More than 6.9 million Canadians, including 1.8 million children, are experiencing food insecurity, numbers that may increase further as high rates of food inflation continue to persist.
Food insecurity is more than just a problem of having limited food – it is a symptom of profound material deprivation. Too many Canadians do not have enough money to support their basic needs. According to the Food Costing in BC 2022 report, the average family of four in British Columbia receiving income assistance has $311.89 left each month after paying for housing and food. A single parent with a child receiving income assistance is in an even more dire financial situation – $111.82 in the red after paying for housing and food.
When people do not have enough money for rent and other basic needs, they may resort to buying cheaper foods that are less nutritious. Individuals may not be able to pay half their rent due to the threat of eviction, but they can spend less on food. However, when individuals rely on cheaper, unhealthy foods, they put their health at risk. Food insecurity greatly increases the risk of developing chronic diseases.
The B.C. government has found a way to increase access to nutritious foods and support food security for people with low incomes. Since 2007, it has been working with the BC Association of Farmers’ Markets and local community organizations to deliver the BC Farmers’ Market Nutrition Coupon Program (FMNCP). In 2022, the province provided $12 million to support the program over 3 years. Participating households receive $27 per week to buy healthy foods – fruits, vegetables, dairy, eggs, fish, meat, poultry, nuts, honey and fresh herbs – at participating farmers’ markets between June and December each year. The FMNCP provides funds to purchase preferred healthy foods in a manner that preserves people’s autonomy and dignity.
Recently, we studied the impact of this program on rates of food insecurity among participants. Our findings, published in October in the Journal of the Academy of Nutrition and Dietetics, showed the program reduced short-term household food insecurity by 79 per cent. Notably, this decline was sustained four months after the program ended. It is not clear why these large and sustained reductions in food insecurity were sustained after the program ended. However, we speculate this may be due to participants preserving foods they bought with their coupons (e.g., freezing, canning) or that they may have developed social connections through the FMNCP that enhanced their access to food and other supportive resources post-program. For instance, FMNCP coupons are distributed to participants by community partners (e.g., social support organizations) who may have assisted participants in finding more affordable housing, accessing lower-cost transportation or filing their taxes, thereby making them eligible for government supports.
We also found a suggestive trend that the program may have improved participants’ mental well-being and sense of connection with others in their communities. However, the program did not improve participants’ diet quality. Our findings suggest that higher subsidy amounts may be needed to improve access to nutritious foods for all household members. This study is the first randomized controlled trial (RCT) of a farmers’ market food-subsidy program, which means it can show cause and effect. While it may seem counterintuitive that a healthy food coupon program did not improve adults’ diet quality, we suspect that parents used their subsidies to improve food security for their households and gave most of the food to their children. In a future study, we plan to assess children’s diet quality alongside that of their parents so we can determine if this may have been the case.
There is disagreement among food insecurity researchers regarding the optimal means to reduce household food insecurity. Some argue that policies and programs must be prioritized to address the “root causes” of food insecurity – inadequate wages and social supports (e.g., increasing the minimum wage and social assistance rates). We agree that such policies are an important way to reduce household food insecurity. However, evidence indicates that increasing the minimum wage by $1 an hour or providing an additional $1,000 in welfare income would each only reduce the odds of household food insecurity by 5 per cent at a population level. By comparison, our findings show that the targeted supports provided by the FMNCP reduced the odds of short-term household food insecurity by 79 per cent.
Healthy food subsidies may be a socially acceptable, dignified means of providing people with additional income to purchase nutritious food.
By providing people with money to purchase nutritious foods, healthy food subsidies free up income that can be used to support other material needs such as housing and utilities. In this way, healthy food subsidies are no different than higher wages and social supports because all these programs provide additional income that relieves financial strain. Healthy food subsidies can also provide a nudge to purchase healthier foods, which may improve diet quality when subsidies are large enough and provided over the longer term. When offered in local farmers’ markets, healthy food subsidies may also improve mental well-being and social connections among community members, enhance participants’ knowledge of where their food comes from and how it is produced, and provide benefits for local farmers, food systems and economies. In short, healthy food subsidies may be a socially acceptable, dignified means of providing people with additional income to purchase nutritious food.
But don’t take our word for it, listen to those who participated in our longitudinal qualitative study of the FMNCP, available here and here. Participants told us that “their coupons were like gold,” and described how the FMNCP enhanced their access to nutritious foods and alleviated financial strain by allowing them to divert funds toward other living expenses. They also said the program improved their social connections, sense of community, knowledge of healthy eating and food skills. While a small number mentioned some stigmatizing experiences, the vast majority indicated that the program provided them with a sense of dignity and autonomy in procuring their own nutritious foods. After the program ended, participants described increased financial strain and having to revert to their pre-program shopping practices of buying low-cost, less nutritious foods.
We do not believe there is a single “best” approach to addressing household food insecurity since all programs have strengths and limitations. In addition, there are many root causes of food insecurity. Therefore, if we wish to tackle food insecurity at its roots, a single approach will not suffice. For instance, some individuals may be food insecure because their low educational attainment led to a low paying job. Others may have experienced childhood abuse and the resulting trauma has made it difficult for them to remain consistently employed. While higher wages and social supports may address the income-related manifestations of these individuals’ problems, they will not necessarily address their root causes. Moreover, higher wages and social supports will not help everyone, including undocumented immigrants and people who are homeless. Thus, just as obesity is a complex problem with no single solution, so too is household food insecurity.
For this reason, a suite of policies and programs at all levels and across multiple sectors –including healthy food subsidies, social prescribing interventions and policies that do not specifically relate to poverty (e.g., efforts to prevent domestic abuse) – are needed to reduce household food insecurity in Canada. We support a comprehensive, multi-sectoral approach that includes multiple programs and policies, as there is no single solution.
We acknowledge that, like other approaches, healthy food subsidies have limitations. For instance, our own research has shown that the current subsidies provided by the FMNCP may be too low to measurably improve the diet quality of adults, nor is the program offered year-round. In addition, the FMNCP remains small and would have to be scaled up nationally for substantial population-wide benefits to occur. However, with key improvements, a plan for scale-up and stable long-term funding, such programs can be one important piece of a comprehensive policy package to address household food insecurity.
While higher minimum wages and social supports are certainly needed, such policy reforms have long timeframes for change – meanwhile millions of Canadians continue to suffer. Other evidence-based approaches – some of which may be equally or even more effective – can be part of strategies to reduce household food insecurity. It will require some upfront spending, but reducing household food insecurity will save millions in unnecessary health-care expenses and other costs to taxpayers.
It is time for a more comprehensive approach to one of our most complex and urgent societal problems.