Health Reports
Trends in household food insecurity from the Canadian Community Health Survey, 2017 to 2022

Abstract

Background

Income-related food insecurity is an important determinant of health. This study aimed to provide an update on the food security status of Canadian households using the most recent available data from a health-oriented national-level survey. This study also examined trends in food insecurity since 2017, and how these have tracked with changes in price inflation.

Data and methods

Data on household food security status in the 10 Canadian provinces came from five annual cycles of the population-representative cross-sectional Canadian Community Health Survey (CCHS): 2017, 2018, 2020 (September to December), 2021, and 2022. The Household Food Security Survey Module was used to categorize household food security status during the previous 12 months as food secure or marginally, moderately, or severely insecure.

Results

Before 2019, approximately 1 in 10 households had experienced some level of food insecurity in the previous 12 months (9.6% in 2017 and 11.6% in 2018). Household food insecurity prevalence was slightly lower and stable during the COVID-19 pandemic years (8.5% in fall 2020 and 9.1% in 2021) and increased to 15.6% in 2022. Levels of household food insecurity generally tracked with changes in consumer price inflation. Compared with 2021, there were notable increases in levels of moderate and severe food insecurity in 2022 among one-parent households with children, renters, and those reliant on government financial assistance. 

Interpretation

The prevalence of household food insecurity in the CCHS was relatively stable from 2017 to 2021, increased in 2022, and generally tracked with changes in price inflation. Monitoring levels of household food insecurity will continue to be important as price inflation eases but the cost of living remains high.

Keywords

Canada; Canadian Community Health Survey; food insecurity; food security; inequalities

Author

Jane Y. Polsky is with the Health Analysis Division at Statistics Canada.

 

What is already known on this subject?

• Income-related food insecurity is an important determinant of health.
• Food insecurity is a sensitive marker of household financial circumstances. It reflects sensitivity to rising costs of living and the ability to meet basic needs.

What does this study add?

• This study examined trends in food insecurity levels of Canadian households from 2017 to 2022 using data from a health-oriented survey (the Canadian Community Health Survey). It also examined how these trends have tracked with changes in price inflation.
• Before 2019, approximately 1 in 10 households had experienced some level of food insecurity in the previous 12 months (9.6% in 2017 and 11.6% in 2018).
• Prevalence of food insecurity was slightly lower and stable during the early COVID-19 pandemic years (8.5% in fall 2020 and 9.1% in 2021) and increased to 15.6% in 2022.
• Levels of household food insecurity generally tracked with changes in consumer price inflation. 

Introduction

Food insecurity, referring to inadequate or insecure access to food because of financial constraints, is a potent determinant of health and a sensitive marker of pervasive financial hardship.^Note 1, ^Note 2 Households with children, one-parent households, renters, and those reliant on government assistance for income are particularly vulnerable to experiencing food insecurity in Canada.^Note 2, ^Note 3

The cross-sectional, national-level Canadian Community Health Survey (CCHS) has measured levels of household food insecurity in Canada using the 18-item Household Food Security Survey Module (HFSSM) on a rotating schedule since 2005. Following the onset of the COVID-19 pandemic in March 2020, this module has been included annually for all respondents. The most recent available analysis of CCHS data from fall 2020 estimated that 9.6% of Canadians aged 12 years and older reported some level of food insecurity in their household in the previous 12 months.^Note 4 This figure was lower than before the pandemic and either unchanged or lower among sociodemographic groups vulnerable to food insecurity.^Note s4 Various pandemic-related government support measures, along with low price inflation and reduced spending levels during this period, likely offset a potential surge in low income and food insecurity because of the pandemic.^Note 4, ^Note 5, ^Note 6, ^Note 7

The year 2021 was marked by the phasing out of most pandemic-related benefits and government transfers, as well as rising broad-based price inflation in the latter half of the year.^Note 8, ^Note 9 This was followed by a further increase in the cost of living, particularly food prices, in 2022.^Note 10, ^Note 11 Whether these changing economic conditions are reflected in levels of income-related food insecurity, as measured by the CCHS, has not been previously explored. The purpose of this study is to provide an update on food insecurity levels of Canadian households using the most recent available population-representative data from a health-oriented survey, up until December 2022. This study also examines trends in household food insecurity since 2017 and how these have tracked with changes in price inflation.

Methods

Data sources

This study used data from five cycles of the Canadian Community Health Survey (CCHS): 2017, 2018, 2020 (September to December), 2021, and 2022. Data on food insecurity were not collected for the full sample in 2019 or in the period preceding the COVID-19 pandemic from January to mid-March 2020. These periods are therefore excluded from the present analysis. Because annual data files exclude data from the territories, this analysis presents data only for the 10 Canadian provinces.

The cross-sectional CCHS collects information about the health status and health determinants for the Canadian population aged 12 years and older. Excluded from the survey’s coverage are people living on reserves and other Indigenous settlements in the provinces, full-time members of the Canadian Armed Forces, youth aged 12 to 17 living in foster homes, the institutionalized population, and residents of certain remote regions. Together, these exclusions represent less than 3% of the Canadian population aged 12 years and older. The overall survey response rates were 62.8% for the 2017 cycle, 58.8% for 2018, 24.6% for 2020 (September to December), 24.1% for 2021, and 42.7% for 2022.^Note 12, ^Note 13, ^Note 14, ^Note 15, ^Note 16

This analysis also presents data by sub-annual CCHS collection period. Collection periods are approximately three months long and are each representative of the Canadian population.

Measures and definitions

Household food security status was assessed using the Household Food Security Survey Module (HFSSM), a standardized and validated 18-item scale of food insecurity severity. When the selected respondent was 12 to 17 years of age, a more knowledgeable person in the household completed questions about household food security status. Questions captured experiences of food insecurity related to insufficient money for food in the previous 12 months for adults and any children in the household. Answers were coded using a previously published methodology^Note 17 to classify households as food secure (no indication of difficulty with income-related food access), marginally food insecure (exactly one indication of difficulty with income-related food access, such as worry about running out of food), moderately food insecure (indication of compromise in quality and/or quantity of food consumed), or severely food insecure (indication of reduced food intake and disrupted eating patterns).

Household food security status was tabulated by sociodemographic characteristics for the most recent survey cycles of 2021 and 2022 (data for earlier survey cycles have been previously presented).^Note 4 Because the HFSSM assesses the food security status of the entire household, the focus was on household-level sociodemographic characteristics. These included household composition (with children defined as those younger than 18 years), highest level of education achieved in the household, main source of household income, household income adequacy (quintiles of the ratio of adjusted household income to the low-income cut-off), and whether the dwelling was owned or rented.

The Consumer Price Index (CPI) represents temporal changes in prices for a fixed basket of goods and services and is the most widely used measure of price inflation in Canada.^Note 18 Trends in the CPI from 2017 to 2022 (12-month percentage change) were sourced from the Consumer Price Index Data Visualization Tool.^Note 19 To align with the CCHS data collection periods of approximately three months, the CPI 12-month percentage change was averaged across comparable periods.

Analytic techniques

Weighted frequencies were generated to estimate the percentage of households reporting food security or insecurity by survey cycle and sub-annual collection period. Cross-tabulations were used to examine food security status in the two most recent cycles by sociodemographic characteristics. The present analyses applied household-level weights to reflect the number of Canadian households with experience of food security or insecurity. All analyses applied household survey weights to account for the complex sampling design and the probability of non-response, and to maintain population representativeness. Bootstrap weights provided with each survey cycle were used to calculate robust standard errors, which were used to calculate 95% confidence intervals around prevalence estimates. All analyses were conducted in SAS 9.4 and SAS-callable SUDAAN 11.0.

Results

Chart 1 presents available data on the prevalence of household food insecurity in the 10 provinces from 2017 to 2022. Before 2019, approximately 1 in 10 households had experienced some level of food insecurity in the previous 12 months (9.6% in 2017 and 11.6% in 2018). This figure decreased to about one in nine households during the early pandemic period of fall 2020 (September to December) and in 2021, followed by an increase to 15.6% in 2022. In the same year, over 11% of Canadian households experienced moderate or severe levels of food insecurity.

Description of Chart 1



Data table for Chart 1
Table summary
This table displays the results of Data table for Chart 1 Food insecure (total), Marginal, Moderate and Severe, calculated using percent of households units of measure (appearing as column headers).

	Food insecure (total)	Marginal	Moderate	Severe
	percent of households
2017	9.6	1.7	4.5	3.4
2018	11.6	3.5	5.4	2.7
2019	Note ...: not applicable	Note ...: not applicable	Note ...: not applicable	Note ...: not applicable
Fall 2020	8.5	2.9	3.9	1.8
2021	9.1	3.3	4.2	1.5
2022	15.6	4.1	7.3	4.2
... not applicable Note: Food insecurity data were not collected for a nationally representative sample in 2019 and January to August 2021. Source: Canadian Community Health Survey, 2017, 2018, 2020 (September to December), 2021, and 2022.

Prevalence of food insecurity by sub-annual CCHS collection period, alongside the 12-month percentage change in the CPI, is shown in Chart 2. In general, household food insecurity tracked alongside changes in both the all-items index and the index for food purchased from stores. For example, following relatively stable levels in 2020 and in the first half of 2021, levels of food insecurity began to climb concurrently with approximately a 5% year-over-year increase in the all-items CPI in fall 2021. Rising price inflation in 2022 (ranging from 6% to 7% for the all-items index and from 8% to 11% for food purchased from stores) coincided with notably elevated levels of household food insecurity throughout 2022, particularly for the moderate and severe categories.

Description of Chart 2



Data table for Chart 2
Table summary
This table displays the results of Data table for Chart 2 Food insecure, marginal, Food insecure, moderate, Food insecure, severe, CPI: All-items index and CPI: Index for food purchased from stores, calculated using percentage of households and 12-month % change units of measure (appearing as column headers).

	Food insecure, marginal	Food insecure, moderate	Food insecure, severe	CPI: All-items index	CPI: Index for food purchased from stores
	percentage of households			12-month % change
2017
January to March	1.8	4.4	3.9	1.9	-3.9
April to June	1.5	4.3	3.1	1.3	-1.4
July to September	1.6	4.3	3.3	1.4	0.4
October to December	1.9	4.8	3.3	1.8	1.0
2018
January to March	3.6	5.9	2.6	2.1	1.2
April to June	4.1	5.8	3.1	2.3	2.3
July to September	3.2	5.3	2.5	2.7	0.3
October to December	3.0	4.8	2.7	2.0	1.7
2019
January to December	Note ...: not applicable	Note ...: not applicable	Note ...: not applicable	1.9	3.7
2020
January to August	Note ...: not applicable	Note ...: not applicable	Note ...: not applicable	0.7	2.9
September	3.5	3.8	1.8	0.5	1.3
October	2.9	4.4	1.7	0.7	2.3
November to December	2.6	3.6	1.7	0.9	1.1
2021
January to February	3.2	4.3	1.2	1.1	0.7
March to April	3.3	4.5	1.5	2.8	0.7
June to August	3.1	3.6	1.5	3.6	1.4
September to mid-November	3.2	4.3	1.7	4.6	4.1
Mid-November 2021 to February 7, 2022	4.0	4.9	1.8	4.9	5.6
2022
February to March	4.1	7.2	3.8	6.2	8.1
April to June	4.3	7.3	4.1	7.5	9.6
July to September	3.8	6.8	4.7	7.2	10.7
October to December	4.2	7.9	4.2	6.7	11.1
... not applicable Notes: CPI = Consumer Price Index. Food insecurity data were not collected for a nationally representative sample of the Canadian Community Health Survey (CCHS) in 2019 and January to August 2021. The monthly CPI (12-month percentage change) was averaged to align with CCHS collection periods. Sources: Canadian Community Health Survey, 2018, 2020 (September to December), 2021, and 2022; and Consumer Price Index Data Visualization Tool.

The rise in overall prevalence of household food insecurity from 2021 to 2022 was mainly driven by increases in moderate (4.2% in 2021 versus 7.3% in 2022) and severe (1.5% versus 4.2%) food insecurity categories (Table 1). In both years, food insecurity was highest among households with children, those with less than a high school education, those reliant on government assistance as their main source of income, those in the lowest household income quintile, and renters. Levels of moderate and severe food insecurity increased in nearly all sociodemographic subgroups, particularly one-parent households with children younger than 18 years (15.9% moderately or severely food insecure in 2021 versus 27.8% in 2022). The prevalence of severe food insecurity was notably higher in 2022 among households reliant on employment insurance or workers’ compensation as their main source of income (4.6% in 2021 versus 12.8% in 2022), those receiving social assistance as their main source of income (17.3% in 2021 versus 23.9% in 2022), those with other or no income (3.4% in 2021 versus 8.8% in 2022), and those in the lowest quintile of household income adequacy (3.9% in 2021 versus 8.9% in 2022).



Discussion

This study draws on data from the health-oriented national-level CCHS to examine trends in the prevalence of income-related food insecurity of households in the 10 Canadian provinces from 2017 through 2022. Similar to findings from other large population-representative samples from Canada and the United States,^Note 20, ^Note 21, ^Note 22, ^Note 23 the current study documented a levelling off in the prevalence of household food insecurity after the onset of the COVID-19 pandemic in 2020 and 2021, followed by an increase in 2022. Various pandemic-related support measures, along with low price inflation, likely staved off a surge in low income and food insecurity because of pandemic-related disruptions to employment incomes in 2020 and 2021.^Note 4, ^Note 5, ^Note 6, ^Note 7 Examining data by survey collection cycle and the CPI, this study also found that levels of food insecurity generally tracked with changes in consumer price inflation, particularly in 2022, when inflation reached peak levels.^Note 11 This is consistent with evidence that food insecurity is a marker of household financial circumstances, reflecting sensitivity to rising costs of not only food but also other basic needs such as shelter and transportation.^Note 2, ^Note 24

In 2019, Statistics Canada began measuring household food insecurity annually as part of the national-level cross-sectional Canadian Income Survey (CIS).^Note 25 Although both the CCHS and the CIS employ the same HFSSM questions and the same 12-month lookback period, the CIS has yielded substantively higher estimates of food insecurity than the CCHS.^Note 25 Differing prevalence estimates from different population surveys are not uncommon and are likely driven by a combination of methodological differences between surveys and the framing effect (i.e., respondents may respond differently to the same questions about income-related food insecurity when these are framed in the context of an income-oriented survey versus a health-oriented survey).^Note 25, ^Note 26 However, the impact of any factor potentially driving the discrepancy in estimates is difficult to identify and quantify. Despite the differing food insecurity estimates from the CCHS and CIS, it is noteworthy that trends over time appear consistent in the two surveys. For example, the CIS similarly documented relatively stable levels of household food insecurity during the pandemic years of 2020 and 2021, followed by an increase in 2022.^Note 2  

The CIS collects data on food security status from January to June of each year; in contrast, the CCHS is administered from January through December, thereby providing more current estimates for a given calendar year. The current study found that in 2022, 15.6% of Canadian households reported marginal, moderate, or severe food insecurity, a figure substantially higher than in previous survey cycles and more in line with the roughly contemporaneous CIS estimate (17.8% of households, based on data collected from January to June 2022).^Note 2 Recently released CIS data collected in the first half of 2023 have charted a further increase in levels of moderate and severe food insecurity in Canada, representing the second consecutive increase since the onset of the pandemic.^Note 27 How these trends align with those from more recent cycles of the CCHS should be examined following the release of these data. 

It is important to note that the 2022 CCHS underwent a methodological redesign that centred on a collection mode change from computer-assisted telephone or personal interviews to electronic questionnaires self-completed by respondents.^Note 16 This redesign may have contributed to differences between the 2022 estimates and previous CCHS cycles, although the impact of this change is challenging to quantify. Moreover, Canadian consumers experienced peak price increases in 2022, particularly for food, shelter, and transportation,^Note 11 and many reported being worried about and having difficulties with meeting day-to-day expenses.^Note 28 It is possible that the top-of-mind awareness of the rising cost of living in 2022 for many Canadians may have served to dampen some framing effect differences between the health-oriented CCHS and the income-oriented CIS, thereby contributing to more comparable levels of food insecurity in the two surveys.

In addition to higher overall prevalence of household food insecurity in 2022, this study also noted higher severity of food insecurity, with notably more Canadian households reporting moderate or severe experiences of food insecurity in the previous 12 months. Most affected were subgroups of households known to be at heightened risk of financial hardship, particularly one-parent households with children, those reliant on government assistance in the prior year, and renters. These findings are consistent with evidence of decreased disposable income amid the rising cost of living in 2022, particularly for lower-income households,^Note 29 and an increased poverty rate in 2022 compared with 2021.^Note 27

Strengths and limitations

Among this study’s strengths is the use of five annual cycles of large population samples representative of the 10 Canadian provinces, and of multiple sub-annual collection periods, which facilitates examination of within-year variations in food insecurity and price inflation. Other strengths include the use of a validated 18-item scale to assess multiple categories of household food insecurity, and the examination of a range of household-level sociodemographic characteristics.

Several limitations deserve mention. Although the CCHS is a well-established national-level survey, the pandemic had major impacts on data collection operations for the 2020 and 2021 cycles, including a switch to telephone-only interviews and substantially lower response rates. Although low response rates were mitigated with weighting procedures, they nevertheless raise concerns of bias and warrant caution when interpreting results. Important analytical and data quality implications of CCHS cycles collected during the pandemic have been previously described.^Note 14, ^Note 15 As noted above, the 2022 CCHS underwent a major redesign, which means that caution should be used when comparing 2022 data with previous cycles.^Note 16 Furthermore, household food insecurity is a subjective self-reported measure that, like other subjective measures, can be influenced by the mode of data collection and the framing effect.^Note 26, ^Note 30 Lastly, because data from the territories were unavailable in the annual CCHS data files, estimates are representative of the 10 provinces only.

Conclusions

Consistent with findings from other population-representative surveys, data from the health-oriented CCHS identified relatively stable levels of household food insecurity during the pandemic years of 2020 and 2021, followed by an increase in 2022. Levels of food insecurity, particularly the moderate and severe categories, generally tracked with changes in consumer price inflation and rose in 2022 among vulnerable subgroups, including one-parent households with children, those reliant on government financial assistance, and renters. Looking ahead, although headline price inflation has slowed following its peak in 2022, prices remain elevated for many basic goods and services, including food, rent, and mortgage interest.^Note 11 An increase in the number of Canadians living in moderately or severely food insecure households was recently charted by CIS data collected in the first half of 2023.^Note 27 Continued monitoring of income-related food insecurity in the Canadian population will be essential to gauge the scope of this public health challenge and to inform appropriate program and policy responses.