The. Cost of Eating Well. Food Security in Perth County ANNUAL REPORT 2010

The Cost of Eating Well Food Security in Perth County ANNUAL REPORT 2010

Food Security in Perth County Annual Report 2010 Table of Contents Audience Background to the Nutritious Food Basket The Nutritious Food Basket The Weekly Cost of a Nutritious Food Basket in Perth County Calculating Weekly Food Costs for Households Housing Social Assistance Food Security and Insecurity Limitations of the Nutritious Food Basket Significance of the Results Summary To learn more about the Nutritious Food Basket, call Health Line at 519-271-7600 ext 267 or 1-877-271-7348 ext 267 for Listowel area residents. For more copies or information about healthy eating on a budget, call the Perth District Health Unit 519-271-7600 or visit www.pdhu.on.ca.

Audience This report is intended for the Board of Health of the Perth District Health Unit, health unit staff, people working in social services, and advocacy groups. It can be used to help define the intent of the Nutritious Food Basket survey, which is to increase awareness of food affordability issues, and to help advocate for adequate income and food for everyone. Background to the Nutritious Food Basket In May 2010, the Perth District Health Unit priced the cost of a healthy diet by surveying six grocery stores located across Perth County. Using a survey tool called the Nutritious Food Basket a list of low cost, healthy foods that the average family would probably eat the Health Unit was able to gather new information about the availability and affordability of food in the County. The Ontario Public Health Standards, 2008, requires boards of health to monitor food affordability in accordance with the Nutritious Food Basket (NFB) Protocol. The nutritious food basket is a survey tool that is a measure of the cost of basic healthy eating which represents current nutrition recommendations and average food purchasing patterns. The survey has been completed annually by all Health Units in the province of Ontario since 1999. In 2009, the tool was changed to reflect an example of an eating pattern that meets the updated 2007 Canada s Food Guide and that reflect the eating behaviours of the Canadian Community Health Survey 2.2 results. A complete list of the foods surveyed appears on Health Canada s website for the National Nutritious Food Basket i. The 67 foods surveyed included are: Vegetables and Fruit Orange Vegetables and Fruit Dark Green Vegetables Whole Grains/ Whole Wheat Products Non Whole Grain Products Milk and Milk Alternatives Meat, Poultry, Legumes, Eggs and Fish 2

Changes made to the 2009 food basket include, but are not limited to, the removal of less healthy foods, such as wieners and macaroni and cheese, and the addition of more healthful foods, such as cantaloupe and sweet potato. Foods containing higher amounts of fat and sugar were dropped from the tool. These changes are consistent with the latest research linked to good health. Additional changes were made to reflect changes in package sizes and availability of products. Items in the Nutritious Food Basket reflect the lowest price available in that store in a specified purchase size, regardless of brand. The total cost includes an additional calculation of 5% to cover common food items used in meals (spices, seasonings, condiments, baking supplies, soups, coffee and tea). The food items on the survey do require some food preparation skills. The survey does not make allowances for special dietary needs of individuals, differences in activity levels, or cultural food choices. It does not allow for eating out or inviting friends or other family members over for a meal. The Nutritious Food Basket does not include processed convenience foods, snack foods, foods of little nutritional value, or purchases commonly made at grocery stores like laundry detergent, toilet paper, or soap. On May 25, 26 and 27, 2010, two Community Health summer students under the direction of a Public Health Dietitian from the Perth District Health Unit conducted food pricing in six grocery stores across the Perth County as instructed in the updated Nutritious Food Basket Protocol ii. The food prices are used to estimate the average cost of feeding up to 22 different age and gender groups and a reference family of four (a man and woman each aged 31 to 50 years; a boy, 14 to 18 years of age; and a girl, four to eight years old). The average cost of the nutritious food basket for 2010 can be compared to 2009 survey as the same survey tool was used. The 2009 survey results will continue to be the baseline for comparison with results of future surveys. The results also allow the Health Unit to assess the adequacy of social assistance and minimum wage incomes in meeting basic household needs. This information can form the basis of addressing local poverty and hunger issues through awareness, education, advocacy, and policy development. 3

The Nutritious Food Basket Results How much does it cost to feed a family? In 2010, an average family of four, (a man and woman each aged 31 to 50 years; a boy, 14 to 18 years of age; and a girl, four to eight years old) living in Perth County needs $169.55 a week to buy the complete list of basic food items in the Nutritious Food Basket, to meet their minimum nutrition recommendations. In 2009 the same family needed $164.88 to purchase all the items in the survey basket. The difference between 2009 and 2010 represents an increase of 2.8% The consumer price index, published by Statistics Canada, reports that the cost of food purchased from stores rose 0.8% in May 2010, compared with May 2009 iii. For those who must follow a strict budget, the choice is not between a generic and name brand product. It means the choice between food and hunger. Trends of Time Food costs have risen over time. From 2003 to 2008, in Ontario costs have increased 11.36% to feed a reference family of four. iv Provincial social assistance rates have not seen the same increase. In 1995, rates were cut by 21.6%, while the cost of rent and food has continued to increase. While there have been increases in social assistance rates in the past 10 years, they have not made up for what was cut in 1995. Of all Perth County residents, single-parent families and individuals receiving financial assistance are impacted the most by increasing costs. It is impossible for some social assistance recipients to pay all necessary expenses and have enough money left to eat a nutritious diet. It has been shown that poverty is a significant hazard to health v. Cost Depends on Age and Gender The Perth County Nutritious Food Basket prices are based on the nutrient needs of people at different stages in their lives. The cost of eating well is often lower for women than men. Women are generally smaller than men are and need less food to meet their energy and nutrient needs. It is important to remember that even though women may need less food, the foods should be nutrient dense. Pregnant and breastfeeding women have higher nutrient and energy needs compared to the average woman. Children and teens grow rapidly, therefore they have higher energy and nutrient needs relative to their body sizes than adults. Children and teens may need proportionally more food than adults to support optimal growth and development. 4

The Weekly Cost of the Nutritious Food Basket in Perth County Nutritional needs vary by age, gender, growth and lactation and the weekly food costs reflect these differences. The following table from Eating Well with Canada s Food Guide helps to illustrate these differences, as the number of servings in each food group is dependent on the age, gender, and life stage. Pregnant and breastfeeding women need an extra 2 to 3 Food Guide Servings per day. Children Teens Adults Age in Years 2-3 4-8 9-13 14-18 19-50 51+ Sex Girls and Boys Females Males Females Males Females Males Vegetables and Fruit 4 5 6 7 8 7-8 8-10 7 7 Grain Products 3 4 6 6 7 6-7 8 6 7 Milk and Alternatives 2 2 3-4 3-4 3-4 2 2 3 3 Meat and Alternatives 1 1 1-2 2 3 2 3 2 3 Household food costs vary depending on household size. The fewer people living in a household, the higher the cost is per person. This is due to a variety of factors including higher cost per unit when purchasing smaller volumes and increased food wastes. The following table displays base weekly food costs. Cost adjustments for household size are on page 6. Approximate Cost Per Week ($)* Individual Age (in years) Male Female Child 2-3 22.47 22.04 4-8 28.96 28.11 Pre-teens and Adolescents 9-13 38.44 32.90 14-18 54.20 39.32 Adults 19-30 52.26 40.46 31-50 47.22 40.02 51-70 45.73 35.52 Over 70 45.27 34.92 Pregnancy 18 & Younger 43.85 19-30 44.19 31-50 43.12 Lactation 18 & Younger 45.65 19-30 46.87 31-50 45.80 *Five percent has been added to the figures to cover the cost of miscellaneous items used in everyday meal preparation such as spices, baking supplies, tea, and coffee. Calculating Weekly Food Costs for Households People can use this information to estimate the weekly cost of a nutritious diet for their household. An example is provided below. 5

Example Sex Age Approximate Cost Man 42 $ 47.22 Woman 39 $ 40.02 Boy 14 $ 54.20 Girl 8 $ 28.11 Subtotal = 169.55 X 0 = adjustment $ 169.55 TOTAL Cost/Week Your Household Sex Age Approximate Cost Step 1: Write down the gender and age of each person in the household. Step 2: Using Table 1 on page 4, write down the weekly food cost for each person. Step 3: Add the weekly food costs together and record in subtotal section. Step 4: Adjustments to the cost can be made for families smaller or larger than four. Multiply the subtotal by the adjustment factor for household size to calculate the total cost for your family. If the household has: 1 person multiply by 1.20 2 people multiply by 1.10 3 people multiply by 1.05 4 people make no change 5-6 people multiply by 0.95 7+ people multiply by 0.90 Subtotal = X 0 = adjustment TOTAL Cost/Week Step 5: To determine the household s monthly food cost, multiply the household s weekly food cost by 4.33. For example, the Nutritious Food Basket cost for a family of four, including two parents, a 14-yearold boy and an 8-year-old girl, is $169.55 per week or $734.15 per month. Using the Information Individuals and organizations can use this information to: advocate for adequate income and food for everyone monitor changes in local food prices over time prepare educational resources guide individuals for household food budget planning increase awareness of food security issues Housing The cost of housing is the largest expense for most low income residents. The average monthly rental cost for a three-bedroom apartment in Perth County was $865.00 in 2010, vi yet the maximum monthly shelter allowance from Ontario Works is only $674.00 vii for a family of four. 6

In Perth County, approximately 34%% of renter households and 15.3 % of home owners spend more than 30% of their income on shelter. viii By comparison, in Ontario in 2008, the proportion of average total household budget expenditure on shelter was 21.2% ix, an indication of how the cost of shelter is not as great proportionally when households have an average (adequate) level of income. This situation is compounded by a shortage of affordable rental housing in Perth County and a long waiting list for social housing. The Quality of Life in Perth County a 2008 Profile reports there are 1,214 public, non-profit co-operative and rent supplement housing units in the county representing about 16% of the total rent stock. These units are largely concentrated in the City of Stratford. x Our Choice for a Better Ontario, the 2008 Ontario Association of Food Banks Report notes that a lack of affordable housing is a key cause of hunger in Ontario. xi Trade-offs or compromises required among the poorest households in Perth County, often involve decisions like paying the rent or hydro, instead of buying food. Social Assistance On average, 722 families and individuals in Perth County received Ontario Works assistance each month in the period January 1 to June 30 th 2010. xii The case load in Perth County for the same time period in 2009 was 679 families and individuals. xiii This represents an increase of 6% in one year. Scenario 1, in Appendix A, compares the cost of rent and food for a family of four to the total income available from Ontario Works. These families are required to spend 50% of their income on housing and 38% on food, leaving little for other basic needs. In comparison a same family of 4 earning the median income in Ontario spent 15% of their income on housing and 13 % on food. An average of 1547 families or individuals in Perth County received benefits each month from the Ontario Disability Support Program (ODSP) in the 12 month June 2009 to May 2010. xiv In Ontario the number of families receive Ontario Disability Support Program benefits rose from 255,741 in May 2009 to 271,104 in May 2010. This represents an increase of 6% in one year xv. Scenario 6, in Appendix A, illustrates the income and expenses for a male age 31-50 years on ODSP; he is required to spend 56% of his income on rent and 18% for healthy food. He only has $279.44 per month to cover all other monthly expenses. Sixty one percent of social assistance recipients do not have 7

enough money to purchase food every month and are therefore food insecure. xvi Food bank use continues to be high in the county. The House of Blessings provided food to 2442 people from January 1 to June 30 2010. 888 or 36.3% of the recipients of these food hampers were children. The number of new families receiving food hampers in the first six months of 2010 was 156. xvii For a family of four living on income from Ontario Works, the estimated monthly cost of housing and a nutritious food basket leaves little money at the end of the month. In 2010, $308.85 per month was left to cover other basic necessities, such as hydro, heat, basic phone service, transportation, household and personal care items, clothing and childcare. Notably, the costs of these other basic necessities have also increased at varying rates over the last five years. Food Insecurity and Health Food is very reasonably priced in most parts of Canada, however not everyone can afford to put enough of it on the table. This usually is not because food prices are too high. More often, it is because the dollars at hand just cannot be stretched far enough. Families receiving social assistance or relying on minimum wage income can spend a significant percentage of their total income (e.g. greater than 30%) on housing. Rent and utility bills are inflexible expenses, but food dollars are not necessarily seen the same way. As a result, when more money is needed for basics like clothing, transportation, home maintenance, or in the case of a family emergency, money for food may end up spent on something else. This means not enough money is left for healthy eating. This is evident when we look at food security rates. Food security exists when all people, at all times, have access to sufficient, safe and nutritious food to meet dietary needs and food preferences for an active and healthy life. xviii Food insecurity is evident when one or more of these factors are missing. Food insecurity can occur with or without hunger. Although a person may have an adequate volume of food to avoid hunger; the food available may not be safe, nutritious, or fulfill personal/cultural preferences. Identifying food insecurity is important because it gives a rough estimate of the number of people with compromised diets, either with food quality, quantity, or disrupted eating patterns. Poverty and food insecurity are often associated with obesity. This paradox can 8

be explained in part by food choices. When families on a low income cannot make their dollar stretch far enough, they are forced to choose inexpensive, filling foods and non-perishables. These foods tend to be higher in calories, fat, sugar and sodium and lower in other nutrients. It is no wonder that poverty is associated with poorer health. Canadian data shows 9.2% of households in 2004 were food insecure. Food insecurity was higher in households with incomes in the lowest (<$10 000) and lower middle ($10 000 $20 000) categories of household income. It was also higher for those relying on income from social assistance or worker s compensation/employment insurance, those who did not own their dwellings, and those with children. Lone parent homes, especially when lead by a female lone parent, had a higher prevalence of food insecurity. Rural areas in Canada were less food insecure (7.3%) than urban areas (9.6%). xix Ontario reports 8.4% of households in 2004 were food insecure. Approximately 7.5% of Perth County households report being food insecure. This is a significant issue, particularly for households earning less than $20 000 a year. The picture of food insecurity in the county has not changed in the past 6 years. xx In fact it is likely that the rates of food insecurity continue to be higher than reported because of the sensitive nature of responding to the questionnaires. As well, the regular use of food banks and community meal programs offered throughout Perth County serve as a reminder that food insecurity is an issue within our community. Individuals in food insufficient households are more likely to report poor general health, major depression and distress, and multiple chronic conditions including more heart disease, diabetes, high blood pressure, and food allergies. xxi The study Sick and Tired in 2008(from the Community Social Planning Council of Toronto, Wellesley Institute, and University of Toronto) xxii, found that people with low incomes had worse health on many indicators when compared with the non-poor. The poorest one-fifth of Canadians, when compared to the richest twenty percent, have: more than double the rate of diabetes and heart disease; a sixty percent greater rate of two or more chronic health conditions; more than three times the rate of bronchitis; nearly double the rate of arthritis or rheumatism a staggering 358% higher rate of disability 128% more mental and behavioural disorders; 95% more ulcers; 9

63% more chronic conditions; and 33% more circulatory conditions. Canadian adults and adolescents in food insecure households have lower intakes of fruits, vegetables and milk products, lower vitamin and mineral intakes, and a greater risk of inadequate nutrient intakes. The higher estimated prevalence of nutrient inadequacy is widespread and most marked for protein, vitamin A, thiamin, riboflavin, vitamin B-6, folate, vitamin B-12, magnesium, phosphorus and zinc. xxiii The Canadian Community Health Survey 2.2 data shows that men & women who reported food insecurity had significantly lower intakes of vitamin A, magnesium & calcium. xxiv There is growing evidence that families who cannot afford to buy adequate amounts of nutritious food respond by buying and consuming more energydense, nutrient-poor food products (fats, sweets and snacks), and that this is contributing to the rising incidence of obesity. xxv, xxvi Low household income is a marker for increased risk of overweight and obesity in Canadian children. xxvii Obesity is one more risk factor for poor health and chronic disease. Also increasing numbers of studies indicate that children in food insecure households are more likely to experience a whole range of behavioural, emotional and academic problems than children living in food secure households. xxviii Families need adequate incomes that allow them to buy nutritious food if they are to reduce their risk of health problems, limit nutrient deficiencies and decrease their incidence of obesity. Limitations of the Nutritious Food Basket There are some considerations to keep in mind when using the Nutritious Food Basket calculations. The Nutritious Food Basket is based upon a standardized list of foods that represent typical Canadian spending patterns. Therefore, this information is not reflective of individual food preferences or food purchasing locations, nor is it a recommended shopping list. The Nutritious Food Basket is not reflective of the healthiest food purchasing pattern possible, nor is it meant for an individual on a special diet. People spend food dollars in many locations. The percentage of weekly food expenditures in Ontario is in the range of 31% for restaurants and 69% for grocery purchases. xxix The Nutritious Food Basket survey includes food purchases from 10

grocery stores only. An individual food cost calculation cannot be used to evaluate food budgeting or purchasing habits, nor can it be used to estimate total, minimum, or maximum food expenditures. The cost of the Nutritious Food Basket does not account for the costs or barriers, such as transportation, to accessing food in a rural community where no public transportation is available. The foods in the Nutritious Food Basket require preparation. Individuals and families on low incomes may not have the kitchen appliances and equipment or the skills to prepare these foods. As a result they may be forced to purchase foods that require little preparation, which can cost more and tend to be higher in calories, fat and sodium. This survey was completed in Perth County. These results cannot be compared to food costs in other regions because of differences in grocery store chain buying and marketing practices. Significance of the Results Any rising cost can be a significant hardship for low income residents in Perth County. In1995, provincial social assistance rates were cut by 21.6%, while the cost of rent has continued to increase. While there have been increases in social assistance rates in the past 10 years, they have not made up for what was cut in 1995. Rising cost of essentials, such as food, have a particularly severe impact on people with low and fixed incomes. The shelter component of social assistance does not reflect market conditions. Vacancy rates are low in Perth County and the waiting list for social housing can be particularly long. The high cost of housing, low vacancy rates and incomes that have not kept pace with the increased cost of living, combine to make it extremely difficult for low income families to make ends meet. This means that many low income residents are forced to choose between paying the rent and buying food, which results in many people relying on food banks and other emergency food programs to meet basic needs. Summary Every year, public health units throughout Ontario collect data using the Nutritious Food Basket Survey to raise awareness of food security issues in their 11

communities. Each year, we are reminded that families and individuals on a low income simply cannot afford to eat well. Food costs are more flexible than other expenses, such as rent and utilities. As a result, the food budget is the one that can get cut. When families and individuals cannot afford to eat well, it affects their health and well-being. In the final analysis food insecurity remains an issue in Perth County. 12

i www.hc-sc.gc.ca/fn-an/surveill/basket-panier/index-eng.php ii Nutritious Food Basket Protocol (2008) and for Nutritious Food Basket Guidance Document 2010 www.health.gov.on.ca/publichealthstandards iii http://www.statcan.gc.ca/subjects-sujets/cpi-ipc/cpi-ipc-eng.htm iv Association of Local Public Health Agencies Nutritious Food Basket Survey Update, 2009 Available at: http://www.alphaweb.org/files/nfb%20summary%20report_2009apr.pdf v Sick and Tired: The Compromised Health of Social Assistance Recipients and the Working Poor in Ontario, Community Social Planning Council of Toronto, Wellesley Institute, and University of Toronto. E. Lightman, A. Mitchell, B. Wilson, December 2008 vi Local Apartment Rental Survey June 2010 vii Social Assistance, Pension and Tax Credit Rates, Ministry of Community & Social Services, July 2010 viii Quality of Life in Perth County A 2008 Profile ix Spending Patterns in Canada 2008 Stats Canada x Quality of Life in Perth County A 2008 Profile xi Our Choice for a Better Ontario, The Ontario Association of Food Banks (OAFB), August 19, 2008 xii Perth County Social Services Department 2010 xiii Perth County Social Services Department 2010 xiv Perth County Social Services Department 2010 xv Ontario Disability Support Program Payments 2010 xvi Analysis of Ontario Sample in Cycle 2.2 of the Canadian Community Health Survey (2004) xvii House of Blessings Statistics, July 2010 xviii Food and Agriculture Organization, 2008 xix Canadian Community Health Survey, Cycle 22, 2004 xx Canadian Community Health Survey, Cycle 22, 2004 xxi Household food insufficiency is associated with poorer health. Vozoris NT, Tarasuk VS. J Nutr. 133: 120-126, 2003. xxii Sick and Tired: The Compromised Health of Social Assistance Recipients and the Working Poor in Ontario, Community Social Planning Council of Toronto, Wellesley Institute, and University of Toronto. E. Lightman, A. Mitchell, B. Wilson, December 2008 http://socialplanningtoronto.org/reports/sick-and-tired-report-released/ xxiii Food insecurity is associated with nutrient inadequacies among Canadian adults and adolescents. Kirkpatrick S and Tarasuk V. J Nutr. 138:604-612, 2008. xxiv Analysis of Ontario sample in Cycle 2.2 of the Canadian Community, Health Survey (2004), J. Vogt and V. Tarasuk, December 18, 2007 xxv A review of policy options for increasing food security and income security in British Columbia: A discussion paper. Kerstetter S, Goldber M. September 2007. xxvi The rising cost of low-energy-density foods. Monsivais P, Drewnowski A. J Am Diet Assoc. 2007; 107:: 2071-2076. xxvii Overweight Nova Scotia Children and Youth. St. John M et al. Can J Public Health. 2008; 99:4, 301-306 www.hc-sc.gc.ca/fn-an/surveill/basket-panier/index-eng.php xxviii Social Determinants of Health The Canadian Facts, Juha Mikkonen, Dennis Raphael 2010 xxix Average weekly expenditures per household 2001 13

Appendix 1 Cost of Eating Well in Perth 2010 Scenario 1 Family of 4 Ontario Works Scenario 2 Family of 4 Min. Wage Earner (Full time/ full year) Scenario 3 Family of 4 Median Ontario Income (after tax) Scenario 4 Scenario 5 Scenario 6 Scenario 7 Single Parent Household with 2 Children Ontario Works 1 Person Household Ontario Works 1 Person Household, ODSP 1 Person Household, OAS/GIS Monthly Income Income from Employment $1,777.0 $6,175.00 Allowances/OAS/GIS $1,248.00 $961.00 $585.00 $1,042.00 $1,170.00 Benefits $796.00 $842.00 -$107.00 $796.00 $21.00 $29,00 $31.00 Deductions -$105.00 -$293.00 Total Income $1908.00 $2,514.00 $5,775.00 $1,757.00 $606.00 $1,071.00 $1,201.00 Selected Monthly Expenses Average Monthly Rent(may or may not include heat/hydro) (3 Bdr.) $865.00 (3 Bdr.) $865.00 (3 Bdr.) $865.00 (2 Bdr.) $695.00 (1 Bdr.) $604.00 (1 Bdr.) $604.00 (1 Bdr.) $604.00 % of income required for rent 50% 34% 15% 40% 99% 56% 50% Food $734.15 $734.15 $734.15 $526.02 $187.56 $187.56 $173.61 % of income required to purchase healthy food 38% 29% 13% 32% 31% 18% 14% Total Expenses $1,599.15 $1,599.15 $1,599.15 $1,221.02 $791.56 $791.56 $777.61 Monthly Funds Remaining (for all other expenses) $308.85 $914.85 $4,175.84 $535.98 ($185.56) $279.44 $423.39 14

Written By: Margaret Ann Munoz, MPH RD Public Health Dietitian SEPTEMBER 2010 CA