outcomes and is the main driver of food insecurity. According to the Statistics Canada Labour Force Survey (2023) 41% of Windsor residents have difficulty meeting their financial needs. Table 1 outlines the disparities in a variety of income streams. Of note, the monthly amount a single adult on Ontario Works receives has gone unchanged since 2018, and although the minimum wage rate has increase by $3.20/hr in that same period, it is still well below the living wage rate for our community. 

Link between income and health/well-being: Income has a critical impact on health, with better health outcomes associated with higher income levels, and poorer health outcomes associated with lower income levels (Raphael et al, 2020). The severity of food insecurity makes it more difficult to manage self-care and conditions through diet, which further compromises health overall. This bi-directional relationship is also profoundly seen in mothers experiencing food insecurity, as they tend to cease exclusive breastfeeding sooner than those who are food secure leading to the “breastfeeding paradox”; those who can least afford to buy infant formula and whose babies can benefit most from breastmilk are least likely to breastfeed. This increases the risk infants being inadequately nourished, as research suggests that mothers in food-insecure circumstances struggle to maintain an adequate supply of formula. Evidence suggests income supplementation reduces food insecurity for low-income Canadians and positively impacts childhood health outcomes (e.g., birth weight, mental health) (ODPH, 2020).

Addressing Food Insecurity through income responses: Policy decisions play an important role in determining food insecurity rates, because many of these decisions directly impact households’ financial circumstances. Evidence and modelling clearly indicate that a livable minimum wage and increasing the amount of money provided by social assistance programs (such as the Canada Child Benefit, Employment Insurance, the Canada Pension Plan, and rental assistance programs), reduce the risk of household food insecurity (Dietitians of Canada, 2024). Further, numerous Ontario municipalities and their boards of health, have endorsed basic income, calling on the provincial and federal governments to collaborate to implement a basic income program (Kitchener City Council – 2024; Region of Waterloo - 2023; Hamilton City Council – 2023). Successful examples of a Canadian basic income include the Old Age Security (OAS) and Guaranteed Income Supplement (GIS). In a cohort of individuals over 65 receiving OAS/GIS, compared to a cohort aged 55-64 years, the probability of food insecurity was reduced by half, even when age, sex, income level, and home ownership were considered (McIntyre et al, 2016). Income policies preserve dignity, address the root cause of the problem, give choice of which foods to buy, and ensure the basic right to food. 

Previous Food Security Resolution and Current Work: In 2012, the Board of Health passed a resolution formalizing their commitment to improving food security for Windsor-Essex County residents. Since this resolution, the Chronic Disease and Injury Prevention Department has maintained the local Food Policy Council, monitored the rising cost of food in the community, and advocated for sustainable policy solutions to multiple levels of government. In March of 2024, the Board of Health received and passed the resolution Food Insecurity Compromises Infant Health, which inspired and informed, the Ontario Dietitians in Public Health resolution A24-04 Early Childhood Food Insecurity which was passed at the Association of Local Public Health Agencies (alPHa) AGM in June.

PROPOSED MOTION                                    

WHEREAS the 2024 Monitoring food affordability results demonstrate that households relying on minimum wage and social assistance do not have enough money to cover their living expenses, including food; AND  

WHEREAS food insecurity is a chronic and worsening health issue as documented by annual local data on food affordability and as recognized by multiple alPHa resolutions: AO5-18 (Adequate Nutrition for Ontario Works and Ontario Disability Support Program), A18-02 (Minimum Wage that is a Living Wage), A15-04 (Basic Income Guarantee), A23-05 (Monitoring Food Affordability in Ontario and the Inadequacy of Social Assistance Rates), and A24-04 (Early Childhood Food Insecurity); AND

WHEREAS numerous agencies such as Dietitians of Canda and the Ontario Dietitians in Public Health (ODPH) have position papers calling for income-based policy solutions for food insecurity at all levels of government.

NOW THEREFORE BE IT RESOLVED that the Windsor-Essex County Board of Health call on the federal government to implement income-related policy interventions that have the potential to reduce food insecurity, including: the expansion of the Canadian Child Benefit, implementing a basic income guarantee for those age 18-64, enhancing the Canada disability benefit, and providing access to automated income-tax returns for low income Canadians; AND 

FURTHER, the Board of Health call on the provincial government to incorporate local food affordability data in determining social assistance rates and to index Ontario Works rates to inflation to reflect the current costs of living; AND 

FURTHER, the Board of Health intensify its work with relevant area agencies and community groups, and municipalities to shift the focus of food insecurity initiatives from food charity to income-based solutions, including but not limited to the sharing of data and evidence-based income solutions.

References:

Li T, Fafard St-Germain AA, Tarasuk V. (2023). Household food insecurity in Canada, 2022. Toronto: Research to identify policy options to reduce food insecurity (PROOF). Retrieved from https://proof.utoronto.ca/

Public Health Ontario (2024). Toronto, ON: King’s Printer for Ontario; 2024 [cited 2024 09 09]. Available from: https://www.publichealthontario.ca/en/Data-andAnalysis/Health-Equity/Household-Food-Insecurity   

Statistics Canada (2023). Labour Force Survey, October 2023. Retrieved from: https://www150.statcan.gc.ca/n1/daily-quotidien/231103/dq231103a-eng.htm 

Raphael, D., Bryant, T., Mikkonen, J. and Raphael, A. (2020). Social Determinants of Health: The Canadian Facts. Oshawa: Ontario Tech University Faculty of Health Sciences and Toronto: York University School of Health Policy and Management 

Ontario Dietitians in Public Health. (2020). Position Statement and Recommendations on Responses to Food Insecurity. Available from: odph.ca. 

Dietitians of Canada (2024). Position Statement on Household Food Insecurity in Canada. Available from https://www.dietitians.ca/Advocacy/Priority-Issues-(1)/Position-Statement-on-Household-Food-Insecurity 

McIntyre, L., Duton, D.J., Kwok, C., & Emery, J.C.H. (2016). Reduc􀆟on of food insecurity among low-income Canadian seniors as a likely impact of a guaranteed annual income. Canadian Public Policy 42:3, 274-286. 

Tarasuk V, Li T, Fafard St-Germain AA. (2022) Household food insecurity in Canada, 2021. Toronto: Research to identify policy options to reduce food insecurity (PROOF). Retrieved from https://proof.utoronto.ca/  September 2, 2022.

Windsor Essex County Health Unit (2023). Real Cost of Eating Well in Windsor-Essex. Retrieved from: https://www.wechu.org/healthy-eating/nutritious-food-basket