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Ontario Cancer Facts

Understanding Regional Food Insecurity Helps Set System-level Prevention Priorities

Jun 2015

  • 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.

Source: Canadian Community Health Survey, 2011–2014 (Statistics Canada)                
Notes:
95% LCL: 95% Lower Confidence Limit
95% UCL: 95% Upper Confidence Limit
* Estimates are significantly different from the Ontario estimate.
Interpret estimates with caution due to high sampling variability.
Data from Canadian Community Health Survey cycles 2011 through 2013, and 2012 through 2014, combined to increase sample size for analyses by public health unit.

Percentage of Ontario households that are food insecure, by public health unit, 2011–2013 combined
Public health unit Percentage 95% LCL 95% UCL
*Peterborough County-City 16.3 12.78 19.72
Wellington-Dufferin Guelph 15.0 11.86 18.09
Eastern Ontario 14.9 11.55 18.19
*Toronto 14.7 12.63 16.67
Thunder Bay District 14.1 11.50 16.60
Hastings and Prince Edward Counties 13.7 11.15 16.23
Brant County 13.4 10.61 16.20
North Bay-Parry Sound District 13.4 10.51 16.20
Algoma 12.8 9.03 16.56
Porcupine 12.8 10.14 15.40
Simcoe-Muskoka District 12.5 10.57 14.53
City of Hamilton 12.4 10.09 14.80
Kingston Frontenac and Lennox & Addington 12.4 8.02 16.78
Peel 12.3 10.36 14.32
Durham Region 12.3 9.96 14.62
Middlesex-London 12.3 9.43 15.15
Region of Waterloo 12.1 9.82 14.35
Elgin-St Thomas 11.9 8.83 15.00
Lambton 11.8 8.64 14.88
Perth District 11.7 8.66 14.73
Haldimand-Norfolk 11.6 8.92 14.32
Chatham-Kent 11.5 8.83 14.22
Niagara Region 11.5 9.24 13.69
Windsor-Essex County 11.4 8.32 14.52
Leeds, Grenville, Lanark District 11.2 8.63 13.71
Huron County 11.1 7.02 15.23
Ottawa 10.4 8.76 11.95
Oxford County 10.3 7.48 13.20
Haliburton, Kawartha, Pine Ridge District 9.9 7.31 12.54
Timiskaming 9.9 7.60 12.13
*Grey-Bruce 9.8 7.78 11.79
Renfrew County and District 9.7 6.76 12.67
*Sudbury and District 9.6 7.36 11.83
*Northwestern 7.5 5.21 9.79
*York Region 7.3 5.74 8.85
*Halton Region 7.0 4.84 9.20
Ontario 12.0 11.42 12.52

Source: Canadian Community Health Survey, 2011–2014 (Statistics Canada)                
Notes:
95% LCL: 95% Lower Confidence Limit
95% UCL: 95% Upper Confidence Limit
* Estimates are significantly different from the Ontario estimate.
Interpret estimates with caution due to high sampling variability.
Data from Canadian Community Health Survey cycles 2011 through 2013, and 2012 through 2014, combined to increase sample size for analyses by public health unit.

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.