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Breakfast with...Dr. Lynn McIntyre
 

Breakfast with...Dr. Lynn McIntyre

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Food Insecurity

Food Insecurity

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  • 3 X higher than the Alberta prevalence rate 2.5 times higher than the national prevalence rate At the level of moderate food insecurity the quality of the diet and the quantity of food consumed is reported to be impacted. This is of particular concern for this population because nutrition is a key component of the management of diabetes. Food insecurity is closely linked to poverty Low income – more than half of Canadians in the lowest income group are food insecure Some households are at greater risk than others. Lone parent families headed by women Aboriginal people living off-reserve Those who don’t own their home Those receiving social assistance as their key source of income. This is of particular concern in Alberta.
  • A situation of severe food insecurity unequivocally has implications for the ability of this population to follow a recommended pattern of healthy eating necessary for effective management of diabetes. Severe food insecurity can be expected to place this population at risk for poor disease control and at risk for adverse health episodes such as hypoglycemic incidents. We really had not expected to see these results

Breakfast with...Dr. Lynn McIntyre Breakfast with...Dr. Lynn McIntyre Presentation Transcript

    • Lynn McIntyre MD, MHSc, FRCPC
    • Professor & CIHR Chair in Gender and Health
    • University of Calgary
    • [email_address]
    • NOT the flipside of Food Security
    • “ Food security exists when all people, at all times, have physical and economic access to sufficient, safe and nutritious food that meets their dietary needs and food preferences for an active and healthy life.” (World Food Summit, 1996)
    • Food Insecurity : Household food insecurity refers to the inadequate or insecure access to food due to financial constraints
    • Hunger : Prolonged, involuntary lack of food that results in illness, weakness or pain that goes beyond the usual uneasy sensation
    • NUMBERS
    • 2007: 8% population
    • 140,442 client visits to Calgary Emergency Food Hamper Program.
    • Client visits have increased by 57% since the start of the recession.
    • DYNAMICS
    • Nutritional compromise (enough said)
    • Self-reported health and mental health
    • Chronic conditions
    • Special case of diabetes, HIV/AIDS
    • Childhood toxicity
    • The health burden of food insecurity occurs as a social gradient
    • The health effects are pervasive and beyond nutrition-related conditions
    • Food insecurity has bi-directional causality in mental health, perhaps other conditions
    • Child hunger is toxic to health
  • Health condition Food secure Marginal food insecurity Moderate food insecurity Severe food insecurity Self-rated health ('Poor' or 'Fair')**** 7.8 14.4**** 21.0**** 36.6**** Males**** 7.7 14.2*** 20.6**** 40.7**** Females**** 7.9 14.6**** 21.2**** 33.5**** * = p < .05, ** = p < .01, *** = p <.001 and ****= p<.0001, controlling for age sex, education, aboriginal status, province, household income. Ref=Food secure
  • Health condition Food secure Marginal food insecurity Moderate food insecurity Severe food insecurity Self-rated mental health ('Poor' of 'Fair') **** 3.9 7.1 13.6 25.7 Males**** 3.8 7.0* 13.3**** 23.2**** Females**** 4.0 7.3*** 13.8**** 27.5**** * = p < .05, ** = p < .01, *** = p <.001 and ****= p<.0001, controlling for age sex, education, aboriginal status, province, household income. Ref=Food secure
  • Health condition Food secure Marginal food insecurity Moderate food insecurity Severe food insecurity Mood or anxiety disorder**** 8.9 16.1**** 22.5**** 34.8**** Males**** 6.5 11.5** 15.9*** 23.0*** Females**** 11.4 19.9**** 27.1**** 43.9**** * = p < .05, ** = p < .01, *** = p <.001 and ****= p<.0001, controlling for age, sex, education, aboriginal status, province, household income. Ref=Food secure
  • Health condition Food secure Marginal food insecurity Moderate food insecurity Severe food insecurity Stress**** 23.7 28.3 34.6 48.4 Males**** 22.7 26.8** 32.9**** 48.3**** Females**** 24.8 29.5**** 35.9**** 48.4**** * = p < .05, ** = p < .01, *** = p <.001 and ****= p<.0001, controlling for age sex, education, aboriginal status, province, household income. Ref=Food secure
  • Health condition Food secure Marginal food insecurity Moderate food insecurity Severe food insecurity Migraines**** 10.9 16.5**** 19.2**** 25.0**** Males**** 6.4 9.8 11.5** 16.2*** Females**** 15.6 22.0**** 24.4**** 31.7**** * = p < .05, ** = p < .01, *** = p <.001 and ****= p<.0001, controlling for age sex, education, aboriginal status, province, household income. Ref=Food secure
  • Health condition Food secure Marginal food insecurity Moderate food insecurity Severe food insecurity Diabetes**** 4.1 4.5 6.0* 12.1*** Males**** 4.5 4.7 5.6 16.6** Females**** 3.6 4.3 6.2* 8.6* * = p < .05, ** = p < .01, *** = p <.001 and ****= p<.0001, controlling for age sex, education, aboriginal status, province, household income. Ref=Food secure
  • Nutrition Services, Population and Public Health, Chronic Disease Management and Primary Care; Standards and Practice, AHS; Department of Community Health Sciences, University of Calgary Diabetes, Hypertension and Cholesterol Centre
    • National prevalence rate – 6.9% (2.5 times higher)
    • Provincial (Alberta) prevalence rate – 5.6% (3 times higher)
    • Food Insecurity is indeed a serious problem affecting this patient population.
    • Indicates reduced food intake and disrupted eating patterns
    • National rate – 1.7% (2007); 2.9% (2004)
    • Provincial rate – 1.2% (2007)
    • Total clinic prevalence – 10.0%
    • Therefore 54.4% of all food insecure respondents experienced food insecurity at the severe level.
  • Health condition Food secure Marginal food insecurity Moderate food insecurity Severe food insecurity Heart disease**** 2.4 2.8 3.1 8.1*** Males**** 2.8 3.0 3.4 10.4* Females**** 2.0 2.6 2.9 6.3*** * = p < .05, ** = p < .01, *** = p <.001 and ****= p<.0001, controlling for age, sex, education, aboriginal status, province, household income. Ref=Food secure
  • Health condition Food secure Marginal food insecurity Moderate food insecurity Severe food insecurity Obesity   Males 18.3 15.6 16.6 20.4 Females**** 14.7 19.7*** 24.2**** 26.2*** * = p < .05, ** = p < .01, *** = p <.001 and ****= p<.0001, controlling for age sex, education, aboriginal status, province, household income. Ref=Food secure
  • Health condition Food secure Marginal food insecurity Moderate food insecurity Severe food insecurity Bowel disorders**** 4.1 4.9* 6.4*** 9.4**** Males** 2.7 2.7 4.7 4.7 Females**** 5.5 6.7** 7.6*** 13.0**** * = p < .05, ** = p < .01, *** = p <.001 and ****= p<.0001, controlling for age, sex, education, aboriginal status, province, household income. Ref=Food secure
  • Health condition Food secure Marginal food insecurity Moderate food insecurity Severe food insecurity Oral health**** 11.9 22.3**** 28.2**** 40.9**** Males**** 14.1 25.9*** 33.4**** 45.3**** Females**** 9.7 19.3**** 24.6**** 37.6**** * = p < .05, ** = p < .01, *** = p <.001 and ****= p<.0001, controlling for age sex, education, aboriginal status, province, household income. Ref=Food secure
    • Credit: Cherie Nicholson
    • 6 cycles of follow up (1994-2004)
    • Child hunger = yes to: “Has your child (‘you’ if a youth respondent) ever experienced being hungry because the family had run out of food or money to buy food?”
    • Multiple yes= persistent hunger
    • Adjustments for baseline health, chronic conditions, asthma, permanent income, and other sociodemographics
  • Health Variable Hunger ever Persistent hunger Child health poor/fair @10-15 yrs ↑↑ OR 1.7 ↑↑ OR 4.7 Youth health poor/fair @ 16-21 yrs Chronic health Condition Youth ↑↑ OR 3.4 Asthma All girls↑↑ OR 2.2 Youth ↑↑ OR 6.1
    • New theories of biological sensitivity to context