Journal of Urban Health

, Volume 88, Issue 2, pp 284–296 | Cite as

Housing Circumstances are Associated with Household Food Access among Low-Income Urban Families

Article

Abstract

Household food insecurity is a pervasive problem in North America with serious health consequences. While affordable housing has been cited as a potential policy approach to improve food insecurity, the relationship between conventional notions of housing affordability and household food security is not well understood. Furthermore, the influence of housing subsidies, a key policy intervention aimed at improving housing affordability in Western countries, on food insecurity is unclear. We undertook a cross-sectional survey of 473 families in market rental (n = 222) and subsidized (n = 251) housing in high-poverty urban neighborhoods to examine the influence of housing circumstances on household food security. Food insecurity, evident among two thirds of families, was inversely associated with income and after-shelter income. Food insecurity prevalence did not differ between families in market and subsidized housing, but families in subsidized housing had lower odds of food insecurity than those on a waiting list for such housing. Market families with housing costs that consumed more than 30% of their income had increased odds of food insecurity. Rent arrears were also positively associated with food insecurity. Compromises in housing quality were evident, perhaps reflecting the impact of financial constraints on multiple basic needs as well as conscious efforts to contain housing costs to free up resources for food and other needs. Our findings raise questions about current housing affordability norms and highlight the need for a review of housing interventions to ensure that they enable families to maintain adequate housing and obtain their other basic needs.

Keywords

Household food insecurity Food access Housing affordability Social housing Housing subsidy Poverty Urban Families 

Notes

Acknowledgments

The authors gratefully acknowledge our collaborators at the City of Toronto Shelter, Support and Housing Division, and Toronto Public Health. This study was supported by grants from the Canadian Institutes for Health Research (IGP-74207, MOP-77766) and funding from the Neighbourhood Change & Building Inclusive Communities from Within Community University Research Alliance (CURA) program of the Social Sciences and Humanities Research Council of Canada. Sharon Kirkpatrick was a doctoral candidate at the time that this study was conducted and received financial support from an Ontario Graduate Scholarship and a Social Sciences and Humanities Research Council of Canada Doctoral Scholarship.

References

  1. 1.
    Cristofar SP, Basiotis PP. Dietary intakes and selected characteristics of women ages 19–50 years and their children ages 1–5 years by reported perception of food sufficiency. J Nutr Educ. 1992; 24(2): 53–58.Google Scholar
  2. 2.
    Rose D, Oliveira V. Nutrient intakes of individuals from food-insufficient households in the United States. Am J Public Health. 1997; 87(12): 1956–1961.PubMedCrossRefGoogle Scholar
  3. 3.
    Dixon LB, Winkleby MA, Radimer KL. Dietary intakes and serum nutrients differ between adults from food-insufficient and food-sufficient families: Third National Health and Nutrition Examination Survey, 1988–1994. J Nutr. 2001; 131(4): 1232–1246.PubMedGoogle Scholar
  4. 4.
    Tarasuk VS. Household food insecurity with hunger is associated with women’s food intakes, health, and household circumstances. J Nutr. 2001; 131(10): 2670–2676.PubMedGoogle Scholar
  5. 5.
    Kirkpatrick SI, Tarasuk V. Food insecurity is associated with nutrient inadequacies among Canadian adults and adolescents. J Nutr. 2008; 138(3): 604–612.PubMedGoogle Scholar
  6. 6.
    Che J, Chen J. Food insecurity in Canadian households. Health Rep. 2001; 12(4): 11–22.PubMedGoogle Scholar
  7. 7.
    Alaimo K, Olson CM, Frongillo EA, Briefel R. Food insufficiency, family income, and health of US preschool and school-aged children. Am J Public Health. 2001; 91(5): 781–786.PubMedCrossRefGoogle Scholar
  8. 8.
    Siefert K, Heflin CM, Corcoran ME, Williams DR. Food insufficiency and the physical and mental health of low-income women. Women Health. 2001; 32(1–2): 159–177.PubMedGoogle Scholar
  9. 9.
    Vozoris N, Tarasuk V. Household food insufficiency is associated with poorer health. J Nutr. 2003; 133(1): 120–126.PubMedGoogle Scholar
  10. 10.
    Heflin CM, Siefert K, Williams DR. Food insufficiency and women’s mental health: findings from a 3-year panel of welfare recipients. Soc Sci Med. 2005; 61(9): 1971–1982.PubMedCrossRefGoogle Scholar
  11. 11.
    Seligman HK, Bindman AB, Vittinghoff E, Kanaya AM, Kushel MB. Food insecurity is associated with diabetes mellitus: results from the National Health Examination and Nutrition Examination Survey (NHANES) 1999–2002. J Gen Intern Med. 2007; 22(7): 1018–1023.PubMedCrossRefGoogle Scholar
  12. 12.
    Rose-Jacobs R, Black MM, Casey PH, et al. Household food insecurity: associations with at-risk infant and toddler development. Pediatrics. 2008; 121(1): 65–72.PubMedCrossRefGoogle Scholar
  13. 13.
    Kirkpatrick SI, McIntyre L, Potestio M. Child hunger and long-term adverse consequences for health. Arch Pediatr Adolesc Med. 2010; 164(8): 754–762.PubMedCrossRefGoogle Scholar
  14. 14.
    Seligman HK, Laraia BA, Kushel MB. Food insecurity is associated with chronic disease among low-income NHANES participants. J Nutr. 2010; 140(2): 304–310.PubMedCrossRefGoogle Scholar
  15. 15.
    Statistics Canada. Household food insecurity, 2007–2008. Ottawa, ON: Statistics Canada; 2010. Health Fact Sheet No. 2, Cat. No. 82-625-XWE.Google Scholar
  16. 16.
    Nord M, Andrews M, Carlson S. Household Food Security in the United States, 2008. Economic Research Service, US Dept of Agriculture; 2009. Report No. ERR-83.Google Scholar
  17. 17.
    Office of Nutrition Policy and Promotion. Income-Related Household Food Security in Canada. Ottawa, ON: Health Canada; 2007. Report No. H164-42/2007E.Google Scholar
  18. 18.
    Ledrou I, Gervais J. Food insecurity. Health Rep. 2005; 16(3): 47–51.PubMedGoogle Scholar
  19. 19.
    McIntyre L. Food security: more than a determinant of health. Policy Options. 2003; 24(3): 46–51.Google Scholar
  20. 20.
    Canadian Association of Food Banks. HungerCount 2007. Toronto: Canadian Association of Food Banks; 2007.Google Scholar
  21. 21.
    Power E. Individual and household food insecurity in Canada: position of Dietitians of Canada (background paper). Can J Diet Prac Res. 2005.Google Scholar
  22. 22.
    Chronic Disease Prevention Alliance of Canada. CDPAC Policy Position: Food Security in Canada—A Leadership Opportunity Towards Health Promotion and Reduction in Chronic Disease. Ottawa, ON: Chronic Disease Prevention Alliance of Canada; 2007.Google Scholar
  23. 23.
    Campbell CC, Desjardins E. A model and research approach for studying the management of limited food resources by low income families. J Nutr Educ. 1989; 21(4): 162–171.Google Scholar
  24. 24.
    Tarasuk V, Maclean H. The food problems of low-income single mothers: an ethnographic study. Can Home Econ J. 1990; 40(2): 76–82.Google Scholar
  25. 25.
    Travers KD. The social organization of nutritional inequities. Soc Sci Med. 1996; 43(4): 543–553.PubMedCrossRefGoogle Scholar
  26. 26.
    Hamelin AM, Beaudry M, Habicht J-P. Characterization of household food insecurity in Quebec: food and feelings. Soc Sci Med. 2002; 54(1): 119–132.PubMedCrossRefGoogle Scholar
  27. 27.
    Hulchanski JD. The concept of housing affordability: six contemporary uses of the housing expenditure-to-income ratio. Hous Stud. 1995; 10(4): 471–491.CrossRefGoogle Scholar
  28. 28.
    Canada Mortgage and Housing Corporation. Canadian Housing Observer 2003. Ottawa, ON: Canada Mortgage and Housing Corporation; 2003.Google Scholar
  29. 29.
    Stone ME. Shelter Poverty: New Ideas on Housing Affordability. Philadelphia: Temple University Press; 1993.Google Scholar
  30. 30.
    Moloughney B. Housing and Population Health: The State of Current Research Knowledge. Ottawa, ON: Canadian Population Health Initiative & Canada Mortgage and Housing Corporation; 2004.Google Scholar
  31. 31.
    Kirkpatrick SI, Tarasuk V. Food insecurity and participation in community food programs among low-income Toronto families. Can J Public Health. 2009; 100(2): 135–139.PubMedGoogle Scholar
  32. 32.
    Dachner N, Ricciuto L, Kirkpatrick S, Tarasuk V. Food purchasing and food insecurity among low-income families in Toronto. Can J Diet Prac Res. 2010; 71(3):126.Google Scholar
  33. 33.
    Kirkpatrick SI, Tarasuk V. Assessing the relevance of neighbourhood characteristics to the household food security of low-income Toronto families. Public Health Nutr. 2010; 13(7): 1139–1148.PubMedCrossRefGoogle Scholar
  34. 34.
    Statistics Canada. Canadian Community Health Survey (CCHS) Cycle 2.2, (Nutrition) 2004: Public Use Microdata File (PUMF) Derived and Grouped Variable Specifications. Ottawa, ON: Statistics Canada; 2005.Google Scholar
  35. 35.
    Bickel G, Nord M, Price C, Hamilton WL, Cook J. Guide to Measuring Household Food Security. Alexandria, VA: US Dept of Agriculture, Food and Nutrition Service, Office of Analysis, Nutrition and Evaluation; 2000.Google Scholar
  36. 36.
    Canada Mortgage and Housing Corporation. Canadian Housing Observer 2004. Ottawa, ON: Canada Mortgage and Housing Corporation; 2004.Google Scholar
  37. 37.
    Toronto Public Health. Weekly Cost of the Nutritious Food Basket in Toronto (May 2006). Toronto: City of Toronto; 2007.Google Scholar
  38. 38.
    An A, Watts D. New SAS® Procedures for Analysis of Sample Survey Data. Cary, NC: SAS Institute Inc.; 1998.Google Scholar
  39. 39.
    Rose D. Economic determinants and dietary consequences of food insecurity in the United States. J Nutr. 1999; 129(2S Suppl): 517S–520S.PubMedGoogle Scholar
  40. 40.
    McIntyre L, Connor SK, Warren J. Child hunger in Canada: results of the 1994 National Longitudinal Survey of Children and Youth. Can Med Assoc J. 2000; 163(8): 961–965.Google Scholar
  41. 41.
    McIntyre L, Walsh G, Connor SK. A Follow-up Study of Child Hunger in Canada. Ottawa, ON: Applied Research Branch, Human Resources Development Canada; 2001. Report No. W-01-1-2E.Google Scholar
  42. 42.
    Kirkpatrick SI, Tarasuk V. Adequacy of food spending is related to housing expenditures among lower-income Canadian households. Public Health Nutr. 2007; 10(12): 1464–1473.PubMedCrossRefGoogle Scholar
  43. 43.
    City of Toronto. Rent-Geared-to-Income Guide. Toronto: Social Housing Unit, City of Toronto; 2003.Google Scholar
  44. 44.
    Wehler C, Weinreb LF, Huntington N, et al. Risk and protective factors for adult and child hunger among low-income housed and homeless female-headed families. Am J Public Health. 2004; 94(1): 109–115.PubMedCrossRefGoogle Scholar
  45. 45.
    Ontario Ministry of Municipal Affairs and Housing. 2005 Annual Rent Increase Guideline. Toronto: Ontario Ministry of Municipal Affairs and Housing; 2004.Google Scholar
  46. 46.
    Dunn JR. Housing and inequalities in health: a study of socioeconomic dimensions of housing and self reported health from a survey of Vancouver residents. J Epidemiol Community Health. 2002; 56: 671–681.PubMedCrossRefGoogle Scholar
  47. 47.
    Shaw M. Housing and public health. Annu Rev Public Health. 2004; 25: 397–418.PubMedCrossRefGoogle Scholar
  48. 48.
    Rauh VA, Landrigan PJ, Claudio L. Housing and health: intersection of poverty and environmental exposures. Ann NY Acad Sci. 2008; 1136: 276–288.PubMedCrossRefGoogle Scholar

Copyright information

© The New York Academy of Medicine 2011

Authors and Affiliations

  1. 1.Division of Cancer Control and Population SciencesNational Cancer InstituteBethesdaUSA
  2. 2.Department of Nutritional Sciences, Faculty of MedicineUniversity of TorontoTorontoCanada

Personalised recommendations