- Food insecurity occurs when access to food is compromised, affecting the quality and quantity of food consumed, as well as cancer risk.
- In 2011–2013, food insecurity ranged from 7.0% to 16.3% across public health units.
- Understanding these regional variations helps with prioritization of system-level efforts to improve cancer prevention.
According to combined 2011–2013 data, the prevalence of household food insecurity varies across Ontario’s 36 public health units, revealing opportunities for targeted system-level improvements in cancer prevention. Food insecurity occurs when physical and economic access to sufficient, safe and nutritious food to meet dietary needs and food preferences is compromised. It is the strongest predictor of nutritional inadequacies, affecting the quality and quantity of food consumed, and potentially cancer risk. Compared to adults who are food secure, adults experiencing food insecurity eat significantly fewer servings of vegetables and fruit, which is a cause for concern because eating vegetables and fruit may protect against cancers of the oral cavity and pharynx, larynx, esophagus and stomach. Consuming fruit may also protect against lung cancer. 
Compared to the Ontario average (12.0%) for the 2011–2013 period, the prevalence of household food insecurity was significantly higher in the Peterborough County-City (16.3%) and Toronto (14.7%) public health units; and was significantly lower in the Halton Region (7.0%), York Region (7.3%), Northwestern (7.5%), Sudbury and District (9.6%) and Grey Bruce (9.8%) public health units.
Although reasons for the variation in food insecurity prevalence among public health units have not been formally assessed, regional differences in economic well-being may play a role because food insecurity is predominantly a product of insufficient financial resources. Awareness of these regional differences can help in the planning of system-level initiatives intended to reduce cancer risk at the population level across public health units. Evidence shows that system-level policies and programs that modify risk at a population level often have a greater impact than efforts to change behaviours 1 individual at a time; therefore, additional investigation into regional needs and population-specific characteristics related to food insecurity is warranted. Continuous monitoring and evaluation of these efforts, and the policies and programs that shape them, will help to further refine areas for system improvement.
Household food insecurity data are derived from the Household Food Security Survey Module, administered within the Canadian Community Health Survey. The module contains 18 questions that measure the severity of food insecurity by asking whether household members were able to access the food they needed in the past 12 months, including whether any member of the household worried about running out of food and whether any member of the household did not eat for a whole day.
Food insecurity is 1 of 15 indicators measuring the effects of system-level policies and programs in the 2015 Prevention System Quality Index, which span 7 domains for cancer prevention: tobacco, alcohol, healthy eating, physical activity, environment, ultraviolet radiation and cancer screening. By creating a single resource for policy-makers, planners and public health and health professionals that assesses activity across a range of cancer risk factors and exposures, the PSQI supports the development of policies and broad-scale programs that could make the healthy choice the easier choice for Ontarians. In future PSQI reports, new indicators will likely be developed as opportunities for enhancements through structured consultation with partners and stakeholders emerge, and selection criteria are applied.