Social Housing and Food Security in British Columbia

Transcription

1 Social Housing and Food Security in British Columbia Prepared by Aleck Ostry For Vancouver Coastal Health April 1 Social Housing and Food Security in British Columbia April

2 Social Housing and Food Security in British Columbia Table of Contents Executive Summary Introduction Literature Review on Social Housing and Food Security Housing Poverty and Food Security Food Security and Health Community Based Food Programs and Social Housing Socio-Demography of Social Housing Clients in BC Research in BC on Social Housing and Food Security Research on Food Security, Income, and Housing in BC Research on Food Security among Residents of SROs in the DTES Research on Food Security among Residents of Social Housing in Metro Vancouver Research on Community Capacity for Charitable Meal Provision in Victoria BCNPHA Survey of Food Programs in Social Housing Conclusions and Recommendations References 25 2 Social Housing and Food Security in British Columbia April

3 Executive Summary There is strong research evidence that homeless people have high rates of food insecurity and that people who rent and have low incomes, especially if they also receive social assistance, have higher rates of food insecurity than home owners and people with high income. There is however, virtually no research on the food security status of residents of social housing in Canada. The limited, largely indirect evidence, strongly suggests, that social housing, through the provision of rent subsidies or, more directly through the provision of housing, has the potential to improve the food security situation of residents by freeing up more disposable income to purchase food. BC Housing provided support (in the form of rental subsidy for low income families living in market housing, in the form of support or subsidy to the non-profit housing sector, or more directly, through directly managed social housing units) for 95,824 households in Based on advice from housing and health authorities, it is likely that the 18,270 households (19.1%) classified as frail elderly or special needs, have access to in-house subsidized meal services and are therefore less at risk of food insecurity than many of the remaining 77,554 households who may have less assured access to in-house and subsidized meals and little disposable income to purchase food and other necessities. Of these 77,554 households, 25,890 (33.4%) live in market housing and are supported through rental subsidies by BC Housing. No research studies on food security, as far as is known, have been conducted in BC among these households supported by rental subsidies. This is a significant gap in research that should be remedied as these households may be at risk for food insecurity. Most of the research investigations undertaken in BC on food security and social housing have been aimed at the homeless housed living in Single Room Occupancy Hotels (SRIs) in the Downtown Eastside (DTES) in Vancouver. This group, while essential to study because of their extreme economic and health vulnerability, represents a minority of BC s social housing clients. The studies of these clients point to the need for in-house provision of subsidized meals and better coordination between housing authorities and charitable meal providers in the community to facilitate this type of meal provision to clients. Except for a single study confined to Metro Vancouver and conducted in 2011, no investigations have been made across all three of the client groups living in social 3 Social Housing and Food Security in British Columbia April

4 housing projects in BC. This study is the only one which provides empirical information on the food security situation of independent seniors, low income families and the homeless housed living in social housing in several neighbourhoods in Metro Vancouver. It showed that over 90 percent of respondents obtained most of their food from local grocery stores and used charitable food sources of various kinds as a less regular means of accessing food, implying that access to food for these families living in social housing was highly dependent on disposable income. The author recommended a comprehensive poverty reduction program to increase disposable income among these families, improvement of in-house kitchen and food preparation and storage facilities, measures to improve access to community gardens and kitchens, and better integration with local charitable food provision services. Some of these recommendations, and many that arise from the studies conducted among residents of SROs in the DTES, imply a functioning charitable food system in the community near social housing projects as they call for direct delivery of meals or food from local charities to social housing sites or more open access to these charitable meal services in the community for clients of social housing. Yet, research by Bosckei and Ostry (2010) in the city of Victoria indicates that charitable agencies may not have the capacity to meet the needs of existing, let alone, more clients from local social housing projects. The question of the capacity of local charitable agencies to support further client loads needs to be addressed through further research otherwise calls for greater provision of meals and/or food from local charities may not be a realistic policy option for clients of social housing or these may be realistic in some communities (with strong well-funded charities) but not realistic in others. There are several recommendations that arise from this report: 1. Develop comprehensive poverty reduction programs that increase housing support and supports to improve food security. 2. Conduct empirical research on food security across all housing categories in social housing and among those living in market housing who receive rental subsidies. These studies need also to be conducted in regions in BC with a significant concentration of social housing projects and programs. 3. Determine the capacity of local communities in BC to support expanded access to existing community food and meal provision programs by clients of social housing. 4. Following the studies conducted in Vancouver s DTES, implement, as these have all recommended - especially for residents of SROs - in-house provision of fully subsidized meals. 5. Expand access to community gardens and kitchens as they appear to both directly improve food security in indirectly, through increased social capital and network formation, to improve the lives of residents of social housing. 4 Social Housing and Food Security in British Columbia April

5 1.0 Introduction According to the Food and Agricultural Organization (1996), food security is a situation that exists when all people, at all times, have physical, social, and economic access to sufficient, safe, and nutritious food that meets their dietary needs and food preferences for an active and healthy life. There is strong research evidence that people in Canada with low incomes and who are also receiving social assistance (employment insurance, welfare, or disability pensions of various kinds) have high rates of food insecurity (CCHS, 2004). Eligibility for social housing in BC is based on low income sometimes in combination with other needs (such as the presence of multiple disabilities). People living in social housing in BC tend to have low incomes and most are recipients of social assistance and are likely at high risk for food insecurity even though a proportion (and in some cases all) of their housing costs are subsidized. There are many common terms for social housing including non-market housing, public housing and subsidized housing. In BC, a government agency, BC Housing and numerous non-profit housing providers (organized mainly, but not entirely, under the umbrella of the BC Non-profit Housing Association- BCNPHA) manage and/or subsidize social housing in BC. Tenants in these facilities tend to have low incomes, many are seniors, and many are disabled mentally and/or physically. Canadian research has shown that food insecurity tends to be higher among young than old people, among Aboriginal people, and among single families headed by women. While unemployment in BC has tended to be lower than the national average and economic growth higher, over the past quarter century, child poverty rates have been among the worst in Canada indicating that the economic circumstances for many vulnerable families in the province may be quite precarious (First Call, 2011). This is exacerbated, especially in many of BC s cities, by housing costs much higher than the national average which reduces disposable income placing, especially for low income families, considerable pressure on food budgets. While approximately two-thirds of British Columbians own their own home, high costs of home ownership and high rents for citizens who do not own their own homes reduces the proportion of disposable income available for food. In this economic environment, when government and non-profit agencies step up to support housing costs (through rent subsidies and by direct provision of social housing) low income families have more disposable income available to purchase food than they might have without this essential housing support. In this way supportive housing policies 5 Social Housing and Food Security in British Columbia April

6 and programs targeting low income citizens may act to reduce food insecurity. As well, social housing providers can improve food security for tenants by ensuring buildings have proper food preparation (kitchen) and garden facilities and, for some clients, programs of direct and subsidized food provision as there is clear evidence that despite the rental and housing subsidies provided to tenants in social housing, for many, their food security situation remains precarious. While research has clearly shown the linkages between low income and food insecurity, detailed research on the links between social housing policies and programs and food security remains limited. This means that the multiple ways in which social housing policies and programs could be crafted to also enhance food security for a fairly large and vulnerable population in BC have not been fully explored. This type of research is essential to better understand the social and economic situation among BC s social housing clients and especially to know more about how, when, and where they purchase, otherwise acquire, prepare, and store food and the extent to which they suffer from food insecurity and food insecurity related ill health. The purpose of this paper is to 1) bring up to date the research on food security and housing in Canada and in BC; 2) describe and characterize more fully the type of clients in social housing in BC in order, to better understand, in turn, the kinds of research needed to improve their food security; 3) to review the limited research on both food security and housing conducted in BC over the past five years; and 4) to make recommendations to improve food security among tenants of social housing in the province. This paper is organized as follows. The first section provides a brief review of the general literature on food security and housing. The second section describes the socio-demographic circumstances of most social housing clients in BC. Social housing in BC is provided to an extraordinarily heterogeneous group of clients across a complex program and housing infrastructure. This section is required to understand this complexity and to develop a foundation upon which to base more targeted research on food security for these vulnerable people. The third section is a review of recent investigations in BC which link together social housing and food security. The final section summarizes results of this overview and presents recommendations for further research and policy. 2.0 Literature Review on Social Housing and Food Security There is an extensive literature on the connections between food security and physical and mental health (Mathews et al. 2010; Seligman 2010) as well as between housing and health (Bryant 2003). And, some research has been conducted on the food security status of homeless people (Dachner & Tarasuk 20002, Tarasuk et al. 2009; 6 Social Housing and Food Security in British Columbia April

7 Hamlin & Hamel 2009). While little research is available on the links between housing and food security (Ma et al. 2008; Kushel et al. 2006) these separate literatures can be reviewed to help better understand linkages between food insecurity and housing. This literature is organized into three sub-sections. In the first sub-section the literature on housing, poverty, and food security is reviewed. In the second subsection the literature on food security and health is reviewed. In section three, literature exploring food insecurity and various community based food programs (which could and may be used by residents of social housing) is outlined. 2.1 Housing, Poverty, and Food Security Findings from the Canadian Community Health Survey indicate that 9.2% of Canadian households experienced food insecurity in 2008 (CCHS, 2009). However this proportion is higher for Aboriginal families, for households with low incomes, for those receiving social assistance, and in female-headed households with children (Kirkpatrick &Tarasuk 2008; Willows et al. 2009). In BC, while the proportion of families that are food insecure is somewhat lower than the national average, among those receiving social assistance, the rate of food insecurity was 59.2 percent (BC Provincial Health Office 2006). Most clients of social housing in BC receive some form of social assistance, putting them potentially at high risk for food insecurity. In a study conducted in Toronto, Kirkpartrick and Tarasuk (2011) found that families with housing costs that consumed more than 30% of their income, had an increased risk of food insecurity. Additionally, food spending has been found to decline as the proportion of household income devoted to housing increases for low-income Canadians (Kirkpatrick & Tarasuk 2007). Fletcher et al. (2009) conclude that increases in rental costs are associated with higher rates of food insecurity for lowincome households. They note that expenditure shocks, such as energy costs, rising food prices, and medical expenses, may also increase the risk of food insecurity for low-income families. Social housing whether it provides rental subsidy or directly provides housing, may help improve the food security status of low income Canadians by making additional income available that can be used to purchase food. Kirkpatrick and Tarasuk (2003, 2007) found that housing subsidies had a positive effect on the adequacy of food spending among renter households. However, in another Canadian study, 40% of families living in social housing were found to be moderately or severely food insecure (Dachner et al. 2010). In this study, food spending fell below the cost of a basic nutritious diet, suggesting that while supportive social housing policies may free up more money for clients to purchase food, the support provided may still not be adequate to reduce food insecurity. 7 Social Housing and Food Security in British Columbia April

8 2.2 Food Security and Health Food insecurity has been associated with a number of adverse health conditions including metabolic syndrome, type 2 diabetes and risk of diabetes, hypertension, obesity, increased hospitalizations among children, more chronic health conditions, and poor mental health (Cook et al. 2004; Carmichael et al. 2007; Adams et al. 2003; Vozoris & Tarasuk 2003; Holben et al. 2009; Gucciardi 2009; Seligman et al. 2010; Weinreb et al. 2002). The relationship between food insecurity and these adverse medical conditions, however, is complex. One pathway by which food insecurity may affect health is through nutrition. Food insecurity has been found to be associated with both nutritionally deficient diets, low intakes of fruits and vegetables as well as with diets high in fat and calories at least for adults (Tarasuk 2001; Tarasuk & Beaton 2001; Kirkpatrick & Tarasuk 2008). Tarasuk et al (2007) found that for low-income women who receive a monthly social assistance cheque, intakes of energy, milk products, and vegetables decreased significantly when their economic resources ran out. They also found significant declines in energy, carbohydrate, vitamin B-6, and fruit and vegetable intake for women with moderate or severe food insecurity. Food insecurity may also make managing or controlling chronic disease more difficult (Brown et al 2008). Food insecure diabetic adults have been found to have poor blood sugar control (Nelson 1998, 2001). One study found that among a very food insecure homeless population, the majority had difficulty managing their blood glucose levels because they were reliant on food provided by soup kitchens and shelters (Hwang & Bugeja 2000). Food insecurity has also been associated with higher HIV viral loads, lower CD4 cell counts, and poorer treatment adherence among individuals with HIV/AIDS (Kalichman et al. 2010; Normen et al. 2005; Weiser et al. 2009). Sullivan et al. (2010) found that food-insecure emergency department patients were more likely to put off paying for medication in order to conserve their limited funds for food. Chronic stress might also mediate the relationship between food insecurity and diabetes. Individuals in food insecure households report high levels of anxiety and worry. Stress has been associated, in previous studies, with upper body adiposity, which is a risk factor for diabetes (Seligman et al. 2007). In addition, those who are food insecure are also likely to have poor social support, which is another predictor of morbidity and mortality (Vozoris & Tarasuk 2003). 2.3 Community Based Food Programs and Social Housing 8 Social Housing and Food Security in British Columbia April

9 There is a growing focus on community based food programs to increasing food security, including community kitchens and gardens as well as farmers markets and programs such as those that provide good food boxes. In some cases, these programs have been located in non-market housing sites (Friendly 2008). For example, Toronto Community Housing (TCH) has over 100 community gardens that are supported by TCH staff and community partners (Friendly 2008). Community gardens can provide fresh produce to participants and help build social networks. However, these programs are typically ad hoc, are subject to funding and staff availability and are usually not included in policy and program development for social housing. Typically the goals of community food programs are to enhance food security, promote skill building (e.g., cooking, gardening) and increase social capital (Hamelin et al. 2011). Thus, the goals of these programs tend to be much broader than improved feeding of vulnerable populations. While concerns have been raised that community food programs fail to reach those living in severe poverty due to economic and social barriers (Tarasuk & Reynolds 1999), when these programs are located within social housing, they may be more likely to reach those in greatest need. Thus, some social housing providers have begun offering community based food programs such as community gardens and community kitchens as a way to improve food access and to utilize communal spaces for social benefit (Friendly 2008). However, it is unclear whether these programs have a significant effect on food security and associated health indicators despite their growing use (Kirkpatrick & Tarasuk 2009). There have been few evaluations of community food programs and only a handful of these assess their ability to improve food security. To date, none of these studies (except a recent study conducted in Metro Vancouver and reviewed in section 4.3) have specifically examined the use of community food program among social housing tenants. Aliamo et al. (2006) found that community gardeners consumed fruits and vegetables 1.4 more times per day than those who did not participate in community gardening, and were 3.5 times more likely to consume fruits and vegetables at least 5 times daily. Community gardens have been found to improve social cohesion and social capital among participants (Armstrong 2000; Aliamo et al. 2010; McCormack et al. 2010). Community garden can serve as therapeutic landscapes and have been shown to have positive effects on feelings of health and well-being and may also address lack of food access in underserved locations (Corrigan 2011). Based on their review of the literature, McCormack et al. (2010) conclude that community gardens have the potential to increase access to fruits and vegetables, especially in low-income areas that have poor access to affordable, healthy foods. Locating community gardens in these areas could increase access to fresh fruits and vegetables during growing seasons, which could result in more healthful dietary patterns and reduced health risks. 9 Social Housing and Food Security in British Columbia April

10 Community kitchens are another type of program that bring participants together to cook and share meals. These programs may be particularly important for social housing clients who are single, isolated, and disabled and living in units that lack adequate kitchens. According to Engler-Stringer and Berenbaum (2007) low income clients reported reduced food insecurity with participation in a community kitchen and that food was healthier and more acceptable than when obtained through charitable food resources. On the other hand, Tarasuk and Reynolds (2001) found no association between food insecurity and participation in a community kitchen. The literature remains insufficient to determine whether these programs have a positive impact on food security or not. The third type of community-based program that could benefit low income social housing residents are farmers pocket or good food markets as well as good food box programs. While farmers markets may not be affordable for social housing residents, efforts to improve access include coupon programs such as the, now discontinued, Farmers Market Nutrition and Coupon (FMNCP) program in BC. The FMNCP provided weekly coupons to utilize at farmers markets throughout BC to low-income women although it is not known what proportion of coupon recipients were living in social housing. There are also small scale produce stands (i.e., pocket markets) in Metro Vancouver or good food markets operated by FoodShare in Toronto that have been set up in association with social housing sites to improve food access for residents (Friendly 2008). While there are only a few examples of food box programs being operated out of or delivering to social housing, there is some limited evidence that these programs enhance fruit and vegetable consumption and food security as well as social capital (Friendly 2008). The location of social housing buildings in relation to food and social service resources may also play a role in the food security situation of residents (Bryant 2003). Fertig and Reingold (2007) suggest that because social housing is often located in close proximity to social service organizations, including food banks, residents have better access to food than those living in market housing. On the other hand, in the US and the UK some studies have found that grocery stores located in areas with higher concentrations of low-income people were more likely to stock fewer choices of food, which were of poorer quality and more calorically dense (Furey et al. 2001; Hendrickson et al. 2006; Powell et al. 2007). More specifically, Regan et al. (2006) found that few public housing developments in the US had stores that sold groceries within one block and that instead, fast food outlets served as a primary source of food. Neighbourhood social capital or the perceptions of social cohesion and feelings of safety and trust in one s community has been found to have positive implications for health for residents in social housing (De Jesus et al. 2010). Food programs, such a community kitchens, gardens and meal programs serve both as sites to provide food 10 Social Housing and Food Security in British Columbia April

11 but, also to enhance social ties and to build social capital (Hancock 2001; Wakefield et al. 2007; Friendly 2008), which in turn, may have a positive effect on health and well-being. Social capital, specifically reciprocity among neighbors, has been found to enhance household food security (Martin et al. 2003). Canadian studies have been inconclusive on the connection between the accessibility of neighborhood food resources and food security status. Kirkpatrick and Tarasuk (2010, 2011) found that in Toronto, distance from retail food sources was not related to food security status and that food insecurity existed in neighborhoods with good access to grocery stores implying the barriers to access were primarily income related. However, Larsen and Gililand (2008) revealed that residents of inner-city neighbourhoods of low socioeconomic status in London, Ontario have the poorest access to supermarkets. And, Bertrand et al. (2008) found that in Montreal 40% of the population lack access to fruits and vegetables within a walk able distance from their home. Research to date is inadequate and fairly high level and needs to be better grounded in investigations that are place specific and also that take into account the unique complexity of the lives of residents in social housing. Specifically, this means developing greater knowledge about social housing clients in various places and better understanding their life circumstances in general and in relation to their food and nutritional needs. Accordingly, in the next section of this paper we review data on the socio-demography of most, but not all, social housing clients in BC. 3.0 Socio-Demography of Social Housing Clients in BC In British Columbia there are approximately 1.6 million households. Approximately 500,000 of these households are renters and approximately 250,000 of these renting households earn less than $35,000 a year (Statistics Canada 2006). In partnership with housing providers, BC Housing provides both financial support and housing along a continuum, ranging from emergency shelters to supportive housing to independent housing in non-market units and including subsidy in the private rental market for approximately 96,000 households in BC, representing approximately 40 percent of BC s low income rental households. BC Housing divides their clients into four major groups 1) those accessing emergency shelters and housing for the homeless (10,006 units); 2) transitional supported and assisted living clients (18,270 units); 3) Independent Social Housing (41,658 units); and 4) rental assistance in the private market (25,890 units). On December 31, 2011 BC Housing supported a total of 95,824 units (BC Housing Data Services ). Clients in transitional supported and assisted living units (people with special needs and frail seniors) tend to have most or all of their meals provided in-house and so are 11 Social Housing and Food Security in British Columbia April

12 likely less at risk for food insecurity than the other three client groups. The client groups in independent social housing (independent seniors and low income families) and the homeless housed live in housing provided or subsidized by BC Housing but with a wide and complex range of meal services,food subsidy and kitchen facilities. Some projects in these three client groups will have no on-site food or meal provisions and others will They also live in neighbourhoods with varied off-site and nearby food resources across the continuum of grocery stores, charitable meal provision services, food banks, community gardens and community kitchens, good food box programs, and farmers markets. In terms of food security, it is important to better understand the basic socio-demographic circumstances and likely food needs of these categories of social housing clients. The homeless housed are clients at risk of homelessness, or formerly homeless for a period of at least 30 days and up to three years. Supports for these tenants include onor off-site services to help them become self-sufficient and independent. Independent seniors are usually over 65. Housing for this group includes units for independent Aboriginal seniors. Independent family housing is available for low to moderate income households with a minimum of two people including at least one dependent child. This group includes units for Aboriginal families. Table 1 indicates that, as of December 31, 2011, approximately 50,000 low income families, homeless housed, and independent seniors were housed in 2,223 housing projects. In terms of units, independent seniors and low income families account for approximately 40 percent each and the homeless housed account for approximately 20 percent. The average number of units per project indicates that housing projects for independent seniors tend to be largest with 36 units per project whereas housing projects for low income families are smaller averaging 15 units per project. Average size of projects for the homeless housed are about 27 units per project. Table 1: Number of Housing Projects and Units and Average Number of Units per Project by Selected Client Groups for Units Administered by BC Housing in BC, December 31, 2011 Client Group # of Projects # of Units *Average # Units per Project Homeless Housed 320 (14%) 8,660 (18%) 27 Low Income Families 1,321 (59%) 19,584 (40%) 15 Independent Seniors 582 (26%) 21,208 (43%) 36 Total 2,223 49, Source: BC Housing, Unit Count by Month by Client WebFocus Report, December 31, 2011 *Calculated from columns 2 and BC Housing only tracks subsidized units where they have a financial relationship. There may be other subsidized housing units that are not included within this data set. Households receiving rent 12 Social Housing and Food Security in British Columbia April

13 Table 2 shows the annual household incomes for the three client groups These income figures likely overstate incomes for these groups because people with absolutely no income were not included in these data. Table 2: Distribution of Households for BC Housing Administered Units by Selected Client Groups and Annual Household Income, December 31, 2011 Annual Household Income Homeless Housed Low Income Families Independent Seniors 5% 3% 2% Under $5,000 62% 10% 10% $5,000-$9,999 25% 31% 40% $10,000-$14,999 4% 19% 36% $15,000-$19,999 $20,000+ 4% 37% 12% *Source: BC Housing, Housing Connections, December 31, 2011 (Prepared by BC Housing s Research and Corporate Planning Branch February ) Table 3: Distribution of Households for BC Housing Administered Units by Selected Client Group and Principle Income Source, December 31, 2011 Income Source Homeless Housed Low Income Families Independent Seniors Employment 6% 45% 4% Income Assistance 87% 35% 26% Pension Income 5% 10% 67% Other Sources 2% 9% 2% Table 4 shows the varied gender structure of these client groups. While 55% of independent senior households are female led, 58% of the homeless housed are male led, and 76% of low income families are female led. subsidies in the Shelter Aid for Senior Renters (SAFER) Program and Rental Assistance Program (RAP) are excluded from these tables. Within BC Housing s portfolio, only tenant households required to file an annual Declaration of Income and Assets report are included. Units targeted for independent seniors and low income families include units targeted for Aboriginal families and Aboriginal seniors. Households with no income are excluded from these tables because it is known whether the household has no income or the income is not reported. 13 Social Housing and Food Security in British Columbia April

14 Table 4: Distribution of Household Heads by Selected Client Groups and Gender in BC Housing Administered Units, December 31, 2011 Household Head Gender Homeless Housed Low Income Families Independent Seniors Female 41% 76% 55% Male 58% 23% 42% Not Specified/Unknown 1% 0% 3% Table 5 shows that 33% of the low income family households have one child, 31% have two children, 19% have three or more children. 18% of the units intended for low income families do not have any children living in them. Table 5: Distribution of Family Households by Number of Children for BC Housing Administered Units, December 31, 2011 # of Children in Household Percentage of Family Households with Children None 18% One 33% Two 31% Three or more 19% In summary, in terms of food security research it is essential to understand the very different circumstances facing social housing clients in BC. Among the approximately 50,000 households supported by BC Housing which also do not tend to have full in-house meal provision, the homeless housed are most likely single householders and approximately 60% are male. The circumstances for low income families is much different, with 76% female led, 45% are employed, and with half of the low income family households consisting of a single parent and at least 2 children. While incomes are higher for this group of clients than for the homeless housed, these monies are needed to feed more people so the economic circumstances for these families may not be better than they are for the homeless housed. The nutritional needs of single, mainly male, homeless housed, male and female seniors, and single female headed families with children are fundamentally different. Women raising children and children have very different nutritional requirements than the elderly and the homeless housed. In terms of the latter group, many have been in and out of housing or living rough on the street for years and are often in poor 14 Social Housing and Food Security in British Columbia April

15 health and mentally and/or physically disabled. The nutritional requirements for these often ill individuals will also be different than they are for the other two main client groups. Finally, especially in the case of the homeless housed, and as shown in the literature, members of all these groups are often vulnerable, not only economically, but also in terms of ill health which gives further urgency to ensuring that they are adequately nourished. It is important to repeat that the breakdown in data for BC Housing clients that we have presented is for 49,452 of approximately 96,000 clients served by the agency as of December 31 st Data for frail seniors and clients with special needs has not been presented because, as noted previously, these clients are likely at low risk for food security because their meals are mainly provided in-house. As well, no data has been presented for the approximately 25,000 households living in market housing for whom BC Housing provides rental subsidies. This latter group may be at risk for food insecurity as they are mainly low income households especially given high rental costs in many BC cities. In this section we have identified socio-demographic circumstances for the main client groups in social housing that are likely at greatest risk for food insecurity. In the next section we review the limited research available on the food security situation for some of these types of social housing clients in BC. 4.0 Research in BC on Social Housing and Food Security Each year, the Dietitians of British Columbia conduct a survey to determine the average price of a healthy and nutritious food basket in each of the province s five geographic Health Authorities. They also estimate the cost of housing for different types of families in order to determine the extent to which families, after paying for their housing, are able to afford a healthy food basket. In 2011, they conducted a survey. The results of this survey are reviewed as, although not specifically focused on social housing and food security, it does provide methodologically sound evidence on the food security situation faced by many of the kinds of families that live in social housing in the province (Dietitians of BC, 2011). As well, since 2009, six studies have been conducted in BC to explore the food security situation specifically for residents of social housing (Miewald, 2009; Fodor, 2010; Anema et al. 2010; BCNPHA, 2010; Vasarhelyi et al. 2011; Thomson, ). The studies by Miewald (2009) and Fodor (2010) focused exclusively on one neighbourhood in Vancouver (the Downtown East Side) and on the food security situation for a sub-population of the homeless housed living in Single Room Occupancy (SRO) hotels in this neighbourhood. The studies by Anema et al (2010) and Vasarhelyi et al (2011) focused on a smaller sub-population living in the DTES of injection drug users (IDUs) and people with HIV / AIDS. The study by Thomson () was focused more broadly both geographically, across several neighbourhoods 15 Social Housing and Food Security in British Columbia April

16 in Metro Vancouver, and in terms of housing type as it investigated food security for homeless housed, independent seniors, and low income households. The BCNPHA in 2010 conducted an inventory, among some of its housing association members, of food facilities located on-site in their social housing projects. Finally, only one study as far as is known, has been conducted in BC to explore the capacity of charitable food providers to provide meals for vulnerable populations including homeless people and the homeless housed (Bosckei & Ostry, 2010). This study provides evidence of the capacity of the portion of the charitable food system in a community (in this case the city of Victoria) that provides meals to poor and vulnerable people including, potentially, those living in social housing. 4.1 Research on Food Security, Income, and Housing in BC According to the Dietitians of BC, in 2011, the average cost of a healthy food basket for a family of four was $ per month. According to their Cost of Eating Report In the ten years that the Cost of Eating in BC Report has been published, the situation has only gotten worse for individuals and families earning low wages or receiving government assistance. (Dietitians of BC, 2011, p.1. Where people live in BC matters, as the cost of this food basket is highest in the Vancouver Coastal Health Authority ($944.16) and least in the Interior Health Authority ($832.82). The report investigated the dual impact of the cost of food and housing for different types of families receiving social assistance. Some of these results are presented in table 6. After paying housing costs, families on social assistance with four children spent, on average, approximately 50 percent of their disposable income on food. This compares to the approximately 35% of income spent to purchase food by single parent families with two children, and households consisting of a single elderly woman, and households consisting of a single man on disability. After paying for housing and food, these four different types of families living on social assistance in 2011 would all be in debt owing, at one extreme, $287/per month (for single older women living on their own) to $10/per month for a single parent family with two children. In other words, these families, all on social assistance, need to go into debt on a regular basis in order to purchase a healthy food basket (enough food to provide them with adequate nutrition) after paying for their housing costs. And, the situation is most difficult for single older women living on their own. 16 Social Housing and Food Security in British Columbia April

17 Table 6: Cost of Food and Housing and Proportion of Disposable Income Spent on Food and Housing for Four Different Family Types in BC Living on Social Assistance, Single older woman Single man on disability pension Monthly Income and Costs Family of 4 Single parent with 2 children Disposable Income $1,851 $1,786 $663 $959 Housing Costs $1,107 $1,107 $732 $732 % of Income for Housing 60% 62% 110% 76% Cost of Food $868 $689 $218 $322 % of Income for Food 47% 39% 33% 34% Income Left Over (-$124) (-$10) (-$287) (-$95) Source: Dietitians of BC. Cost of Eating Report, 2011 p.6. The housing costs in table six are based on BC averages and therefore likely underestimate the real cost of housing in regions such as Metro Vancouver and Greater Victoria where housing costs are much higher than they are in the rest of the province and where the majority of the province s social housing projects are located. For example, it is difficult to see how a family of four people can obtain a place to live in Vancouver for $1,107 per month. In other words, in regions with very high housing costs, for families of various types on social assistance, disposable income available for food is likely much less than shown in table 6. Furthermore, just as is demonstrated in the limited literature on the impact of social housing support on food security, table 6 suggests that, for BC Housing clients whose housing costs are entirely subsidized, this support is extremely important in making income available to purchase food thereby reducing the potential for food insecurity in these vulnerable families. However, as Dachner et al. (2010) observed in Toronto, while their study of supportive social housing policies in that city showed more money was freed up for clients to purchase food it was still not adequate to reduce food insecurity. Results from the Dietitians report emphasize the potential vulnerability to food security even for those with housing support and further suggest the need for detailed, place-based investigations, that determine the relationships between housing support (as direct housing and as rental subsidy), income, food security, and health. Results 17 Social Housing and Food Security in British Columbia April

18 from the Cost of Eating report suggest that families with partial subsidies, especially among the 25,890 (as of December 31 st 2011) living in market housing and receiving rental subsidies, to the extent that their incomes may be quite low and their rents not fully subsidized (and especially if they are living in high rent cities like Vancouver and Victoria) may have very little disposable income to purchase food and may be at particularly high risk for food insecurity relative to low income families fully supported by BC Housing. 4.2 Food Security Among Residents of SROs in Vancouver s Downtown Eastside (DTES) Miewald (2009) conducted focus groups and interviews with food and housing providers in the DTES and conducted structured interviews with 47 residents of SROs who were currently or had previously been homeless or marginally housed. The purpose of these interviews was to document the factors that contribute to food insecurity within this population. Within the DTES, there are several types of housing and shelter. This includes seasonal and all year shelters that provide at minimum a place to sleep and one to two meals for those that stay there. There are also a number of Single Room Occupancy Hotels (SROs). SROs typically consist of one room about 10 x 10 feet, with shared bathrooms. A survey of DTES SROs in 2005 found that only a small percentage had communal kitchens and that most buildings allowed residents to cook in their own room. Some newer buildings come equipped with kitchenettes, but residents often had to provide their own small appliances such as a microwave and hotplate (Miewald, 2009). As well, Meiwald noted that a high proportion of this population suffered from ill health, including HIV/AIDS, mental illness and addiction problems. She recommended housing authorities provide in-house cafeterias and / or meal delivery programs especially for the sub-population with severe addictions and/or mental illnesses are they require the greatest support and stabilization. She also recommended meal delivery programs involving preparing food at one central location and transporting it to several buildings as this way of providing meals has the potential to incur less cost since the buildings do not each require their own commercial kitchens or staff. While in-house cafeterias already exist in a few SROs in the DTEs they require cooks and kitchen managers who are chiefly responsible for food preparation compared to a community kitchen in which tenants have greater participation. If one central location can t be found, there is potentially, also the possibility that local restaurants, with professional chefs and kitchen infrastructure in place and proven ability to produce high quality meals, could be used in as providers of meals for local social housing residents. It may be possible (e.g., Cool Aid in DTES) to contract with local restaurants to obtain meal delivery services. It is worth exploring this option as it may be cost effective because it obviates the need to invest money in kitchen infrastructure and staff. 18 Social Housing and Food Security in British Columbia April

19 BC Housing followed this study up, with a literature review, an environmental scan of existing relevant program, and with key informant interviews with policy makers from around North America to identify best practices and lessons learnt for introducing on-site food provisioning and programming within SROs in the DTES (Fodor, 2010). The study attempted to identify practical programs and delivery approaches to integrating food security and social housing. This study was, in part, stimulated by BC Housing s acquisition of 24 Single Room Occupancy Hotels (SROs) in Vancouver s Downtown Eastside (DTES) (Klein & Copas, 2010). These studies by Miewald and Fodor concluded that for these vulnerable, mainly men, housed in SROs in the DTEs, it was essential for the housing authorities to provide in-house meals or access to subsidized meal provision services in the community. Two further studies conducted in the DTES focused on men, either homeless or mainly living in SROs in the neighbourhood, who also had HIV/AIDs many of whom were also IDUs (Anema et al. 2010; Vasarhelyi et al. 2011). Anema et al. found that 74% of food insecure IDUs were unstably housed. They suggest that some IDUs may not be accessing adequate nutritional services or housing needed to maintain food security. In a study of mainly unstably housed people enrolled in a drug treatment program for HIV/AIDS, Vasarhelyi et al. (2011) demonstrated that better living conditions, especially stable housing and food security, likely contribute to treatment success and suggest that a way to improve treatment outcomes for HIV/AIDS among the homeless housed in the DTES would be to improve both conditions of housing and food security for these people. 4.3 Research on Food Security among Residents of Social Housing in Metro Vancouver Thomson, in 2011, conducted, for the Metro Vancouver Housing Corporation (MVHC) and the BC Non-Profit Housing Association (BCNPHA) an investigation of the food security needs of its tenants. MVHC owns and operates more than 50 rental housing sites across the Lower Mainland providing housing for more than 10,000 people. MVHC housing clients are a mix of families, seniors, and people with disabilities. This survey was conducted, in 2011, across 12 MVHC sites representing a mix of buildings with and without community gardens and with combined community garden and kitchen programs. The purpose of this questionnaire survey was to assess food security among clients living in these sites. The 12 MVHC study sites had 995 household units. Response rates were approximately 10 percent with household heads in 97 units responding to the survey. Because many households consisted of multiple family members, information was obtained on approximately 250 individuals living in these 97 households. As well, 9 key informant interviews were conducted with residents. 19 Social Housing and Food Security in British Columbia April

20 Most respondents were female, with 68% of surveys completed by women. Most (68%) were Caucasian. Children (aged 0-14) accounted for 30%, young adults (25-44) for 27%, middle-aged adults (45-64) for 19%, youth (15-24) represented 14%, and seniors (65+) accounted for 10% of these individuals. Over a third of respondents were working full time, about 15% worked part-time, 20% were receiving a disability pension of some kind and, the remainder were retired. While income information was only available for 77 of 97 respondents, this showed that 77% earned less than $40,000 a year and 39% earned less than $20,000 a year. By comparing these questionnaire responses with the Tables 1 to 5 in the preceding section, it is clear Thomson s survey has captured responses from independent seniors, low income families, and the homeless housed but with an overrepresentation (relative to BC Housing s profile of homeless housed, independent seniors and low income households) from low income families and an underrepresentation from seniors and the homeless housed. The main finding from this study, also supported by key informant interviews, was that the single greatest barrier to a healthy diet is income. Specifically the study found that 1) seventeen percent of respondents from households that earned under $20,000 indicated that they regularly had to skip meals for an entire day due to lack of funds; 2) of households earning under $20,000, 30% reported poor or very poor diet and, 13% reported poor or very poor knowledge of food preparation; 3) thirty-eight percent of households earning between $20,000 and $30,000 indicated poor or very poor health, and 37% of households earning under $20,000 indicated poor or very poor health. The study also provided information on where participants accessed food and how they prepared their food. Ninety-four percent of respondents obtained most or all of their food over the year prior to the survey at grocery stores. Seventy-five percent of households cooked most of their weekly meals at home As well, farmers markets were accessed by 59% of respondents. The research findings also showed that food programs, especially community gardens and community kitchens had positive impacts on users including greater food security, better access to healthy food and benefits from improved social networks, building of relationships with neighbours, and an improved sense of wellbeing. Additionally, the survey results show that individuals using food programs tended to be lower-income households (earning under $40,000 annually). While these households were more likely to experience food insecurity and poor health, they also tended to report more positive outcomes from using food programs. Key informants noted that while community gardens may not significantly increase the quantity of food they can access, the availability of fresh vegetables (e.g., for salads) increased 20 Social Housing and Food Security in British Columbia April