1. Household food insecurity among low-income Toronto families: Implications for social policy Sharon Kirkpatrick & Valerie Tarasuk Department of Nutritional Sciences, University of Toronto Canadian Public Health Association Conference June 3, 2008 Funded by operating grants from the Canadian Institutes for Health Research and a doctoral scholarship from the Social Sciences and Humanities Research Council of Canada.

2. Household food insecurity Inability of households to access adequate food due to financial constraints. Estimated to have affected almost 1 in 10 Canadian households in 2004 (Health Canada, 2007).

3. Low income is the key predictor of household food insecurity. (Health Canada, 2007) Income adequacy categories

4. What policy-relevant factors influence vulnerability to food insecurity among low-income households? Housing circumstances: –Households that do not own their dwellings have higher odds of food insecurity (Health Canada, 2007). –Tension between housing and food documented in in-depth studies (e.g., ‘pay the rent or feed the kids’).

5. Affordable housing Consumes 30% or less of gross household income. –Basis of subsidy levels for rent-geared-to income housing. Not known how notion of housing affordability or receipt of housing subsidy influences household food security.

6. What is the relationship between housing circumstances and household food security among low-income urban families? 1.Cross-sectional survey. 2.Mapping of food retail and food programs. 3.Qualitative interviews with sub-sample of families.

7. Study design 1.Cross-sectional survey. 2.Mapping of food retail and food programs. 3.Qualitative interviews with sub-sample of families.

8. Study design 464 low-income families subsidized housing n = 250 market housing n = 214

9. Study areas

10. Survey data collection Door-to-door recruitment, stratified by housing type. In-home interviews with person with primary responsibility for food shopping/management. Conducted by interviewers with personal experience of poverty. Response rate – 65%.

11. Eligibility criteria At least one child ≤ 18 years of age. Lived in market or subsidized rental accommodations and had lived in their current dwelling for ≥1 month. Gross household income at or below income adequacy cut-off based on household size. Sufficient fluency in English to complete oral interview.

12. Highest ≥$60,000 if 1 or 2 ≥$80,000 if 3+ Upper Middle $30,000 to $59,999 if 1 or 2 $40,000 to $79,999 if 3 or 4 $60,000 to $79,999 if 5+ Middle Income$15,000 to $29,999 if 1 or 2 $20,000 to $39,999 if 3 or 4 $30,000 to $59,999 if 5+ Lower Middle $10,000 to $14,999 if 1 or 2 $10,000 to $19,999 if 3 or 4 $15,000 to $29,999 if 5+ Lowest <$10,000 if 1 to 4 people <$15,000 if 5+ people Income Adequacy Categories

13. Sample characteristics Total (n = 464) Household type - Two parent - Lone mother - Lone father 42% 54% 4% Income source - Employment - Welfare - Other gov’t transfers - Other 53% 28% 16% 4% Immigrant status - Born in Canada - Recent immigrant - Immigrated 10+ y ago 18% 42% 40% Education - Less than HS - Graduated HS - Some/completed PS 23% 34% 43%

14. Sample characteristics Total (n = 464) Subsidized (n = 250) Market (n = 214) Household type - Two parent - Lone mother - Lone father 42% 54% 4% 24% 71% 5% 64% 34% 2% Income source - Employment - Welfare - Other gov’t transfers - Other 53% 28% 16% 4% 40% 32% 23% 5% 68% 22% 8% 2% Immigrant status - Born in Canada - Recent immigrant - Immigrated 10+ y ago 18% 42% 40% 23% 26% 51% 12% 61% 27% Education - Less than HS - Graduated HS - Some/completed PS 23% 34% 43% 28% 41% 32% 18% 26% 57%

15. Sample characteristics Total (n = 464) Subsidized (n = 250) Market (n = 214) Household type - Two parent - Lone mother - Lone father 42% 54% 4% 24% 71% 5% 64% 34% 2% Income source - Employment - Welfare - Other gov’t transfers - Other 53% 28% 16% 4% 40% 32% 23% 5% 68% 22% 8% 2% Immigrant status - Born in Canada - Recent immigrant - Immigrated 10+ y ago 18% 42% 40% 23% 26% 51% 12% 61% 27% Education - Less than HS - Graduated HS - Some/completed PS 23% 34% 43% 28% 41% 32% 18% 26% 57%

16. Sample characteristics Total (n = 464) Subsidized (n = 250) Market (n = 214) Household type - Two parent - Lone mother - Lone father 42% 54% 4% 24% 71% 5% 64% 34% 2% Income source - Employment - Welfare - Other gov’t transfers - Other 53% 28% 16% 4% 40% 32% 23% 5% 68% 22% 8% 2% Immigrant status - Born in Canada - Recent immigrant - Immigrated 10+ y ago 18% 42% 40% 23% 26% 51% 12% 61% 27% Education - Less than HS - Graduated HS - Some/completed PS 23% 34% 43% 28% 41% 32% 18% 26% 57%

17. Sample characteristics Total (n = 464) Subsidized (n = 250) Market (n = 214) Household type - Two parent - Lone mother - Lone father 42% 54% 4% 24% 71% 5% 64% 34% 2% Income source - Employment - Welfare - Other gov’t transfers - Other 53% 28% 16% 4% 40% 32% 23% 5% 68% 22% 8% 2% Immigrant status - Born in Canada - Recent immigrant - Immigrated 10+ y ago 18% 42% 40% 23% 26% 51% 12% 61% 27% Education - Less than HS - Graduated HS - Some/completed PS 23% 34% 43% 28% 41% 32% 18% 26% 57%

18. Sample characteristics Total (n = 464) Subsidized (n = 250) Market (n = 214) Household type - Two parent - Lone mother - Lone father 42% 54% 4% 24% 71% 5% 64% 34% 2% Income source - Employment - Welfare - Other gov’t transfers - Other 53% 28% 16% 4% 40% 32% 23% 5% 68% 22% 8% 2% Immigrant status - Born in Canada - Recent immigrant - Immigrated 10+ y ago 18% 42% 40% 23% 26% 51% 12% 61% 27% Education - Less than HS - Graduated HS - Some/completed PS 23% 34% 43% 28% 41% 32% 18% 26% 57%

19. Household income Average income (adjusted for household composition): –Past 12 months: $23,271 (range $4,800-$56,913) –Past 30 days: $2,077 (range $389-$7,325) Lower incomes on average among families in subsidized housing compared to those in market housing.

20. Housing costs On average, families spent 35% of their income on housing: –27% among subsidized (range 3%-99%) –43% among market (range 19%-92%) Average after-shelter income over past 30 days: –$1431 (range $12-$7,133) –No difference in after-shelter incomes by housing type.

21. Household food security over the past 12 months Household Food Security Survey Module (HFSSM): –Food-secure households: No food insecurity among either adults or children. –Moderately food-insecure households: Compromised intake among adults and/or children. –Severely food-insecure households: Food deprivation among adults and/or children. (Health Canada, 2007)

22. Household food security over the past 12 months One indication of difficulty with food access among 13% of families

23. Household food security status reflects household income. Food secureModerately food insecure Severely food insecure Mean ± SE Household income 1 over past 12 months ($) $24,857 ± 573 a $23,882 ± 544 a $20,565 ± 634 b Household income 1 over past 30 days ($) $2,238 ± 66 a $2,125 ± 62 a $1,821 ± 72 b 1 Adjusted for household composition. ab Different letters indicate statistical differences in means, p<0.05 (derived from ANOVA).

24. Access to other financial resources also impacts food security. Families that accessed other financial resources (e.g., savings, credit) were 51% less likely to be severely food-insecure. Food secureModerately food insecure Severely food insecure Proportion accessing other financial resources 44%39%26%

25. After-shelter income is associated with household food insecurity. Food secureModerately food insecure Severely food insecure Mean ± SE After-shelter income 1 over past 30 days ($) $1,582 ± 63 a $1,453 ± 60 a $1,220 ± 70 b 1 Adjusted for household composition. ab Different letters indicate statistical differences in means, p<0.05 (derived from ANOVA).

26. ‘Affordable housing’ does not ensure household food security. Moderately food insecure Severely food insecure Food secure Proportion of families Housing type

27. Families are equally likely to be food insecure regardless of housing type. Living in subsidized housing was associated with increased odds of severe food insecurity (OR = 1.83, 95% CI = 1.31-2.57). After adjusting for income & household characteristics*, no difference in relation to housing type (OR = 0.84, 95% CI = 0.54-1.31). *Household characteristics included source of income, household type, immigrant status, and respondent education.

28. Housing and food problems co-exist within poor families. 78% of families were in ‘core housing need’: –68% lived in housing that was unaffordable (≥30% of income). –60% lived in crowded housing conditions. –26% lived in housing that was in need of major repair. Having rent arrears and borrowing money for rent was associated with greater odds of severe food insecurity.

29. Household food insecurity is commonplace among low-income Toronto families. Vulnerability is associated with: –Declining income. –Declining after-shelter income. –Lack of access to other financial resources.

30. Housing subsidies are not powerful enough to combat poverty. Have an equalizing effect on income  no difference in after-shelter income between market and subsidized families. Are inadequate to address food access problems  high levels of food insecurity among subsidized and market families.

31. There is a need for a re-examination of ‘housing affordability’. Currently, affordability is defined in relation to the proportion of income allocated to shelter costs. –Does not account for adequacy of actual amount of income remaining to obtain food and other basic needs.

32. Food security and housing affordability are inextricably linked to the adequacy of household economic resources. Need for adequate incomes through: –Labour market participation. –Income assistance programs.