Food, glorious food! In all its forms of consumerism, is food insecurity real?
Hello. Bonjour. Aaniin. Boozhoo.
Welcome back from the holiday season. Hopefully everyone had a wonderful break. Here at NOSM, we are all raring to get on with the business of the School’s new plans for leadership, advocacy, strategic planning and curricular innovation. Of course, there are those New Year’s resolutions – to lose weight, exercise and to be nicer to everyone, right?
With this in mind, it’s important to recognize that having a choice of healthy food options is a privilege not available to many. Many Indigenous communities in Northern Canada are experiencing a food security crisis with serious implications for health and well-being.
Food insecurity in the North is a multifaceted problem. Northerners rely on a mix of traditional or wild food and market food, and both harvesting and food shipping costs are extremely high. Canada's efforts to provide Northerners in isolated communities with improved access is failing to lower the cost of perishable and nutritious food in northern communities by providing northern retailers with a subsidy on a select list of foods.
Food is simply more expensive in Northern Ontario. Remote Northern communities face the consequences of skyrocketing food transportation costs at sometimes triple the price. It’s safe to say that Northerners’ lack of access to healthy food is ultimately costing people their health.
In November 2019, a decade-long Canadian study found that barriers to access healthy traditional foods are eroding food security for First Nations. The First Nations Food, Nutrition and Environment Study (FNFNES) found that 24 to 60 per cent of First Nations experience food insecurity at a rate of up to five-times more than the general Canadian population.
As a medical school with a social accountability mandate, we intend to tackle the issue. We must get ahead of the problem that food insecurity and malnutrition is a leading root cause of complex chronic disease in the North. Our faculty and students are well versed in the areas of chronic disease diagnosis and treatment, but have little influence over the poor diets of patients, let alone entire communities. As influencers of health policy, NOSM is compelled to raise awareness of food insecurity in the North and work toward advocating for, and stewarding, improved food security systems. In my opinion, NOSM can help Indigenous communities and leadership develop a national food policy that includes the northern context, and the recognition of the right to food for Indigenous Peoples in Canada. The Canada Food Guide must represent other kinds of diets as well, including Northern and multicultural influences.
According to a 2018 article published by Foodtank.com, “Indigenous communities in the remote northern portion of Canada’s province of Ontario are expanding efforts to mitigate the impact of high food costs and a general lack of available nutritious fruit and vegetables in supermarkets by increasing crop production.” The same article points out that a “standard basket of food—officially known as the Revised Northern Food Basket—costs twice as much in the North… despite government subsidies...” Food for a family of four in Toronto is $847/month versus the same food basket in Attawapiskat First Nation costing $1,909/month. At more than double the price, this demonstrates the disparity between the cost of living in the north and south.
This begs the question: who controls Northern food systems, and the cost and flow of food? Some Northern communities and leaders are taking matters into their own hands by revitalizing traditional food systems, specifically food systems sustained through hunting, gathering and growing. NOSM supports this food sovereignty lens. We are not afraid to explore ideas that will improve community health outcomes and we are prepared to support new methods that are unconventional.
For example, this year NOSM offered its first hunter safety course. The School’s intention is that NOSM students will have the tools to actively participate in healthy cultural activities, whether it be a traditional hunt, or learning alongside community members about traditional food systems. As well, we educate our students about culinary medicine labs, boil water advisories, community environmental threats and hazards, socio-economic barriers to health and cultural sensitivity teachings.
NOSM students gain insight during their longitudinal integrated clerkship when they spend their entire third year of medical school (eight months) in a mid-sized community in Northern Ontario. Before that, they also gain lived experiences that they’ll bring to their practices during their Integrated Community Experience, when they spend four weeks living in Indigenous communities to learn about First Nations and Métis culture and history, and to understand some of the health issues facing these communities.
We know that food insecurity is linked to food supply and transportation systems, and their ongoing relational business and economic consequences. NOSM is prepared to promote policy changes for food security and food protections, as well as the importance of traditional diet and new or renewed methods of sustainable food sources and production. We must ensure our medical school curriculum includes nutrition education on food supplements and alternate nutritional strategies that are culturally sensitive. Indigenous Food Sovereignty speaks to the ability to make decisions over the amount and quality of food Indigenous people hunt, fish, gather, grow and eat.
As a study highlighting exploratory work, conducted with Waasegiizhig Nanaandawe’iyewigamig and Shkagamik-Kwe Health Centre (two Indigenous-led Aboriginal Health Access Centres in urban service centers in Northern Ontario) points out, food sovereignty is “work that requires innovation and resiliency… such work is not impossible and when implemented, an IFS [Indigenous Food Sovereignty] framework can expand health paradigms and health practitioners’ role in relation to community and land.”
Joseph Leblanc, NOSM’s Director of Indigenous Affairs, tells me there are communities in the North who are making very innovative strides in food sovereignty. We have much to learn from them.