Does healthy eating cost more for First Nation people living on reserve

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Does healthy eating cost more for First Nation
people living on reserve?

• Jacqueline Tetreault

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Outline

• Introduction
• Procedure Methods
• Results
• Discussion
• Conclusion
• Acknowledgements
• Question Period

Patrick Amos
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Introduction
Lyle Campbell
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Health Canadas First Nation and Inuit Health

• Work to improve health and to prevent chronic and
  contagious diseases
• Focus on nutrition programs to address the
  increased rates of obesity and type II diabetes
• Healthy eating initiatives
• Problems encountered perception that healthy
  eating on First Nation reserves is more expensive
  than healthy eating

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Food Security

• Food security exists when all people, at all
  times, have physical and economical access to
  sufficient safe and nutritious food to meet their
  dietary needs and food preferences for an active
  an health life.
• Food and Agriculture Organization, 1996
• Food Insecurity among First Nations
• 33.3 are food insecure
• 14.4 are severely food insecure
• Canadian Community Health Survey, 2004

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Food Insecurity

• Factors that cause food insecurity among First
  Nation people
• Vulnerable population
• Low income
• Low education
• Remote isolated First Nation communities
• ? availability and access to fresh healthy food
• Food Mail Program

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Diet of First Nation peoples

• Changes in the last 60 years
• Traditional diet based on hunting and fishing,
  diet was high in protein, mod. in fat, low in CHO
  
• 24-hour dietary recalls from a Northern Ontario
  First Nation reserve diet was high in saturated
  fat and simple sugars, low in dietary fibre, high
  glycemic index value
• Gittelsohn et.al Journal of Nutrition 1998
  vol128

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Assessing the cost of food

• Nutritious Food Basket
• Food costing tool created by the Ontario Ministry
  of Health and Long Term Care
• Calculates the weekly cost of a fixed basket of
  food items for various age/sex groups
• Was created in 1998 and was based on the old
  Canadas Food Guide to Healthy Eating
• Monitoring the Cost of a Nutritious Food Basket
  Protocol, 1998

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Objectives of the project

• Assess the cost of eating nutritious food on
  First Nation reserves because of the perception
  that healthy eating is more expensive
• Compare the cost of a nutritious meal plan to the
  cost of a less nutritious meal plan in four
  different reserve locations across Ontario
• Evaluate the geographical impact on the cost of
  eating nutritious food

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Procedure Methods
Norval Morrisseau
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Selection of Communities

• Convenience sample
• Urban south Chippewas of the Thames
• Urban north Fort William First Nation
• Rural Sioux Lookout
• Remote locations Fort Severn
• On-reserve or nearest off-reserve grocery stores
  were contacted
• Permission to enter the store and conduct the
  food costing survey was obtained

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Ottawa
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Creation of Meal Plans

• Two 5-day meal plans including 4 week days and
  1 weekend day
• Food consumption patterns of a child aged 9-13,
  an adult female and an adult male aged 19-50
• Nutritious Meal Plan new Eating Well with
  Canadas Food Guide as a guide
• Less Nutritious Meal Plan food consumption
  patterns that were considered to be unhealthy
• Plans were reviewed by 5 registered dietitians

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(No Transcript)
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Child 9-13y
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Costing of Meal Plans

• Locations were visited to survey the cost of
  selected foods in the local grocery stores
• Food prices were collected according to
• The Ministry of Healths Monitoring the Cost of a
  Nutritious Food Basket Protocol
• The total cost of food planned for each of the
  five days was calculated

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Statistical Analyses

• Performed separately for the three individuals as
  well as for the four locations
• First objective
• Compare difference between the cost of eating
  nutritious foods and the cost of less nutritious
  foods
• Independent t-tests
• Second objective
• Evaluate geographical impact on the cost of
  eating nutritious food
• ANOVA with Post-hoc test for multiple comparisons

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Results
Carl Ray
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The cost of eating nutritious food compared to
the cost of eating less nutritious food
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The difference in the daily cost of the
nutritious meal plan between locations
Mean difference is significant at the plt0.00
level.
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Discussion
Norval Morrisseau
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Can First Nation people living on reserve consume
healthy food for less than unhealthy food ?

• Results suggest that it is possible to consume
  healthy foods at a lower cost than unhealthy
  foods
• This information will help by
• Encouraging healthy eating among this population
• Reducing the barriers related to the consumption
  of healthy food
• Reduction of the prevalence of diet related
  diseases in this population may be possible

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Is there a geographical impact on the cost of
eating nutritious food?

• In Fort Severn the cost of nutritious food was
  significantly (plt0.00) more expensive
• This raises problems as individuals and families
  living in remote locations typically
• Are the most food insecure
• Struggle with low income
• Programs may need to expand to be able to provide
  better prices on healthy food

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Limitations

• Meal plans were created exclusively for this
  project and are not validated tools
• No evaluation was completed to determine if the
  meal plans were representative of actual eating
  habits
• More research is required to
• Evaluate meal plans with a nutrient analysis
  system
• Evaluate actual food intake of healthy and
  unhealthy eaters
• Repeat project a different times of the year

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Conclusion
Norval Morrisseau
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Healthy eating does not cost more for First
Nation people living on reserve

• Important implications for health professionals
  and community workers
• Address food security issues
• Improve food choices
• More action needs to be taken to lower the cost
  of nutritious foods in remote locations
• Additional research is necessary to evaluate the
  meal plan tools developed for this project

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Acknowledgements

• I would like to thank Renée C. Crompton for her
  guidance and support, Sharmaline Fernando, Jane
  Hammingh, Sara Chênevert and Julie Bernard for
  reviewing the food basket tools and Louise
  Gariepy for providing direction with the data
  analysis. This research project was supported by
  Health Canadas First Nation and Inuit Health who
  provided funds for travel and accommodation
  expenses for the four day excursion to Northern
  Ontario.

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Questions?
Joane Cardinal-Schubert
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