From Alberta to Ontario - When it comes to community and societal interventions, what is available from each province on the topic of food insecurity & mental health?
Co-authors: Mary Ann Gatbonton, RN CCHN (c) and Kylie McLean, RD
The COVID-19 pandemic has impacted the mental health of many Canadian families (Gadermann et. al, 2021). Food insecurity and financial strain are determinants of mental health for individuals and families (Alegría et al., 2018) and highly important to intervene at the community and societal levels. According to a report by Statistics Canada (Polsky & Gilmour, 2020), one in five Canadian households experience challenges meeting their financial needs and food insecurity were linked to increased rates of mental health symptoms. In this co-authored blog, Mary Ann Gatbonton, RN CCHN (c) and Kylie McLean, RD partner up to compare food insecurity, as it relates to population mental health promotion in Alberta and Ontario, using the socio-ecological model and focusing specifically on societal and community levels.
In a report published in 2022, Alberta is stated to have the highest rate of household food insecurity at 20.3% and Ontario is reported at 16.1%, which includes those reporting severe, moderate and marginal food insecurity (Tarasuk et. al, 2022). This report also highlights that the percentage of children under the age of 18, living with food insecurity in Alberta and Ontario are 21.7% and 20.6% respectively (Tarasuk et. al, 2022). Food insecurity is a complex issue that has many contributing determinants, as well as solutions.
Kylie - Alberta:
When I worked as a Dietitian in outpatient care the healthcare team would talk about food insecurity with patients if it was found to be a barrier to achieving their nutrition goals but at that time it was not a required question during patient intake or initial assessments. However, things may be changing in Alberta. Nutrition Services within Alberta Health Services (the provincial health authority) released a report in 2022 which recommends that in healthcare settings individuals are screened for poverty as a marker to help identify household food insecurity. The intention is that the healthcare provider(s) may then support the individual to address their financial strain rather than only be referred on to a food hamper/assistance program. The overall assessment of financial strain would help the treating healthcare professional/team to other areas, such as mental health, which are being impacted by financial strain and food insecurity. Screening for poverty in the healthcare setting would have benefits to all individuals across the lifespan, as well as the action from the screening would have a positive ripple effect on mental health.
At a community level, a few examples of food assistance available for Albertans includes:
Food Banks Alberta - Providing food hampers to individuals and families from over 100 locations in Alberta.
The Grocery Run Program in Edmonton - Provides essential groceries to newcomers and refugees in Edmonton.
·Fresh Routes - A non-profit who brings groceries at wholesale price to communities in Calgary and nearby First Nations communities who have barriers to access affordable and healthy food.
In Alberta, there is also a variety of Alberta Income Supports for those who may be eligible. This includes Alberta Child and Family Benefit, Assured Income for the Severely Handicapped (AISH), and Alberta Adult Health Benefits, among other social supports. Although the recommendation to have screening in the healthcare institutions for poverty, it is not currently a required screening item. From my perspective, Alberta lacks robust societal level interventions to support those who are experiencing food insecurity.
Mary Ann - Ontario:
Mental health, financial stress, and food insecurity have been long-standing public health issues. As a nurse working in public health, advocating for adequate income, affordable housing, and access to nutritious and culturally appropriate food has been a long-standing priority. As part of Ontario's poverty reduction strategy, Ontario developed the following food security strategy that focuses on four areas. It states:
Empowered communities with custom-made solutions. Food security challenges and solutions differ across the province. Communities need tools to help mobilize solutions and supports to individuals and communities based on their needs.
Integrated food initiatives that use knowledge to drive collective impact. We recognize the need for a shared vision, clear goals, common metrics and a set of connected, mutually reinforcing activities based on the best available knowledge. We can increase food security in our province by working together towards a shared vision.
Food Security is about more than food. Income, the cost of food and other basic necessities matter. There are lots of ways to increase economic access and reduce the frequency of trading off one basic need against others at the household level.
Driving innovation. To tackle significant challenges and issues we need new ways to get to solutions. We will support, encourage and learn from creative, innovative disruptors who will help us find them.
Source: Ontario's Food Security Strategy (Ministry of Children, Community and Social Services, 2022)
At Toronto Public Health, the Healthy Babies, Healthy Children program services families in the perinatal period and those with children under three years old. To be eligible for this program and services, the screening tool identifies families at-risk or in highest risk for isolation/no support, history of physical and/or mental health challenges, and families facing challenging life situations which include financial barriers and food insecurity. The pandemic has limited access to these supports due to redeployment of resources and scaling back of services. As we our health system looks to recovery from the pandemic, we need to address both the economic and social aspects of mental health and food insecurity.
Examples of financial and food support for Ontario families:
Feed Ontario - is a collaborative initiative uniting food banks, industry partners and local communities to develop solutions and create opportunities to promote food security
Ontario Works – provides social assistance to support residents with financial needs for food, shelter, clothing and other costs of living
FoodShare – provides a good food box with fresh, locally grown, culturally diverse produce to residents facing moderate food insecurity
Community Gardens – the City of Toronto provides access to land in the community for groups of residents to grow their own produce
From this comparative exercise, we observe that there are various similarities with respect to programming available in both Alberta and Ontario with respect to food insecurity at societal and community level. This includes community programs which offer food and financial assistance, in addition to societal interventions such as Alberta Health Services’ recommendations to incorporate screening for financial strain in healthcare facilities and Ontario’s poverty reductions strategy. Like many areas of human health and wellbeing, the many determinants of mental health are multifaceted; food insecurity, is just one contributing factor to the health of individuals and populations (Alegría at al., 2018). The socio-ecological model of health can be a valuable tool to view and compare interventions inter-provincially at different levels, such as community and societal.
Thanks and appreciation to Mary Ann for sharing her insight and collaborating on this blog post. Check out her ePortfolio at https://mae1138.wixsite.com/mary-ann-gatbonton
- Kylie
References
Alegría, M., NeMoyer, A., Falgas, I., Wang, Y., & Alvarez, K. (2018). Social Determinants of Mental Health: Where We Are and Where We Need to Go. Current Psychiatry Reports, 20(11), 95. https://doi.org/10.1007/s11920-018-0969-9
Alberta Health Services. (2022). Identification of Food Insecurity in Healthcare Setting. Recommendations for Nutrition Services, Alberta Health Services. Nutrition Services, Population and Public Health. Retrieved from https://albertahealthservices.ca/assets/info/nutrition/if-nfs-pph-evrev-fullreport-hfi-healthcare-settings.pdf
Gadermann, A. C., Thomson, K. C., Richardson, C. G., Gagné, M., McAuliffe, C., Hirani, S., & Jenkins, E. (2021). Examining the impacts of the COVID-19 pandemic on family mental health in Canada: Findings from a national cross-sectional study. BMJ Open, 11(1), e042871. https://doi.org/10.1136/bmjopen-2020-042871
Ministry of Children, Community and Social Services. (2022, June 15). Archived—Building Ontario’s First Food Security Strategy. Retrieved November 1, 2022, from https://www.ontario.ca/page/building-ontarios-first-food-security-strategy
Polsky, J.Y., Gilmour, H. (2020). Food insecurity and mental health during the COVID-19 pandemic. Government of Canada, Statistics Canada. https://www150.statcan.gc.ca/n1/pub/82-003-x/2020012/article/00001-eng.htm
Tarasuk, V., Li, T., Fafard, St-Germain AA. (2022) Household food insecurity in Canada, 2021. Toronto: Research to identify policy options to reduce food insecurity (PROOF). Retrieved from https://proof.utoronto.ca/
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