People with lower incomes who struggle to put food on the table use the health care system more, leading to higher health care costs, according to new research from the University of Toronto, the Centre for Addiction and Mental Health (CAMH), the Institute for Clinical Evaluative Sciences (ICES), and the University of Illinois.
A key finding: people with food insecurity used the health system more than those with the same levels of poverty who didn’t struggle to obtain food.
“Food insecurity – independent of income and education – appears to lead directly to health consequences like increased emergency room use,” says Professor Valerie Tarasuk of the University of Toronto. “It would be much cheaper for taxpayers and more humane if we addressed hunger on the front end rather than treating the health problems that result.”
An increasing number of Canadians live with food insecurity. In 2012, 12.6 per cent of Canadian households experienced inadequate or insecure access to food because of financial constraints — the highest rate since 2007 when national monitoring began.
“We know that people who have trouble affording the food they need have poorer health in general as well as more chronic disease,” says Tarasuk, professor of nutritional sciences and the principal investigator of PROOF, a CIHR-funded program researching policy solutions to food insecurity in Canada. “For children and adults, living with food insecurity also leads to increased barriers to managing those health conditions, which in turn leads to heavier use of the health care system.”
Researchers found that as levels of food insecurity increased, people used more health care services and thus incurred higher health care costs. For people living with severe food insecurity, health costs were more than double that of the food-secure population.
Researchers looked at patient data for 67,033 adults in Ontario aged 18 to 64 years who had participated in the Canadian Community Health Survey between 2005 and 2010. They used data provided by the Institute for Clinical Evaluative Sciences (ICES) to determine participants’ direct health care costs, including emergency department visits, acute and psychiatric hospital stays, physician visits, day surgeries and home care over a one-year period. They also considered the costs of prescription drugs that are covered by the province of Ontario for people on social assistance.
“Our ability to link food insecurity data with health care expenditures provides a unique window into the burden of this pervasive social problem on our health care system, and is what sets this research apart from other studies on health and food insecurity” says Dr. Paul Kurdyak, study co-author, director of Health Systems Research at CAMH, lead of the Mental Health and Addictions Research Program at ICES, and an associate professor of psychiatry at UofT.
The household characteristics associated with vulnerability to food insecurity have been well documented over the years since Canada began tracking this problem, and there is a growing body of research pointing to directions for effective policy solutions. To date though, there has been no provincial or federal initiative with the explicit target of reducing food insecurity. “The high health care costs associated with food insecurity revealed in this study highlight the pressing need for effective intervention,” says Professor Tarasuk.
The study, “Health care costs associated with household food insecurity in Ontario,” appears online (ahead of print) today in the Canadian Medical Association Journal. The research was supported by a Programmatic Grant in Health and Health Equity from the Canadian Institutes of Health Research.
Author block: Valerie Tarasuk, Joyce Cheng, Claire de Oliveira, Naomi Dachner, Craig Gundersen, Paul Kurdyak.
The University of Toronto has assembled one of the strongest research and teaching faculties in North America, presenting top students at all levels with an intellectual environment unmatched in breadth and depth on any other Canadian campus. U of T faculty co-author more research articles than their colleagues at any university in the US or Canada other than Harvard. As a measure of impact, U of T consistently ranks alongside the top five U.S. universities whose discoveries are most often cited by other researchers around the world. The U of T faculty are also widely recognized for their teaching strengths and commitment to graduate supervision. Established in 1827, the University of Toronto today operates in downtown Toronto, Mississauga and Scarborough, as well as in nine renowned academic hospitals.
The Centre for Addiction and Mental Health (CAMH) is Canada's largest mental health and addiction teaching hospital, as well as one of the world's leading research centres in the area of addiction and mental health. CAMH combines clinical care, research, education, policy development and health promotion to help transform the lives of people affected by mental health and addiction issues. CAMH is fully affiliated with the University of Toronto, and is a Pan American Health Organization/World Health Organization Collaborating Centre.
ICES is an independent, non-profit organization that uses population-based health information to produce knowledge on a broad range of health care issues. Our unbiased evidence provides measures of health system performance, a clearer understanding of the shifting health care needs of Ontarians, and a stimulus for discussion of practical solutions to optimize scarce resources. ICES knowledge is highly regarded in Canada and abroad, and is widely used by government, hospitals, planners, and practitioners to make decisions about care delivery and to develop policy.
For the latest ICES news, follow us on Twitter: @ICESOntario
For further information please contact:
- Heidi Singer
- Communications and Media Relations Specialist, U of T Medicine
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- Kate Richards
- Senior Media Relations Specialist, CAMH
- 416-535-8501 ext. 36015
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- Kathleen Sandusky
- Media Advisor, ICES
- (o) 416-480-4780 or (c) 416-434-7763
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