Canadian Medical Association Journal
"We know that people who have trouble affording the food
they need have poorer health in general as well as more chronic disease,"
states Dr. Valerie Tarasuk, Department of Nutritional Sciences, University of
Toronto, Toronto, Ontario.
The term "food insecurity" describes inadequate or
insecure access to food because of financial constraints. In Canada in 2012,
almost 13% of households had some level of food insecurity, the highest rate
since 2007, when national monitoring began.
The researchers assessed
food insecurity with an 18-point scale (also used in the United States for the
same purpose). They linked food security status to data from the Institute for
Clinical Evaluative Sciences (ICES) on participants' direct health care costs,
including emergency department visits, acute and psychiatric hospital stays, physician
visits, day surgeries and home care over a 1-year period.
They also considered
the costs of prescription drugs that are covered by the province for people
receiving social assistance.
Of the total sample, 12.2% lived in food-insecure households.
When food insecurity status was considered, 3.9% lived in marginally, 5.2% in
moderately and 3.1% in severely food-insecure households -- a measure of
extreme deprivation.
People with higher severity of food insecurity used more health
care services and incurred higher health care costs.
"We found that health care costs were 23% higher for adults
in marginally food-insecure households, 49% higher for those in moderately
food-insecure households and 121% higher for those in severely food-insecure
households, compared with adults in food-secure households," Dr. Tarasuk
states. "Our findings suggest that food insecurity takes a significant
toll on health care spending."
Canada has a universal, publicly funded health care system in
which all Canadians have access to health care regardless of ability to pay.
However, prescription drugs are not provided universally to Canadians, although
drug costs for people receiving social assistance may be covered by provincial
plans, as in Ontario.
"Household food insecurity was a potent predictor of health
care costs incurred by working-age adults in Ontario, independent of other
well-established social determinants of health," states Dr. Tarasuk.
Because there are no public programs designed to address food insecurity in Canada,
health care professionals are limited in their ability to help patients who are
struggling to put food on the table.
"To date, no provincial or federal intervention has been
introduced with the explicit goal of reducing household food insecurity, but
our study findings suggest that such intervention would offset considerable
public expenditures on health care and improve overall health," write the
authors.