ITK looking for more from nutrition in the north

The auditor general’s recommendations on the federal government’s Nutrition North Program are welcomed by National Inuit Leader Terry Audla, but the president of Inuit Tapiriit Kanatami is quick to point out that the report encompasses only one aspect of living in Canada’s north.

“You need to look at not only the subsidy programs, (but) income disparity, income distribution, transference of knowledge when it comes … to being able to live off the land, and there’s an education aspect as well,” said Audla.

The auditor general’s report follows on the heels of the ITK comprehensive report on the Social Determinants of Inuit Health.

Looking at food security, the ITK report presented grim numbers for Nunavut: 70 per cent of Inuit preschoolers resided in food insecure homes; the rate of household food insecurity is six times compared to the Canadian national average; Nunavut food insecurity is the highest for an Aboriginal population residing in a developed country; and it costs between $395-$460 to feed a family of four in an isolated Inuit community compared to $226 for the same diet in a southern city centre.

Other social determinants examined in the report include the quality of early childhood development, culture and language, livelihoods, income distribution, housing, personal safety and security, education, availability of health services, mental wellness and the environment.

The report determines that effective solutions to health disparities will involve addressing these underlying factors and focusing on a holistic view of health.

Auditor General Michael Ferguson’s report focuses on food security. In the 28-page chapter on Nutrition North Canada, Ferguson notes that there is no indication that changes in the program have resulted in savings being passed on to the consumers.

Initially food costs were lowered through the Food Mail Program, which subsidized shipping costs for nutritious perishables and other items. Inuit saw direct savings, but this approach was not without difficulties, said Audla, as orders could only be placed through credit cards and many Inuit did not have credit cards.

In 2012, Nutrition North Canada replaced that program. Now, subsidies are provided directly to the retailer. And that raises concerns for the auditor general, who wrote in his report, “Overall, we found that Aboriginal Affairs and Northern Development Canada has not verified whether the northern retailers pass on the full subsidy to consumers. The department has not required the information it needs to verify this in the contribution agreements it has signed with northern retailers.”

Audla is not surprised by this finding, which was also noted as a yet unassessed concern in ITK’s Social Determinants.

“In the initial revamping of what was known before as the Food Mail program, we had tried to reach out to participate in consultations and discussions and we weren’t necessarily included,” he said. “At the time we felt that (the changes) were a bit too centred on the retailers.”

Audla also says that as retailers are subsidized regardless, they have no incentive to ensure their product is sold.

Another shortfall of the program highlighted by the auditor general was the lack of clearly identified communities requiring subsidies.

“Overall, we found that although (AANDC) has consulted with Health Canada to base food eligibility … on nutritional value, (AANDC) has not identified eligible communities on the basis of need. This finding is important because it is essential that subsidized foods be healthy and that communities in need benefit from the subsidy,” said the report.

Audla says all 53 communities ITK represents are being subsidized based on historical use, which is reliant on credit card orders. However, that skews numbers as fly-in southern workers have credit cards but many of those who call the north their permanent home, do not have credit cards.

AANDC has responded to the report by listing actions already completed or underway, including striving for “greater clarity” in funding agreements with retailers that will take effect April 1, 2015, and undertaking retailer compliance reviews in 2014-2015.

For community eligibility, AANDC says it “has been examining this matter for the past year, and is conducting a detailed review of the requirements for eligibility.”

While Inuit getting the full subsidies available to them in food costs is important, Audla says more comprehensive action is necessary.

“There needs to be an educational aspect to it, preparing nutritional food… How do you build the southern grown produce into a nutritional meal?” he said. “That’s one aspect the auditor general didn’t necessarily touch on.”

Too often unhealthy food is purchased, says Audla, and with harvesting becoming an expensive proposition and dying tradition, health issues, such as diabetes, are cropping up.  Audla would like to see localized community kitchens established, with retailers instructing Inuit on what food products are being subsidized, their nutritional values, and preparing meals with a budget in mind.

“We want to try and take the holistic approach,” said Audla. “Looking at all aspects of how one can, at the end of the day, put food on the table and ensure that their family is fed and that the hungry are fed.”