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 People who have food insecurity, meaning inadequate or insecure
access to food due to low income, “have poorer (physical and mental)
health, this is documented extensively for adults and children,”
said lead author Valerie Tarasuk of the University of Toronto.
“We finally have been able to quantify the healthcare expenditures
associated with it,” Tarasuk told Reuters Health by phone.
In countries like the U.S., low income might be tied to both food
insecurity and poorer access to the healthcare system, which would
complicate the analysis, she said. But in Canada, low income people
have equal access to the publicly funded health system.
The new study included 67,033 adults in Ontario ages 18 to 64 who
had participated in the Canadian Community Health Survey in 2005,
2008 or 2010.
The participants answered 18 questions about their daily access to
food. The researchers linked their answers, and neighborhood level
income data, to a database of participants’ direct healthcare costs
in Canada’s publicly funded health care system, including emergency
room visits, acute and psychiatric hospital stays, physician visits,
day surgeries, home care and prescription drugs.
In total, almost four percent of households were marginally food
insecure, another five percent were moderately insecure, and three
percent were severely insecure. As food insecurity worsened,
healthcare utilization and total healthcare costs increased, Tarasuk
and colleagues reported in CMAJ.
During the year before each survey, researchers estimated, food
secure individuals cost the healthcare system an average of $1,608,
compared to $2,806 for moderately food insecure and almost $4,000
for severely food insecure individuals. All costs were calculated in
2012 Canadian dollars.
“What we know is that somebody who is living in a food insecure
environment faces many daily struggles, putting food on the table is
one of many,” Tarasuk said.
Less food, or lower quality food, may influence health status and
lead to more medical needs, but there may be other factors involved
as well, she said.
“If you’re struggling to put food on the table you’re also
struggling to pay rent or find work,” she said.
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Food insecure people with diabetes will struggle to manage their
disease, and this may be true for people with other chronic
conditions as well, Tarasuk said.
“It is likely that food insecure individuals are not able to manage
their health through optimal nutrition due to the cost of food and
factors such as living in neighborhoods that lack grocery stores
that sell fresh food,” said Noreen Willows, associate professor of
community nutrition at the University of Alberta in Edmonton, who
was not part of the new Canadian study.
Food insecurity is “certainly more common” in the U.S. than in
Canada, said Graham Riches of the School of Social Work at the
University of British Columbia in Vancouver. Riches was not part of
the new study.
In 2011, one in six Americans lived in a food insecure household,
compared to one in eight in Canada, he told Reuters Health by email.
“We have governments across this country struggling to manage their
budgets,” Tarasuk said. “Healthcare is a major expense,” which
should give Canadian and international governments an economic
incentive to fund programs alleviating food insecurity, she said.
“To get healthcare expenses down we need to get food insecurity
down,” she said.
Low income people should not be discouraged from using the
healthcare system, nor should they be asked to rearrange their
limited budgets as they are likely knowledgeable about the
importance of good nutrition, Willows told Reuters Health by email.
“Health care providers such as physicians or registered dietitians
could play a role by screening patients for food insecurity and then
assisting them to access social workers, publicly funded food
assistance programs (where available) or charitable food programs,
such as food banks,” she said.
SOURCE: http://bit.ly/1DHYVUy CMAJ, online August 10, 2015.
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