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      Geographic and socio-demographic predictors of household food insecurity in Canada, 2011–12

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          Abstract

          Background

          Household food insecurity is a potent social determinant of health and health care costs in Canada, but understanding of the social and economic conditions that underlie households’ vulnerability to food insecurity is limited.

          Methods

          Data from the 2011–12 Canadian Community Health Survey were used to determine predictors of household food insecurity among a nationally-representative sample of 120,909 households. Household food insecurity over the past 12 months was assessed using the 18-item Household Food Security Survey Module. Households were classified as food secure or marginally, moderately, or severely food insecure based on the number of affirmative responses. Multivariable binary and multinomial logistic regression analyses were used to determine geographic and socio-demographic predictors of presence and severity of household food insecurity.

          Results

          The prevalence of household food insecurity ranged from 11.8% in Ontario to 41.0% in Nunavut. After adjusting for socio-demographic factors, households’ odds of food insecurity were lower in Quebec and higher in the Maritimes, territories, and Alberta, compared to Ontario. The adjusted odds of food insecurity were also higher among households reliant on social assistance, Employment Insurance or workers’ compensation, those without a university degree, those with children under 18, unattached individuals, renters, and those with an Aboriginal respondent. Higher income, immigration, and reliance on seniors’ income sources were protective against food insecurity. Living in Nunavut and relying on social assistance were the strongest predictors of severe food insecurity, but severity was also associated with income, education, household composition, Aboriginal status, immigration status, and place of residence. The relation between income and food insecurity status was graded, with every $1000 increase in income associated with 2% lower odds of marginal food insecurity, 4% lower odds of moderate food insecurity, and 5% lower odds of severe food insecurity.

          Conclusions

          The probability of household food insecurity in Canada and the severity of the experience depends on a household’s province or territory of residence, income, main source of income, housing tenure, education, Aboriginal status, and household structure. Our findings highlight the intersection of household food insecurity with public policy decisions in Canada and the disproportionate burden of food insecurity among Indigenous peoples.

          Electronic supplementary material

          The online version of this article (10.1186/s12889-018-6344-2) contains supplementary material, which is available to authorized users.

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          Most cited references57

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          Food insecurity and the risks of depression and anxiety in mothers and behavior problems in their preschool-aged children.

          We sought to determine if the prevalence of depression and anxiety in mothers and the prevalence of behavior problems in preschool-aged children are more common when mothers report being food insecure. A cross-sectional survey of 2870 mothers of 3-year-old children was conducted in 2001-2003 in 18 large US cities. On the basis of the adult food-security scale calculated from the US Household Food Security Survey Module, mothers were categorized into 3 levels: fully food secure, marginally food secure, and food insecure. The 12-month prevalence in mothers of a major depressive episode and generalized anxiety disorder was assessed by the Composite International Diagnostic Interview-Short Form. A child behavior problem in > or = 1 of 3 domains (aggressive, anxious/depressed, or inattention/hyperactivity) was based on the Child Behavior Checklist. Seventy-one percent of the respondents were fully food secure, 17% were marginally food secure, and 12% were food insecure. After adjustment for sociodemographic factors plus maternal physical health, alcohol use, drug use, prenatal smoking, and prenatal physical domestic violence, the percentage of mothers with either major depressive episode or generalized anxiety disorder increased with increasing food insecurity: 16.9%, 21.0%, and 30.3% across the 3 levels. Among children, after further adjustment for maternal major depressive episode and generalized anxiety disorder, the percentage with a behavior problem also increased with increasing food insecurity: 22.7%, 31.1%, and 36.7%. Mental health problems in mothers and children are more common when mothers are food insecure, a stressor that can potentially be addressed by social policy.
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            Are food insecurity's health impacts underestimated in the U.S. population? Marginal food security also predicts adverse health outcomes in young U.S. children and mothers.

            This review addresses epidemiological, public health, and social policy implications of categorizing young children and their adult female caregivers in the United States as food secure when they live in households with "marginal food security," as indicated by the U.S. Household Food Security Survey Module. Existing literature shows that households in the US with marginal food security are more like food-insecure households than food-secure households. Similarities include socio-demographic characteristics, psychosocial profiles, and patterns of disease and health risk. Building on existing knowledge, we present new research on associations of marginal food security with health and developmental risks in young children (<48 mo) and health in their female caregivers. Marginal food security is positively associated with adverse health outcomes compared with food security, but the strength of the associations is weaker than that for food insecurity as usually defined in the US. Nonoverlapping CIs, when comparing odds of marginally food-secure children's fair/poor health and developmental risk and caregivers' depressive symptoms and fair/poor health with those in food-secure and -insecure families, indicate associations of marginal food security significantly and distinctly intermediate between those of food security and food insecurity. Evidence from reviewed research and the new research presented indicates that households with marginal food security should not be classified as food secure, as is the current practice, but should be reported in a separate discrete category. These findings highlight the potential underestimation of the prevalence of adverse health outcomes associated with exposure to lack of enough food for an active, healthy life in the US and indicate an even greater need for preventive action and policies to limit and reduce exposure among children and mothers.
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              Food insecurity in Canadian households.

              J. Che, J. Chen (2001)
              This article examines the prevalence of food insecurity in Canada, the characteristics of people most likely to live in households lacking sufficient funds for food, and several related health problems. The data are from the cross-sectional household component of the 1998/99 National Population Health Survey and the Food Insecurity Supplement to that survey. Cross-tabulations were used to estimate the percentage of Canadians experiencing food insecurity and the prevalence of five selected health outcomes among people who were and were not food insecure. Multivariate logistic regression was used to assess the association of several socio-demographic and economic factors with food insecurity and to determine the association of food insecurity with the selected health outcomes. In 1998/99, 10% of Canadians, or about 3 million people, were living in food-insecure households. Low-income households, households depending on social assistance, lone-parent families headed by women, tenants, children, and Aboriginal people had significantly high odds of experiencing food insecurity. Food insecurity was significantly associated with poor/fair health, multiple chronic conditions, obesity, distress and depression.
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                Author and article information

                Contributors
                1-416-978-0618 , valerie.tarasuk@utoronto.ca
                andreeanne.fafardst.germain@mail.utoronto.ca
                andy.mitchell@utoronto.ca
                Journal
                BMC Public Health
                BMC Public Health
                BMC Public Health
                BioMed Central (London )
                1471-2458
                3 January 2019
                3 January 2019
                2019
                : 19
                : 12
                Affiliations
                ISNI 0000 0001 2157 2938, GRID grid.17063.33, Department of Nutritional Sciences, Faculty of Medicine, , University of Toronto, ; 1 King’s College Circle, Toronto, ON M5S 1A8 Canada
                Author information
                http://orcid.org/0000-0001-6013-7859
                Article
                6344
                10.1186/s12889-018-6344-2
                6318847
                30606152
                9025e232-20b4-437c-941b-87f51e590612
                © The Author(s). 2019

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 5 April 2018
                : 19 December 2018
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100000024, Canadian Institutes of Health Research;
                Award ID: FRN 115208
                Award Recipient :
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2019

                Public health
                household food insecurity,income,social assistance,indigenous peoples,canada
                Public health
                household food insecurity, income, social assistance, indigenous peoples, canada

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