(photo by Kevin Jaako via Flickr)

How hunger leads to higher health-care costs

Researchers find growing evidence of link between food security and health

People who struggle to put food on the table use health care more – and account for much higher health-care costs – than people with the same income level who don't experience food insecurity, University of Toronto researchers say.

Published on August 10 by the Canadian Medical Association Journal’s website, the new study by Professor Valerie Tarasuk is already making headlines thanks to its many troubling findings. For example, among working-age adults in Ontario, those living with severe food insecurity accounted for more than double the health-care costs of the food-secure population over a one-year period.

“Food insecurity – independent of income and education – appears to lead directly to health consequences like increased emergency room use,” said Tarasuk (pictured below). “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.”
photo of Valerie TarasukFood insecurity is about the struggle to afford food. Low income is a key part of the problem, but other factors, including the affordability of housing, also influence food security. And an increasing number of Canadians are facing this predicament.
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,” said Tarasuk, professor of nutritional sciences and the principal investigator of PROOF, a CIHR-funded program researching policy solutions to food insecurity in Canada. “We’re now able to see how this translates into higher health-care costs. And with only a one-year time frame, we’ve just begun to scratch the surface.”
The study involved researchers at the University of Toronto, the Centre for Addiction and Mental Health (CAMH), the Institute for Clinical Evaluative Sciences (ICES), and the University of Illinois.
They examined 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. Then, by accessing ICES data, the team was able 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 factored in the costs of prescription drugs covered by the province of Ontario for people on social assistance.
Researchers found that as levels of food insecurity increased, people used more health care services and thus incurred higher health care costs – with the most severe group accounting for more than two times the health costs of the food-secure population.
Chart: Mean health care costs incurred over 12 months by Ontario adults (18-64 years of age), by household food security status
chart demonstrating specific breakdown of costs as discussed in article
“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” said 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 U of T.
Despite mounting evidence of the perils associated with food insecurity, no provincial or federal government has developed an initiative to reduce this problem. Tarasuk wants to see this change.
“The high health-care costs associated with food insecurity revealed in this study highlight the pressing need for effective intervention.”


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