I would like to congratulate the authors of the Pilot Food Costing Project, Dr. Jennifer Taylor and Dr. Colleen Walton, for their timely and necessary report (Study finds rising food costs in P.E.I., Guardian, November 25, 2013).
As a family physician and a board member of the P.E.I. Food Security Network, I have serious concerns about the levels of food insecurity in P.E.I. and the effects of this problem on the health of Islanders. Food security, an important determinant of health, exists when all people, at all times, have physical and economic access to sufficient, safe, and nutritious food to meet their dietary needs and food preferences for an active and healthy life.
It is well known that an individual’s health and wealth are highly correlated, and that relative poverty is the No. 1 determinant of poor health outcomes. Specifically, members of households with marginal and very low food security are at increased risk of metabolic syndrome, a cluster of conditions (such as increased blood pressure, a high blood sugar level, excess body fat around the waist, and abnormal cholesterol levels) that occur together, increasing the risk of heart disease, stroke and diabetes.
Household food insecurity prevalence is higher among Canadians with diabetes and is associated with an increased likelihood of unhealthy behaviors, psychological distress (including anxiety and depression), and poorer physical health. This report now provides early evidence that social assistance and minimum wage are insufficient in P.E.I. to afford a base healthy diet, contributing to a host of preventable diseases.
The health-care costs associated with food insecurity are medical expenditures for diagnosis, treatment, continuing care, rehabilitation, and terminal care as well as non-medical expenditures caused by diseases directly related to food insecurity. Major categories of medical expenditures may include hospitalization, outpatient care, nursing home services, home care, services of primary physicians, specialists, and other health professionals, medications, and rehabilitation.
Non-medical expenditures include costs of transportation to healthcare providers, expenses related to changes in diet, housing, and other similar changes necessary for disease management. Undoubtedly, there are strong ethical and economic incentives to deal with these issues in an upstream manner, by providing all Islanders with a livable wage and income to allow purchase of a healthy diet.
In these times of fiscal restraint, there is now evidence to show that by subsidizing those who are food insecure, the escalating cost of healthcare (estimated to be more than 50 per cent of P.E.I. resources by 2018), could be slowed significantly by “investing” in reducing poverty. The Canadian Medical Association concluded in its town hall report on health care in Canada, What makes us sick?, “that a national food security program be established to ensure equitable access to safe and nutritious food for all Canadians regardless of neighbourhood or income.”
The Medical Society of P.E.I. passed a unanimous resolution at the 2012 AGM requesting that annual food costing for a healthy diet be restarted in P.E.I. as a priority. I urge the provincial government to take action on the results of the Pilot Food Costing Project, reinstate annual food costing studies in P.E.I., and adjust social assistance and minimum wage accordingly, for the health and well-being of all Islanders.
Dr. Jenni Zelin,