Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, 1 King's College Circle, Toronto, ON, M5S 1A8, Canada.
BMC Public Health. 2019 Jan 3;19(1):12. doi: 10.1186/s12889-018-6344-2.
Household food insecurity is a potent social determinant of health and health care costs in Canada, but understanding of the social and economic conditions that underlie households' vulnerability to food insecurity is limited.
Data from the 2011-12 Canadian Community Health Survey were used to determine predictors of household food insecurity among a nationally-representative sample of 120,909 households. Household food insecurity over the past 12 months was assessed using the 18-item Household Food Security Survey Module. Households were classified as food secure or marginally, moderately, or severely food insecure based on the number of affirmative responses. Multivariable binary and multinomial logistic regression analyses were used to determine geographic and socio-demographic predictors of presence and severity of household food insecurity.
The prevalence of household food insecurity ranged from 11.8% in Ontario to 41.0% in Nunavut. After adjusting for socio-demographic factors, households' odds of food insecurity were lower in Quebec and higher in the Maritimes, territories, and Alberta, compared to Ontario. The adjusted odds of food insecurity were also higher among households reliant on social assistance, Employment Insurance or workers' compensation, those without a university degree, those with children under 18, unattached individuals, renters, and those with an Aboriginal respondent. Higher income, immigration, and reliance on seniors' income sources were protective against food insecurity. Living in Nunavut and relying on social assistance were the strongest predictors of severe food insecurity, but severity was also associated with income, education, household composition, Aboriginal status, immigration status, and place of residence. The relation between income and food insecurity status was graded, with every $1000 increase in income associated with 2% lower odds of marginal food insecurity, 4% lower odds of moderate food insecurity, and 5% lower odds of severe food insecurity.
The probability of household food insecurity in Canada and the severity of the experience depends on a household's province or territory of residence, income, main source of income, housing tenure, education, Aboriginal status, and household structure. Our findings highlight the intersection of household food insecurity with public policy decisions in Canada and the disproportionate burden of food insecurity among Indigenous peoples.
家庭食物不安全是加拿大健康和医疗保健费用的一个重要社会决定因素，但对导致家庭易遭受食物不安全的社会和经济条件的理解有限。
使用 2011-12 年加拿大社区健康调查的数据，确定了全国代表性样本中 120909 户家庭的家庭食物不安全的预测因素。过去 12 个月的家庭食物不安全状况使用 18 项家庭食物安全调查模块进行评估。根据肯定回答的数量，将家庭分为食物安全或边缘性、中度或严重食物不安全。使用多变量二项和多项逻辑回归分析确定家庭食物不安全的存在和严重程度的地理和社会人口预测因素。
家庭食物不安全的患病率从安大略省的 11.8%到努纳武特地区的 41.0%不等。在调整社会人口因素后，与安大略省相比，魁北克省的家庭食物不安全的可能性较低，而在海洋省份、地区和艾伯塔省则较高。依赖社会援助、就业保险或工人补偿、没有大学学位、18 岁以下儿童、单身人士、租房者和有原住民受访者的家庭的食物不安全的调整后可能性也较高。较高的收入、移民和依赖老年人收入来源对食物不安全具有保护作用。居住在努纳武特地区和依赖社会援助是严重食物不安全的最强预测因素，但严重程度也与收入、教育、家庭构成、原住民地位、移民状况和居住地有关。收入与食物不安全状况之间存在分级关系，收入每增加 1000 加元，边缘性食物不安全的可能性就降低 2%，中度食物不安全的可能性降低 4%，严重食物不安全的可能性降低 5%。
加拿大家庭食物不安全的概率和严重程度取决于家庭的省或地区、收入、主要收入来源、住房状况、教育、原住民地位和家庭结构。我们的研究结果突出了家庭食物不安全与加拿大公共政策决策的交叉点，以及食物不安全在原住民中不成比例的负担。
