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

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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

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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

OSNPPH Food Security Workgroup Responses to Food Insecurity Sub-group

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About OSNPPH

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

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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 21st century
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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.

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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

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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/

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How many Ontarians are affected by food insecurity?

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.

5 10 15 20 25 2005 2007 2008 2009 2010 2011 2012 2013 2014

Prevalence of Household Food Insecurity

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How is food insecurity relevant to public health practice?

  • Application of Nutritious Food Basket data
  • Determinants of health and reducing health

inequities

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NFB Scenarios Spreadsheet

Family / Income Scenarios Family of 4 Family of 4 Family of 4 Single parent, 2 children One person One person One person Ontario Works Full-Time minimum wage Median ON income Ontario Works Ontario Works Ontario Disability Support Program Old Age Security + Guaranteed Income Supplement Monthly Income $2196 $2882 $6952 $1988 $740 $1193 $1544 Average Monthly Rent $1030 $1030 $1030 $889 $582 $744 $744 Monthly cost

  • f food

$827 $827 $827 $624 $279 $279 $202 Funds remaining $339 $1025 $5095 $475

  • $121

$170 $598 % income for rent 47% 36% 15% 45% 79% 62% 48% % income for food 38% 29% 12% 31% 38% 23% 13%

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NFB Education & Advocacy

  • Reports to Boards of Health on results
  • f 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)

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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

  • High odds of becoming a high-cost user of health

care

Poor health Food insecurity

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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
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Food banks...solving hunger?

  • False impression that people receive enough from

food banks

  • Defines ‘hunger’ as the problem and charity as the

solution

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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

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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

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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

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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

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Food charity: A counterproductive response to food insecurity

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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.

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What is the solution?

  • Build social and political

movement – “nutcracker effect”

  • Raise awareness, educate
  • Recognize barriers:

political, social, economic

Baum, F. (2007) Cracking the nut of health equity: Top down and bottom up pressure for action on the social determinants of health. Promotion & Education, 14(2), 90-95. See more at: http://nccdh.ca/resources/entry/cracking- the-nut-of-health-equity

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.
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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

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Position Statement

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

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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

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Position Statement calls on

  • Ontario PHUs
  • Ontario Boards of Health
  • Municipal governments
  • Individuals
  • Schools, faith-based organizations, emergency

services, local businesses and community

  • rganizations
  • Media
  • Federal and provincial governments
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Additional Resources

http://www.osnpph.on.ca

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Outputs and outcomes to date

  • 130 endorsements from individuals and
  • rganizations 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
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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

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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

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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

  • f Finance at: http://tinyurl.com/hdzbjot )
  • Focus on ‘upstream’ or systems efforts when

possible (e.g., advocacy for a basic income)

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Aspirations for Public Health

  • 1. Take a leadership role in confronting and

influencing the social, political, and economic factors that determine population health to sustainably protect the health of the public against old and new threats.

  • 2. Take a leadership role in reducing inequities by

working to narrow health gaps across groups in ways that promote social justice and human rights.

Reference: Galea, S and Annas G. JAMA. 2016;315(7):655-656. doi:10.1001/jama.2016.0198.

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Public Health Strategies for the 21st Century

  • 1. Relentlessly prioritize actions to do what matters

most to the health of populations.

  • 2. Engage the mechanisms that explain how core

foundational structures produce population health.

  • 3. Move from government-dominated public health

to multi-sectoral public health.

  • 4. Formally adopt the Universal Declaration of

Human Rights as the Code of Public Health Ethics.

Reference: Galea, S and Annas G. JAMA. 2016;315(7):655-656. doi:10.1001/jama.2016.0198.

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Questions or comments?

Contact Us! maryellen.prange@hamilton.ca 905-546-2424 Ext.3484 tracy.woloshyn@york.ca 905-895-4512 Ext.74352