1. Mixing Policy and Activism: The Poor and Sick Need to Eat Too Rebecca Green, MSc, PDt(c) Jill Ratcliff, Halifax Coalition Against Poverty CPHA June 3, 2008

2. 2 Outline WHAT? –Provincial income assistance rates leave their recipients in extreme poverty. IA rates do not provide enough money for households to afford nutritious food SO WHAT? –There exists a clear link between poverty, food insecurity, poor health and chronic disease NOW WHAT? –The Halifax Coalition Against Poverty special needs campaign –Challenges with special needs clinics –The role of health providers in combating poverty, food insecurity, poor health and chronic disease

3. 3 How do you spend your money each month? Shelter Utilities Food Phone/cable/internet Transportation/gas Cell phone Haircuts Clothes/shoes Toiletries Cleaning supplies

4. 4 Nova Scotia Income Assistance Basic Allowances Single Adult: Personal Allowance$ Shelter Allowance$ 204/month 300/month http://www.gov.ns.ca/coms/employment/income_assistance/IncomeAssistanceFAQ.html

5. 5 Examining the Affordability of a Nutritious Food Basket in NS Family of Four on IA Mom & Dad (25-49y); Son (13y); Daughter (7y) Income: $2124.48 - Expenses: $1556.04 - Food: $648.33 -$79.89 Single Adult on IA Male (30y) Income: $600.82 - Expenses: $595.08 - Food: $223.13 -$213.70 2007 Nova Scotia Food Costing Project

6. 6 Health Canada, CCHS 2.2, 2007

7. 7 Welfare and Food Insecurity CCHS 2.2. (2004) Income-Related Household Food Security in Canada 59.7% of Canadians families receiving Social Assistance were moderately or severely food insecure. Hunger Count 2007 50.7% of Canadian food bank clients’ primary source of income was from social assistance.

8. 8 Why care about food insecurity? Food security is a key social determinant of health (McIntrye, 2002 ) Canadians who are food insecure are more likely to report their health as fair or poor and are more likely to have multiple chronic diseases (McIntrye, 2002)

9. 9 Why care about food insecurity? Food insufficient households are more likely to report incidents of heart disease, high blood pressure and diabetes than food sufficient households (Vozoris, 2003) These diseases can be mediated by a nutritious diet.

10. 10 Money Available for “Special Diets” “Special Diet” provision in the Employment Support and Income Assistance (ESIA) regulations Up to $150/month for various general and therapeutic diets MD, PDt/RD and RNP are the gatekeepers to this additional money

11. 11 Special Diet Campaign HCAP, in partnership with Dalhousie Legal Aid Society is now working on a campaign to get as much money as possible for people on social assistance so that they are able to afford the cost of basic needs, such as nutritious food, transportation, phone bills and childcare. The long term goal of this campaign is to have welfare rates in Nova Scotia doubled so that poor communities can have access to what they need: - decent housing - a humane income - access to healthy food - necessary medications

12. 12 Special Diet Clinics HCAP and DLAS began to organize clinics in the summer of 2007 Five on side health professionals worked in poor communities around HRM meeting with IA recipients

13. 13 Special Diet Clinics Until the campaign encountered hurdles from the Department of Community Services blocking the special needs requests that came out of the clinics Today, HCAP and its allies are outreaching to healthcare professionals as well as informing IA recipients about their Special Needs entitlements

14. 14 Health Professionals’ Role Be sensitive & Non-judgmental –It’s not that lower income individuals don’t know what to eat, they often can’t afford it If your client is receiving Income Assistance an MD, PDt or RN can write a letter to the case worker requesting a special diet allowance As trusted voices in our communities on topics of public health and wellbeing we encourage you to speak out publicly against low income assistance rates and food insecurity

15. 15 For More Information Halifax Coalition Against Poverty www.hfxcap.ca Thought About Food? A Workbook on Food Security and Influencing Policy www.foodthoughtful.ca Nova Scotia Nutrition Council (posts NS Food Costing Reports) www.nsnc.ca