By Elaine Power
I’ve been studying the issue of food insecurity for over 20 years. Food insecurity refers to the state in which people can’t afford to buy healthy, culturally appropriate and personally acceptable food to feed themselves or their families.
It is a serious public health concern, affecting over 4 million Canadians including about 1.15 million children. It is clearly a symptom of poverty.
In low-income households, a lot of work (usually invisible) goes into managing the household budget. When it looks like there won’t be enough money for food, the person primarily responsible for food provisioning, usually a woman, intensifies the management process, first decreasing the quality of the food, substituting cheaper, more filling foods, to the detriment of fresh produce and dairy products.
If the management strategies are still inadequate, then the family food provisioner will reduce the quantities of food until, in the most severe situations, people skip meals, sometimes for a whole day. To the extent possible, mothers will protect their children from hunger with multiple strategies, including sending them to relatives’ for meals, going hungry themselves, going to food banks, or even stealing food.
It is not hard to imagine that food insecurity has a detrimental effect on nutritional status and health. It is also not hard to imagine that the stress of this management process takes a tremendous toll on physical health. Social health also suffers when it becomes difficult or impossible for people to participate in social, cultural or religious activities that involve sharing food with others.
We know from the social determinants of health literature that there is a gradient in health, such that people who live in poverty are much more likely to develop chronic diseases requiring dietary management, such as diabetes and heart disease. Being food insecure makes it impossible to eat properly to manage these conditions. We also have evidence that for those who are precariously food secure, getting a diagnosis of a chronic disease may be enough to tip the household into food insecurity. This may be a result of the extra associated costs of the disease (e.g., paying for blood sugar monitoring equipment) or because of the disruption of the careful management strategies, or some combination.
Canadian research published last summer shows that as food insecurity worsens, health care costs rise. In the most food insecure households, where people were skipping meals, health care costs were 76% higher than in households that were food secure. When the cost of prescription drugs was added in, health care costs were 121% higher in the most food insecure households compared to food secure households. This means that reducing food insecurity, by addressing poverty, will save money in the health care system.
Analysis of food insecurity measurements on the Canadian Community Health Survey shows that the vast majority of Canadian households on social assistance are food insecure, reflecting the low levels of benefits in almost all provinces and territories. However, the majority of food insecure households report their primary income from earnings, suggesting the inadequacy of wages in keeping people out of poverty.
A basic income guarantee could replace social assistance, with all its problems, as well as supplement earned income. An adequate basic income would virtually eliminate food insecurity in this country. This is one of the major ways in which basic income would operate to save us money, by improving health and saving costs in the health care system.
In addition, if a basic income were effective in addressing poverty, we would see the food banks in this country disappear because no one would need them anymore. Imagine what other projects we could tackle with so much energy and time and enthusiasm released from charitable food provisioning.