Food budget ratio as an equitable metric for food affordability and insecurity: a population-based cohort study of 121 remote Indigenous communities in Canada

Abstract

Abstract Background Food insecurity is a public health issue for many regions globally, and especially Indigenous communities. We propose food budget ratio (FBR)—the ratio of food spending to after-tax income—as an affordability metric that better aligns with health equity over traditional price-focused metrics. Existing census and inflation monitoring programs render FBR an accessible tool for future affordability research. Methods Public census and food pricing datasets from 2011 to 2021 were analyzed to evaluate food affordability for a cohort of 121 remote Indigenous communities in Canada (n = 80,354 persons as of March 2021). Trends in population-weighted versus community-weighted averages, inflation-adjusted mean price of the Revised Northern Food Basket (RNFB), and distributions of FBR, per-capita price of food, and per-capita after-tax income were calculated and compared to Canada at large. Results Population-weighted versus community-weighted mean price of the RNFB differed by < 5% for most points in time, peaking at 17%. Mean raw price of the RNFB was relatively stable, while mean inflation-adjusted price of the RNFB decreased 19%. Mean and standard deviation in FBR trended downwards from (0.40; 0.21) in 2011 to (0.25; 0.10) in 2021, while the mean for Canada held stable at 0.10 ± 0.01. Mean and standard deviation in inflation-adjusted per-capita price of food fell from ($5,621; $493) to ($4,510; $243), while the Canada-wide mean rose from $2,189 to $2,567; values for per-capita after-tax income increased from ($17,384; $7,816) to ($21,661; $9,707), while the Canada-wide mean remained between $24,443 and $26,006. Current Nutrition North Canada (NNC) subsidy rates correlate closely with distance to nearest transportation hub (σXY = 0.68 to 0.70) whereas food pricing, after-tax income, and FBR correlate poorly with distance (σXY = -0.22 to 0.03). Conclusions The FBR approach yields greater insights on food affordability compared to price-based results, while using readily available public datasets. Whereas 19% reductions in RNFB per-capita food price were observed, FBR decreased 63% yet remained 2.5 times the Canada-wide FBR. The reduction in FBR was driven both by the reduced price of food and a 25% increase in after-tax income. It is recommended that NNC consider FBR for performance measurement and setting subsidy rates.