Health Reports
Changes in households’ vulnerability to food insecurity in Canada before and after the COVID-19 pandemic

Abstract

Background

The prevalence of household food insecurity in the 10 provinces rose from 16.8% in 2019 to 18.4% in 2022 and 22.9% in 2023. This study examines whether and how the sociodemographic and economic patterning of households’ vulnerability to food insecurity changed across these years.

Data and methods

Using data from the master files for households in the 10 provinces from the 2018, 2021, and 2022 cycles of the Canadian Income Survey, year-specific logistic regression models were conducted to estimate the predicted probability of household food insecurity by sociodemographic and economic characteristics. The predicted probability of food insecurity was also charted in relation to household income from the prior tax year, expressed in 2022 constant dollars and adjusted for household size, for each survey year.

Results

The probability of food insecurity increased significantly for most households, irrespective of the sociodemographic or economic characteristics considered. In 2019 and 2022, households receiving 50% or more of their income from employment or self-employment had a lower probability of food insecurity than those with a smaller proportion of their income from employment, but there was no difference between these groups in 2023. The probability of food insecurity was significantly higher in 2022 than 2019 at all household income levels above $20,000 and higher along the entire household income continuum in 2023 than 2022.

Interpretation

The probability of food insecurity is highest for low-income households, but food insecurity is becoming more prevalent among moderate- and higher-income households, and reliance on employment income is no longer protective against food insecurity.

Keywords

food insecurity, Canadian Income Survey

Authors

Andrée-Anne Fafard St-Germain, Timmie Li and Valerie Tarasuk are with the Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario.

 

What is already known on this subject?

• Household food insecurity is an indicator of material hardship and a potent social determinant of health.
• Household food insecurity is tightly linked to having low income, having less than a postsecondary education, renting instead of owning a home, being Black or Indigenous, being in a one-parent household, and relying on social assistance or Employment Insurance.
• Household food insecurity was more prevalent in 2023 than before the pandemic.

What does this study add?

• This study found that all sociodemographic and economic groups, including with different income levels, were more likely to experience food insecurity after the pandemic, compared with before.
• In 2023, households receiving 50% or more of their income from employment or self-employment were no longer less likely to be food-insecure than those receiving less of their income from employment sources, suggesting an increased vulnerability among households in the workforce. Future research should investigate how changing labour circumstances have affected the risk of food insecurity and how these changes intersect with other household characteristics.

Introduction

Household food insecurity, the inadequate or insecure access to food caused by financial constraints, is a serious population health problem in Canada, strongly associated with numerous adverse health outcomes among children and adults, including increased risk of type 2 diabetes,^Note 1 poorer mental health,^Note 2, ^Note 3, ^Note 4, ^Note 5, ^Note 6 higher rates of infectious^Note 7 and non-communicable diseases,^Note 8 more health care use,^Note 9, ^Note 10, ^Note 11, ^Note 12 and premature mortality.^Note 13 These relationships are graded, with more severe food insecurity associated with more negative health outcomes^Note 3, ^Note 6, ^Note 13 and health care use,^Note 9, ^Note 10, ^Note 11, ^Note 12 even after controlling for income and other demographic characteristics.

Household food insecurity has been measured on the Canadian Community Health Survey (CCHS) since 2004 and was added to the Canadian Income Survey (CIS) in 2018 to facilitate tracking on Canada’s Official Poverty Dashboard of Indicators.^Note 14 CIS data indicate a marked increase in prevalence in the 10 provinces over the last two years relative to the prevalence before the 2020 onset of the COVID-19 pandemic, with the observed increase present across all levels of severity (Chart 1).^Note 15 A similar trend has been observed in the CCHS over this period.^Note 16  

 

Description of Chart 1

  

Data Table
Table summary
This table displays the results of Data Table 2019 (2018 CIS), 2020 (2019 CIS), 2021 (2020 CIS), 2022 (2021 CIS) and 2023 (2022 CIS), calculated using percent of people living in food-insecure households units of measure (appearing as column headers).

	2019 (2018 CIS)	2020 (2019 CIS)	2021 (2020 CIS)	2022 (2021 CIS)	2023 (2022 CIS)
	percent of people living in food-insecure households
Marginal food insecurity	5.2	5.1	4.6	5.6	6.0
Moderate food insecurity	8.0	7.6	7.6	8.9	10.9
Severe food insecurity	3.6	3.2	3.6	4.0	6.0
Any food insecurity	16.8	15.9	15.7	18.4	22.9
Notes: CIS stands for Canadian Income Survey. Data on food insecurity from CIS are collected during interviews in the year following the survey reference year, assessing experiences over the prior 12 months. The data is labelled based on the year of data collection with the survey reference year in brackets to better reflect the measurement of household food insecurity. Sources: Canadian Income Survey (CIS) 2018-2022. Statistics Canada Table 13-10-0834-01 Food insecurity by economic family type.

Household food insecurity is an indicator of material hardship.^Note 17 The probability and severity of food insecurity rise as household income declines,^Note 16, ^Note 18, ^Note 19, ^Note 20 but households’ food insecurity status is also related to their costs of living^Note 21, ^Note 22, ^Note 23, ^Note 24, ^Note 25 and housing circumstances, including homeownership,^Note 21 and for those that own their home, whether or not they have a mortgage.^Note 19, ^Note 21 Other characteristics associated with heightened vulnerability include relying on social assistance, being Indigenous, being Black, having lower education, and being in a one-parent female-led family.^Note 16, ^Note 18, ^Note 19, ^Note 20, ^Note 26, ^Note 27

The recent rise in food insecurity prevalence has paralleled a marked increase in the cost of food and other goods and services,^Note 16 but this inflation and subsequent tightening of monetary policy and growth in interest rates have not affected all Canadian households equally. The increase in average household disposable income from 2019 to 2023 was outpaced by inflation for households in the bottom two income quintiles, resulting in reduced purchasing power.^Note 28 These households also faced higher rates of food inflation after taking into account their allocation of a greater budget share to food and the fact that they were already purchasing lower-cost items and therefore less able to find cheaper substitutes.^Note 29 On average, they also spent more than they were saving, with this gap growing since the onset of the COVID-19 pandemic.^Note 30 Conversely, households in higher income quintiles saw larger growth in their savings, net worth, and purchasing power, profiting from the rise in interest rates as increases in investment incomes surpassed interest payments.^Note 28, ^Note 30 In addition, from 2019 to 2023, the median net worth of homeowners rose substantially as housing assets appreciated, whereas renters experienced minimal gains.^Note 31 The monthly payments of mortgage holders with a variable rate grew sharply when interest rates rose, and lower-income mortgage holders saw the increase in mortgage debt offset real estate gains.^Note 31

Insofar as household food security is a function of households’ incomes, assets, and debt, which together shape their ability to buffer negative income shocks,^Note 32, ^Note 33 the recent rise in food insecurity may reflect the escalating vulnerability of particular subsets of the Canadian population. Understanding whether and how the “face” of food insecurity is changing is important to inform interventions. Drawing on data from the 2018, 2021, and 2022 cycles of the CIS , this study was undertaken to examine changes in the sociodemographic and economic patterning of vulnerability to household food insecurity among Canadian households in the 10 provinces before and after the onset of the pandemic. The 2019 and 2020 cycles of the CIS are not included because the pandemic-related interruption to data collection in 2020, followed by severe labour disruptions and pandemic relief programs in late 2020 through 2021, potentially affected the correlates of household food insecurity and comparability of data in these survey years.

Methods

Data sources and sample

This study used the master files from the 2018, 2021, and 2022 cycles of the CIS . The CIS is a cross-sectional population-based survey that is administered to a subset of respondents to the Labour Force Survey (LFS). It combines detailed income data derived from income tax files with interview information on individual and household sociodemographic characteristics and household food insecurity collected from the LFS respondent, a household member with knowledge of the labour force activities of the other members.^Note 34 The CIS had a response rate of 77.4% in 2018, 70.8% in 2021, and 70.1% in 2022.^Note 34 The cycle of the CIS refers to the reference year for which the income data were collected, but the survey interview, during which household food insecurity and many sociographic characteristics are measured, occurred between January and July of the following calendar year, and households’ experiences of food insecurity were assessed over the prior 12 months. In this study, the year during which the food insecurity measurement occurred rather than the cycle’s reference year is used to refer to the period being analyzed (i.e., 2019 for the 2018 CIS , 2022 for the 2021 CIS , and 2023 for the 2022 CIS ). 

The CIS is representative of approximately 98% of Canadians.^Note 34 Exclusions from the survey coverage include individuals living in institutions, in remote areas, or on reserves or other Indigenous settlements in the provinces. The current study focuses on the 10 provinces because the CIS microdata for the territories were not available to researchers at the time of conducting the analyses.

The study sample includes all surveyed households in the three CIS cycles, except those with incomplete food insecurity measurement (n = 5,140), with two or more economic families (n = 3,880), and with household size-adjusted household income of $0 or less (n = 150). Households with two or more economic families were excluded because it is unclear whether the food insecurity measurement applies to all economic families in the household or only to the economic family of the person responding to the CIS interview. Households with household size-adjusted household income of $0 or less were excluded because they tend to have a low food insecurity prevalence, suggesting their income is a poor indicator of the economic resources available to them for consumption.^Note 35 The final study sample sizes were 37,770 households in 2019, 36,400 households in 2022, and 38,680 households in 2023.

Measures and definitions

Household food insecurity was measured using the 18-item Household Food Security Survey Module, a validated scale used for national monitoring in Canada and the United States.^Note 36 The full module can be accessed at Canadian Income Survey - 2018, Food security (FSC). The questions capture experiences that range from worrying about running out of food to compromising the quality of the food purchased to compromising the quantity of the food consumed over the past 12 months because of a lack of money. Following Canada’s classification scheme, households were classified as food secure or marginally, moderately, or severely food insecure based on the number of affirmative responses to the questions.^Note 37 The outcome of overall food insecurity was defined by combining marginal, moderate, and severe food insecurity. Because more severe levels of food insecurity are associated with greater risk of adverse outcomes,^Note 3,^Note 9, ^Note 10, ^Note 11, ^Note 12, ^Note 13 the outcome of moderate or severe food insecurity was also examined.

Household-level sociodemographic and economic characteristics were selected based on the data available in all three CIS cycles and prior research showing a relationship with household food insecurity.^Note 18, ^Note 19, ^Note 20, ^Note 21, ^Note 38 These included household type; the Indigenous and immigrant status of the main earner in the household; the highest education level achieved in the household; housing tenure; whether employment and self-employment incomes represented 50% or more of total household income during the reference year; four binary indicators measuring whether households received any social assistance, seniors’ public pension, private pension, and investment incomes during the reference year; whether any household member experienced unemployment during the reference year; province of residence; and household income for the reference year adjusted for household size by dividing by the square root of household size^Note 39 and converted to 2022 constant dollars using the provincial annual all-items Consumer Price Index (2022 represents the most recent year for which the annual income data are available among the three CIS cycles included in the study).^Note 40

Household income was defined as the sum of income from all sources (including transfer payments), capital gains, and Registered Retirement Savings Plan (RRSP) withdrawals before age 65 minus income taxes paid and mandatory contributions or payments (contributions to the Canada Pension Plan or Québec Pension Plan, Employment Insurance, or an employer-sponsored retirement pension; union dues and professional membership fees; alimony support payments; and, in the 2022 CIS , pandemic benefit repayments) to capture households’ available economic resources for consumption.^Note 41 All households with household size-adjusted household income over $125,000 in 2022 constant dollars were recoded as having an income of $125,000 because the very low number of food-insecure households at this income range caused model convergence issues. For a household of four, this would equate to $250,000 in household income. The top-coding permitted the inclusion of high-income households in the analyses while having minimal impact on the shape of the relationship between household income and food insecurity. A binary indicator identifying households with income imputation by Statistics Canada was included as a control variable.

Statistical analysis

To examine changes in the patterning of households’ vulnerability to food insecurity over the three years, year-specific multivariable logistic regression models were conducted to estimate adjusted odds ratios (AORs) of household food insecurity and the average adjusted predicted probability of household food insecurity by sociodemographic and economic characteristics and by household size-adjusted household income.^Note 42, ^Note 43 The presence of a curvilinear relationship between household size-adjusted household income and household food insecurity was tested by including a quadratic and cubic term; these terms were statistically significant (p < 0.05) and kept in the model for all three years. Within each sociodemographic and economic group, adjusted Wald tests were used to test for the difference in the average adjusted predicted probability of household food insecurity between 2019 and 2022 and between 2022 and 2023.^Note 42 For household size-adjusted household income, average adjusted predicted probabilities were estimated at set values from $10,000 to $120,000 with increments of $10,000 to depict the curvilinear relationships, and differences between years were tested at each set value using adjusted Wald tests.

To explore potential changes in the distribution of food-insecure households along the income continuum over time, a cumulative percentage curve was created for each year among the food-insecure households by estimating the percentage of food-insecure households within each $5,000 income bin from $0 to $125,000 and then cumulatively adding these percentages. Cumulative percentage curves were also created for food-secure households as a comparison.

To explore whether the results were driven by changes related to marginal versus more severe food insecurity, all analyses were repeated with moderate or severe food insecurity as the outcome. These results are presented in the supplementary material.

All analyses applied household survey weights to account for the complex sampling design and probability of non-response while maintaining population representativeness. The 95% confidence intervals (CIs) of the AORs were calculated using standard errors estimated using the 1,000 bootstrap weights provided with each survey cycle. The 95% CI s of the average adjusted predicted probabilities were calculated using unconditional standard errors.^Note 44 The analyses were conducted in Stata 15 (StataCorp LLC, College Station, Texas).

Results

The AORs estimated within each year suggest that the pattern of associations between the household-level characteristics and household food insecurity remained similar across all three years, with three exceptions (Table 1). Couples with children had higher adjusted odds of food insecurity than couples without children in 2019 (AOR 1.18 [1.02, 1.35]) and 2022 (AOR 1.24 [1.08, 1.43]) but not in 2023 (AOR 1.10 [0.98, 1.23]). Compared with households whose main earner was a non-immigrant born in Canada, those whose main earner was a non-recent immigrant had higher adjusted odds of food insecurity in 2022 (AOR 1.44 [1.27, 1.63]) and 2023 (AOR 1.20 [1.07, 1.34]) but not in 2019 (AOR 1.06 [0.92, 1.21]). Receiving less than 50% of household income from employment or self-employment was associated with higher odds of food insecurity in 2019 (AOR 1.42 [1.22, 1.66]) and 2022 (AOR 1.22 [1.07, 1.41]) but not in 2023 (AOR 0.95 [0.83, 1.10]).



The predicted probability of food insecurity tended to rise for all sociodemographic and economic groups from 2019 to 2022 and from 2022 to 2023, and most of the increases were statistically significant (Figure 1).

 

Description of Figure 1

  

Data Table for figure 1

Table summary
This table displays the results of Year, 2019, 2022 and 2023, calculated using percent units of measure (appearing as column headers).

	Year
	2019	2022	2023
	percent
Household type
Unattached, living alone	15.3	18.8	22.0Note ***
Couple without childrenData Table for figure 1 Note §	13.3	15.3	20.3Note **
Couple with childrenData Table for figure 1 Note §	15.0	17.9	21.6Note ***
Female one-parent householdData Table for figure 1 Note §	20.4	22.3	27.9
Male one-parent householdData Table for figure 1 Note §	15.2	16.7	22.4
OtherData Table for figure 1 Note ††	16.5	18.6	24.4
Indigenous and immigrant status of the main earner
Born in Canada, non-Indigenous	15.3	16.5	21.2Note **
Indigenous	17.6	24.0	27.7Note ***
Non-recent immigrant (10 years or more)	15.9	21.1	23.8Note ***
Recent immigrant (less than 10 years)	13.1	19.0	21.1Note ***
Other, not born in CanadaData Table for figure 1 Note ‡‡	8.9	14.5	20.9Note *
Highest education level in household
Less than high school	14.8	18.6	20.2Note **
High school	15.5	18.5	23.8Note **
Some postsecondary education (no certificate)	15.4	19.1	24.6Note *
Postsecondary education below bachelor level	17.2	19.6	24.9Note ***
Bachelor’s degree or more	12.5	15.1	18.2Note ***
Housing tenure
Mortgage-free owner	8.9	12.1	14.2Note ***
Owner with mortgage	15.5	18.8	22.8Note ***
Market renter	17.8	19.7	25.6Note **
Government-subsidized renter	20.0	21.7	27.9
Other subsidized renter	14.4	19.0	21.5
At least 50% of total household income from employment and self-employmentData Table for figure 1 Note §§
No	17.53	19.34	21.38
Yes	13.75	16.85	22.08Note ***
Received any social assistance
No	13.94	16.19	20.61Note ***
Yes	23.00	30.24	32.69Note ***
Received any seniors’ public pension
No	16.94	19.06	23.58Note ***
Yes	9.93	13.92	16.70Note ***
Received any private pension
No	15.80	18.65	22.83Note ***
Yes	11.31	13.65	17.41Note *
Received any investment income
No	16.34	19.42	23.35Note ***
Yes	12.82	15.09	19.61Note ***
One week of unemployment or more in the household
No	13.76	15.98	20.48Note ***
Yes	19.16	23.50	26.41Note ***
Province
Newfoundland and Labrador	16.75	21.74	23.58Note **
Prince Edward Island	14.47	21.55	24.55Note ***
Nova Scotia	18.58	21.40	25.62Note *
New Brunswick	16.39	21.64	24.02Note ***
Quebec	11.86	13.41	15.43Note *
Ontario	15.22	18.60	24.13Note ***
Manitoba	16.27	17.96	23.36
Saskatchewan	15.98	19.66	24.98Note **
Alberta	19.70	22.61	27.73Note *
British Columbia	15.89	17.40	21.16
Note * Significantly different from reference category (p <0.05) Return to note * referrer Note ** Significantly different from reference category (p <0.01) Return to note ** referrer Note *** Significantly different from reference category (p <0.001) Return to note *** referrer Note § Household may contain other relatives by blood or marriage. Return to note § referrer Note †† Includes households where the main income earner is not part of a couple or one-parent family, but is living with other people related by blood, marriage, or adoption, such as adult siblings living together, adult cousins living together, an aunt or uncle living with a niece or nephew, or an unattached individual main income earner living with other relatives (e.g., caring for and living with parents). Return to note †† referrer Note ‡‡ Includes those not born in Canada and not considered immigrants (e.g., individuals who have a work, study, or temporary resident permit; who have claimed refugee status; who are family members of immigrants but are not landed immigrants themselves; or who are Canadian citizens by descent but were born elsewhere). Return to note ‡‡ referrer Note §§ Includes wages, salaries, commissions, bonuses, tips, gratuities, honoraria, and self-employment. Return to note §§ referrer Notes: Estimates are based on models that included all the listed characteristics, household size-adjusted household income in 2022 constant dollars, and a control variable for income imputation. Data on food insecurity from the Canadian Income Survey are collected during interviews in the year following the survey reference year, assessing experiences over the prior 12 months. The data are labelled based on the year of data collection to better reflect the measurement of household food insecurity. Source: Statistics Canada, Canadian Income Survey (CIS) 2018, 2021, 2022; and authors' calculations.

The overall pattern of vulnerability to food insecurity remained relatively consistent over time, with, for example, the predicted probability of food insecurity highest for one-parent female-led households, market renters, Indigenous households, and households receiving social assistance. However, there was one noteworthy exception: in 2019 and 2022, households receiving 50% or more of their income from employment or self-employment had a lower predicted probability of food insecurity compared with households receiving a lower proportion of their income from this source, but this pattern was not present in 2023.

The predicted probability of food insecurity was significantly higher in 2022 than 2019 along the full household income continuum (p values from adjusted Wald test < 0.05), except at income levels of $10,000 and $20,000 (Figure 2). When comparing 2023 with 2022, the predicted probability of food insecurity was statistically significantly higher along the entire household income continuum.

 

Description of Figure 2

  

The title of Figure 2 is “Average adjusted predicted probability of household food insecurity by household income, 2019, 2022, and 2023.”

The figure illustrates the average adjusted predicted probability of household food insecurity by household income for each year, 2019, 2022, and 2023 with 95% CIs.

The x axis reads household income adjusted for household size in 2022 constant dollars.

The y axis reads average adjusted predicted probability of household food insecurity.

The figure shows three roughly reverse sigmoid curve-shaped lines corresponding to the adjusted predicted probabilities of household food insecurity across household income adjusted for household size, ranging from $10,000 to $120,000 on the horizontal axis, with shaded bands representing the 95% CIs. The negative slope begins more gently on the left-hand side before becoming steeper between $30,000 and $80,000 on the horizontal axis, after which it becomes less steep.

The solid green line and shaded area correspond to the adjusted predicted probability of household food insecurity in 2019, starting at a point corresponding to $10,000 income on the horizontal axis and 25.2% on the vertical axis. The shaded area representing the 95% confidence interval is widest on the left-hand side between $10,000 and $30,000 on the horizontal axis before narrowing. The band becomes slightly wider between $110,000 and $120,000. By $90,000 on the horizontal axis, the point reaches 5.2% on the vertical axis and decreases slightly to reach 4% at $120,000.

The dashed orange line and shaded area correspond to the adjusted predicted probability of household food insecurity in 2022, starting at a point corresponding to $10,000 income on the horizontal axis and 26.2% on the vertical axis and ending at a point corresponding to $120,000 income on the horizontal axis and 6.6% on the vertical axis. The shaded area representing the 95% confidence interval is widest on the left-hand side between $10,000 and $30,000 on the horizontal axis before narrowing. The band widens after $70,000. The orange line for 2022 remains above the green line for 2019 for all income levels, but is closer to it between $10,000 and $30,000, where the shade bands have some overlap.

The dotted blue line and shaded area correspond to the adjusted predicted probability of household food insecurity in 2023, starting at a point corresponding to $10,000 income on the horizontal axis and 33.0% on the vertical axis and ending at a point corresponding to $120,000 on the horizontal axis and 8.8% on the vertical axis. The shaded area representing the 95% confidence interval is widest on the left-hand side between $10,000 and $30,000 on the horizontal axis before narrowing. The band widens after $70,000. The blue line remains above both the orange and green lines for all income levels. The blue shaded area overlaps slightly with the orange shaded area between $110,000 and $120,000.

The cumulative percentage curves illustrate the distinctly lower distribution of income among food-insecure versus food-secure households, but these curves also suggest that food insecurity affected more households with higher incomes in 2022 and 2023 than in 2019 (Figure 3).

 

Description of Figure 3

  

The title of Figure 3 is “Cumulative percentage of food-insecure and food-secure households along the continuum of household income, 2019, 2022, and 2023”.

The figure illustrates the proportion of food-insecure and food-secure households whose household income adjusted for household size falls below the value at each tick mark, illustrating the cumulative distribution of income across the population for each year, 2019, 2022, and 2023.

The x axis reads household income adjusted for household size in 2022 constant dollars.

The y axis reads cumulative percent.

The figure shows six roughly sigmoid curve-shaped lines corresponding to cumulative proportions for food-insecure and food-secure households, and each year. Each line starts at zero income on the horizontal axis and 0% cumulative proportion on the vertical axis and ends at $125,000 on the horizontal axis and 100% cumulative proportion on the vertical axis.

The solid dark green line corresponds to the cumulative percentage of food-insecure households in 2019. In 2019, households with $30,000 or less in household income adjusted for household size accounted for at least 50% of the food-insecure households. Households with $60,000 or less in adjusted household income accounted for at least 90% of the food-insecure households.

The solid light blue line corresponds to the cumulative percentage of food-insecure households in 2022. In 2022, households with $35,000 or less in household income adjusted for household size accounted for at least 50% of the food-insecure households. Households with $70,000 or less in adjusted household income accounted for at least 90% of the food-insecure households.

The dotted red line corresponds to the cumulative percentage of food-insecure households in 2023. It largely overlaps the solid orange light blue line corresponding to the cumulative percentage in 2022, except between $0 and $25,000, where it is slightly above the solid light blue line.

The solid light green, solid dark blue, and dotted orange lines correspond to the cumulative percentage of food secure households in 2019 (solid dark green), 2022 (solid light green), and 2023 (dotted green line). The three lines are close together, but the solid dark green line is slightly higher, followed by the dotted green and solid light green lines. Households with $50,000 or less in household income adjusted for household size accounted for at least 50% of the food-secure households. Households with $100,000 or less in adjusted household income accounted for at least 90% of the food-insecure households.

Similar patterns emerged for the predicted probability and AORs of moderate or severe food insecurity (supplementary figures 1 and 2 and Supplementary Table 1), suggesting that the changes observed for overall food insecurity over the three years were not predominantly driven by changes in marginal food insecurity, with one notable exception. There was no statistically significant difference in the AOR for moderate or severe food insecurity for couples with children versus those without children across all three years (Supplementary Table 1), suggesting that the higher AOR of overall food insecurity observed for couples with children in 2019 and 2022 (Table 1) was a function of them having a higher likelihood of marginal food insecurity than couples without children.

 

Description of Supplementary Figure 1

  

Data for supplementary figure 1
Table summary
This table displays the results of Data for supplementary figure 1 Year, 2019, 2022 and 2023 (appearing as column headers).

	Year
	2019	2022	2023
	percent
Household type
Unattached, living alone	11.3	14.1	17.3Note ***
Couple without childrenData for supplementary figure 1  Note §	9.4	11.0	14.9Note *
Couple with childrenData for supplementary figure 1  Note §	9.4	11.9	15.2Note ***
Female one-parent householdData for supplementary figure 1  Note §	13.6	14.4	19.2
Male one-parent householdData for supplementary figure 1  Note §	8.6	12.5	15.5
OtherData for supplementary figure 1  Note ††	11.8	13.9	18.0
Indigenous and immigrant status of the main earner
Born in Canada, non-Indigenous	11.0	12.3	15.8Note ***
Indigenous	12.7	17.8	21.5Note **
Non-recent immigrant (10 years or more)	10.8	14.5	17.9Note ***
Recent immigrant (less than 10 years)	8.1	12.3	15.3Note **
Other, not born in CanadaData for supplementary figure 1  Note ‡‡	5.9	9.2	13.3
Highest education level in household
Less than high school	10.2	13.2	15.4Note **
High school	10.4	13.4	17.2Note ***
Some postsecondary education (no certificate)	10.9	14.9	17.8Note *
Postsecondary education below bachelor level	12.5	14.0	18.8Note **
Bachelor’s degree or more	8.4	10.8	13.3Note ***
Housing tenure
Mortgage-free owner	6.0	7.9	9.8Note ***
Owner with mortgage	10.6	13.2	16.6Note ***
Market renter	12.4	14.6	19.6Note ***
Government-subsidized renter	15.3	17.1	21.5
Other subsidized renter	9.1	13.5	14.2
At least 50% of total household income from employment and self-employmentData for supplementary figure 1  Note §§
No	11.7	14.1	15.9Note **
Yes	9.9	12.1	16.4Note ***
Received any social assistance
No	9.6	11.4	15.1Note ***
Yes	16.4	22.5	25.5Note ***
Received any seniors’ public pension
No	12.1	14.1	17.6Note ***
Yes	6.4	8.8	12.0Note ***
Received any private pension
No	11.0	13.4	17.2Note ***
Yes	8.0	9.5	11.7
Received any investment income
No	11.6	14.1	17.3Note ***
Yes	8.4	10.5	14.5Note ***
One week of unemployment or more in the household
No	9.5	11.3	15.1Note ***
Yes	13.8	17.4	20.0Note ***
Province
Newfoundland and Labrador	10.9	15.5	17.7Note ***
Prince Edward Island	9.5	14.3	18.1Note **
Nova Scotia	13.3	15.7	19.8Note *
New Brunswick	11.3	16.3	18.6Note ***
Quebec	7.8	8.7	10.8
Ontario	10.7	13.7	18.4Note ***
Manitoba	11.7	12.9	16.8
Saskatchewan	11.5	14.5	19.0Note **
Alberta	15.2	17.5	21.2Note *
British Columbia	11.3	12.5	15.5
Note * Significantly different from reference category (p <0.05) Return to note * referrer Note ** Significantly different from reference category (p <0.01) Return to note ** referrer Note *** Significantly different from reference category (p <0.001) Return to note *** referrer Note § Household may contain other relatives by blood or marriage. Return to note § referrer Note †† Includes households where the main income earner is not part of a couple or one-parent family, but is living with other people related by blood, marriage, or adoption, such as adult siblings living together, adult cousins living together, an aunt or uncle living with a niece or nephew, or an unattached individual main income earner living with other relatives (e.g., caring for and living with parents). Return to note †† referrer Note ‡‡ Includes those not born in Canada and not considered immigrants (e.g., individuals who have a work, study, or temporary resident permit; who have claimed refugee status; who are family members of immigrants but are not landed immigrants themselves; or who are Canadian citizens by descent but were born elsewhere). Return to note ‡‡ referrer Note §§ Includes wages, salaries, commissions, bonuses, tips, gratuities, honoraria, and self-employment. Return to note §§ referrer Notes: Estimates are based on models that included all the listed characteristics, household size-adjusted household income in 2022 constant dollars, and a control variable for income imputation. Data on food insecurity from the Canadian Income Survey are collected during interviews in the year following the survey reference year, assessing experiences over the prior 12 months. The data are labelled based on the year of data collection to better reflect the measurement of household food insecurity. Source: Statistics Canada, Canadian Income Survey, 2018, 2021, and 2022; and authors' calculations.

 

Description of Supplementary Figure 2

  

The title of Supplementary Figure 2 is “Average adjusted predicted probability of moderate or severe household food insecurity by household income, 2019, 2022, and 2023.”

The figure illustrates the average adjusted predicted probability of moderate or severe household food insecurity by household income for each year, 2019, 2022, and 2023 with 95% CIs.

The x axis reads household income adjusted for household size in 2022 constant dollars.

The y axis reads average adjusted predicted probability of moderate or severe household food insecurity.

The figure shows three roughly reverse sigmoid curve-shaped lines corresponding to the adjusted predicted probabilities of moderate or severe household food insecurity across household income adjusted for household size, ranging from $10,000 to $120,000 on the horizontal axis, with shaded bands representing the 95% CIs.

The solid green line and shaded area correspond to the adjusted predicted probability of moderate or severe household food insecurity in 2019, starting at a point corresponding to $10,000 income on the horizontal axis and 19.9%% on the vertical axis and ending at a point corresponding to $120,000 on the horizontal axis and 1.7% on the vertical axis. The shaded area representing the 95% CI is widest on the left-hand side between $10,000 and $30,000 on the horizontal axis before narrowing. The bands become slightly wider between $110,000 and $120,000. The negative slope remains relatively consistent between $10,000 and $70,000, where it gradually becomes less steep.

The dashed orange line and orange shaded area correspond to the adjusted predicted probability of moderate or severe household food insecurity in 2022, starting at a point corresponding to $10,000 income on the horizontal axis and 18.7% on the vertical axis and ending at a point corresponding to $120,000 on the horizontal axis and 4.0% on the vertical axis. The negative slope begins more gently on the left-hand side before becoming steeper between $35,000 and $75,000 on the horizontal axis, after which it becomes less steep. The shaded area representing 95% CI is widest on the left-hand side at $10,000 and narrows until $40,000, remaining consistent in width until about $100,000. The orange line starts below the green line at $10,000 for 2022 and crosses over at about $15,000, remaining above the green line afterwards. The orange and green shaded areas overlap between $10,000 and $30,000.

The dotted blue line and blue shaded area correspond to the adjusted predicted probability of moderate or severe household food insecurity in 2023, starting at a point corresponding to zero income on the horizontal axis and about 26% on the vertical axis and ending at a point corresponding to $120,000 and about 5% on the vertical axis. The shaded area representing 95% CI is widest on the left-hand side at $10,000 and narrows until $40,000, remaining consistent in width until about $80,000. The blue line remains above both the orange and green lines for all income levels. The blue shaded area overlaps slightly with the orange shaded area between $105,000 and $120,000.



Discussion

The probability of food insecurity increased significantly for most households in Canada from 2019 to 2022 and from 2022 to 2023, irrespective of the sociodemographic or economic characteristics considered. Across all three years, the households most vulnerable to food insecurity were those with low or moderate incomes, but the income distribution of food-insecure households shifted upwards over this period. The sociodemographic patterning of household food insecurity observed in this study was generally consistent with prior research,^Note 16, ^Note 18, ^Note 20 but the relationship between vulnerability to food insecurity and employment changed over the period of observation. Whereas households receiving most of their income from employment or self-employment had a lower probability of being food insecure than those with a lower proportion of income from employment in 2019 and 2022, this distinction disappeared in 2023. Strengths of this study include the in-depth, systematic comparison of CIS data from three large population-representative samples; the use of a well-validated measure of household food insecurity; the calculation of covariate-adjusted predicted probabilities of household food insecurity; and the examination of food insecurity across the income continuum, using tax file data to estimate household income from all sources, including capital gains and RRSP withdrawals. Prior Canadian studies have considered incomes above and below the Market Basket Measure^Note 20 or quintiles relative to the low-income cut-off.^Note 16 Assessing the probability of food insecurity across the entire income distribution using a broader concept of income to capture available household economic resources provides a more comprehensive understanding of the shifting relationship between these two variables.

This study is limited by the reliance on cross-sectional data and the time lag between the measurements of income and food insecurity. The income data from the CIS are derived from the prior year’s income tax filing, whereas the 12-month household food insecurity status was determined from data collected at the interview, which occurred between January and June of the following year. This time lag introduces error in the comparison of these two metrics for households who experienced major changes since the prior tax year. The probability and magnitude of changes in income over consecutive years are greatest for those in the lower deciles,^Note 45 i.e., the households at highest risk for food insecurity. Beyond income, households’ ability to buffer negative income shocks is a function of their assets and debts. The analysis of food insecurity in relation to household income was adjusted for housing tenure, but no data were available on the value of the housing assets, mortgage debt, financial holdings, and debts. Additionally, the lack of data on racialized status in the 2018 CIS precluded the inclusion of this important variable in the models.

The fact that the recent rise in food insecurity has occurred during a period of unprecedented food price inflation begs the question of whether this rise simply reflects Canadians’ growing concerns about food affordability.^Note 40 Were this the case, one would expect an increase in affirmative responses to the first few questions on the Household Food Security Survey Module, with more people reporting worrying about running out of food and making compromises in food selection because of financial constraints. However, marginal, moderate, and severe food insecurity have all risen in prevalence (Figure 1), indicating increases in the proportion of Canadian households making both qualitative and quantitative compromises in food consumption because of financial constraints. Moreover, all but one of the results presented here persisted when only moderate or severe food insecurity was considered, suggesting that the observed changes in vulnerability to food insecurity over the three years examined were not driven by changes in marginal food insecurity.

Several factors may have contributed to the observed increase in the probability of food insecurity along the income continuum from 2019 to 2023. The rapid inflation over this period may have led to a decline in the purchasing power of households whose incomes did not increase proportionally, creating a negative income shock for different households located along the entire income continuum, in turn raising their probability of food insecurity. Additionally, there may be households across the income spectrum that were still recovering financially from income shocks triggered by stressful life events (e.g., job loss, catastrophic illness)^Note 46 that occurred during the pandemic. Although the models are adjusted for several sociodemographic and economic variables, the absence of data in the CIS on households’ income histories, detailed information about present assets and debts, and repeated measures of food insecurity precludes testing of these hypotheses.

The finding that by 2023, households reliant on employment or self-employment were no less likely to be food-insecure than those receiving less of their income from this source is consistent with the gradual upward shift observed in the income distribution of food-insecure households. Although the probability of food insecurity is highest for low-income households, food insecurity is becoming more prevalent among households at moderate- or higher-income levels, most of which could be expected to rely on wages, salaries, or self-employment. This study included a simple indicator identifying households primarily reliant on employment and self-employment income. More research is needed to understand what underpins the increased vulnerability of households in the workforce, and how this vulnerability relates to other household characteristics, such as the number of earners; the presence of children; the household’s housing circumstances; and the race or ethnicity, immigrant status, age, and employment circumstances of the main earners.

The extent to which the recent rise in food insecurity prevalence in Canada is driven by the heightened vulnerability of households reliant on employment income has major implications for policy interventions to protect Canadian households from food insecurity. An analysis of data from the 2021 CIS revealed that most food-insecure households reliant on employment income have a main earner with permanent full-time employment.^Note 47 The odds of food insecurity are highest for main earners with low wages, low-skilled employment, shorter job tenure, and recent unemployment,^Note 47 highlighting the importance of wages and job security. Consistent with these findings is the observed inverse relationship between food insecurity prevalence provincially and the provincial minimum wage.^Note 48 Federal policies that influence food insecurity prevalence and severity among working-aged adults and their families include the Canada Child Benefit^Note 49 and Employment Insurance.^Note 38

It will be critically important to determine whether the increased probability of food insecurity among households reliant on income from employment or self-employment persists in future years. As the income distribution of food-insecure households in Canada shifts upwards, research is also needed to interrogate the experiences of food insecurity among moderate- and higher-income households versus lower-income households and determine whether there are important income-related differences in the implications of household food insecurity for individuals’ health and well-being.

Funding acknowledgments

This study was approved by the Ethics Committee at the University of Toronto (Protocol Number 41536). This research was conducted at the Toronto Research Data Centre, part of the Canadian Research Data Centre Network. This service is provided through the support of the Canadian Foundation for Innovation, the Canadian Institutes of Health Research, the Social Sciences and Humanities Research Council, and Statistics Canada, and through the support of the University of Toronto. All views expressed in this work are the authors’. The syntax files for the analyses are available upon request. This study was supported by the Canadian Institutes of Health Research (PJT-178380 and PJT 519580). The funders had no role in the design and conduct of the study; collection, analysis, and interpretation of data; writing of the article; or decision to submit the article for publication. The authors thank the anonymous referees for their valuable input. They declare no conflicts of interest.