Transcript Why public health should reconsider its alignment with the

Why public health
should reconsider its
alignment with the
community food
security movement
Lynn McIntyre MD, MHSc, FRCPC
Professor and CIHR Chair in
Gender and Health, University of
Calgary [email protected]
Learning objectives
• Consider the unintentional harm that may be
occurring from public health alignment with
community food security initiatives
• Reflect upon how public health could advocate
more critically for measures that would
structurally reduce household food insecurity
• Develop arguments and strategies that could
shift public health's current community work
related to food security to a more upstream
approach
1Inadequate
or insecure access to adequate food
due to financial constraints
Moderate food
insecurity,
5.6%
Marginal food
insecurity,
4.1%
Household food security
Severe food
insecurity,
2.5%
Canada 2011
Food secure
Marginal food insecurity
Moderate food insecurity
Severe food insecurity
Source: Canadian Community Health Survey, 2011
Food secure,
87.7%
Household composition:
Food insecurity, by selected household characteristics
Canada, CCHS 2011
All Households
With children under 18
With children under 6
Couple, with children
Female lone parent
Male lone parent
Other
Elderly living alone
Education:
Less than secondary
Secondary school graduate, no post-secondary
Some post-secondary, not completed
Completed post-secondary, below Bachelor's degree
Household
Aborigi Tenure Main source of
income/LIM ratio: nal:
:
household income:
Completed Bachelor's degree or higher
Marginal food insecurity
Wages, salaries or self-employment
Moderate food insecurity
Senior's income, including dividends and interest
Severe food insecurity
Employment insurance of workers compensation
Social Assistance
Other or none
Dwelling owned by member of household
Dwelling rented
Yes
No
< 1.0
1.0 - 1.49
1.5 - 1.9
2.0 - 2.99
3.0 +
0%
5%
10%
15%
20%
25%
30%
35%
Food Secure
Food Insecure
25
Percent of Population
20
15
10
5
0
< 10k 10k to 20k to 30k to 40k to 50k to 60k to 70k to 80k to 90k to 100k to 110k to 120k to 130k to 140k to
19k
29k
39k
49k
59k
69k
79k
89k
99k
109k 119k 129k 139k 149k
Household Income
Source CCHS 4.1
Prevalence of HFI and Unemployment
by major census metropolitan area, Canada CCHS 2011
Food insecure (3-levels)
Unemploym’nt Total households
Rate (04.13)
(000s)1,2
St. John's
Halifax
Moncton
Saint John
Quebec
Montréal
Ottawa-Gatineau
Toronto
Hamilton
Winnipeg
Regina
Saskatoon
Calgary
Edmonton
Vancouver
Victoria
6.6
6.5
6.7
9.2
4.5
8.0
6.2
8.4
6.8
5.8
4.8
3.7
4.7
4.4
6.8
5.3
N (000s)
83.4
157.3
63.4
52.9
318.0
1,546.1
464.0
2,073.4
283.9
295.9
86.0
109.1
479.1
446.5
933.0
137.0
7.1
29.7
14.1
6.7
27.4
217.9
41.7
259.4
21.5
35.6
11.5
11.4
57.8
65.5
87.6
21.3
Percent %
8.5
18.9
22.3
12.6
8.6
14.1
9.0
12.5
7.6
12.0
13.3
10.5
12.1
14.7
9.4
15.5
1
'Total households' excludes those households with missing values for food security. That is, they did not provide a response to
one or more questions on the household food security module.
2 For CMAs other than Montreal, Toronto and Vancouver household numbers have been rounded to the nearest 50.
Average of all CMAs
915.9
12.2
Proportion of Single Persons Aged 60 to 69 with
Income $20,000 or Less Who Are Food Insecure,
CCHS 4.1
25
20
15
10
5
0
Food Insecurity rate
60-64 yrs
65-69 yrs
Main FI drivers
Best FI Policy Practices
• Structural determinants,
leave certain groups
vulnerable
• FI vulnerability: low income
as well as income shocks,
and can be mediated by
social transfers
• Workforce participation &
education, partial
protection, but labour
market practices can
perpetuate FI
• Income
• Income volatility
protection
• Social
protection/transfers
• Labour protection
• Fair market conditions
• Higher education
access
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Dominant responses in the name of
food (in)security
•
•
•
•
•
•
•
Food banks
Community gardens
Farmers’ markets
School food programs
Community kitchens
Community-supported agriculture
Food-related community economic
development
If not run by Public Health; Public Health is a ‘partner’
13
F OOD BANK USE IS THE PROBLEM &
T HE DOMINANT SOLUTION IS TO B UILD
B ETTER FOOD BANKS
• Evidence base on
reduction of FI is weak
• Conflation if not deliberate
appropriation of FI for
other aims
• Superficial communitybased interventions
undermine structural
action
• Most food sovereignty
initiatives increase
inequities
• Health harm of FI is not
food-based
Why public health should
rethink its involvement
with ‘community food
security’
The public health
physician’s role should
be to provide critical
leadership to wellmeaning staff who work
with community food
security actors.
Use their voice to
pursue higher level
public policy goals such
as the reduction of
poverty and income
inequality.
http://nutritionalsciences.lamp.utoronto.ca
16
Thank you