Decade-long, mega-study finds barriers to access to healthy traditional foods are eroding food security for First Nations

by ahnationtalk on November 6, 201916 Views

Decade-long, mega-study finds barriers to access to healthy traditional foods are eroding food security for First Nations

OTTAWA, Nov. 6, 2019  – Today, the Assembly of First Nations (AFN), the University of Ottawa, and Université de Montréal released the draft results of the First Nations Food, Nutrition and Environment Study (FNFNES). The FNFNES presents, for the first time, a body of evi­dence on the importance of traditional foods in the diet of First Nations and the impacts of environ­mental degradation such as chemical contaminants and climate change on First Nations citizens and communities and their ability to access these healthy foods.

The FNFNES reveals that between 24-60% of First Nations experience food insecurity, which is three to five times higher than the general Canadian population. Food insecurity and malnutrition have a significant impact on the overall health of First Nations citizens. The study also recommends actions to address the situation.

The FNFNES was a decade-long investigation, funded and supported by the Government of Canada, into First Nations diets and food-related exposures to environmental pollutants. Using an ecozone sampling framework, the FNFNES gathered information from 92 randomly selected First Nations from all regions of Canada south of the 60th parallel, and asked participants a range of questions dealing with traditional and store-bought food use, and food security. The FNFNES also studied nutrient values and environmental chemical hazards in traditional foods, heavy metals and pharmaceutical metabolites in drinking and surface water, and mercury levels in hair.

The tabling of these results to First Nations who participated in the study marks the process of wrapping-up the FNFNES, but also to new beginnings, as this research points to other areas that need further study. The core partners of the FNFNES are launching another multi-year research project called the Food, Environment, Health and Nutrition of First Nations Children and Youth (FEHNCY) study. Like the FNFNES, this new study is being funded by Indigenous Services Canada’s First Nations and Inuit Health Branch.

Quotes

“The study shows that traditional foods are still the best option for First Nations families when it comes to nutrition and health. The impacts of Climate Change and industry are eroding the land’s ability to provide healthy foods for too many of our people. It is important that food insecurity be addressed, the cost of nutritious food be lowered, and the impacts of industry be assessed. First Nations have long been caretakers of these lands and these lands have taken care of us. First Nations must play a role in this work.  We know that maintaining a healthy environment must include action on climate change and pollution.”

Perry Bellegarde, Assembly of First Nations National Chief

“We are happy to have worked with so many First Nations partners across the country to complete this monumental study over the last 10 years. The results clearly show the need for continuing support and engagement to promote nutrition and environmental health of First Nations. FNFNES serves as a platform to encourage innovative program development at the local and regional levels. Lessons learned from FNFNES will be carried forward to a new study focusing on children and youth.”

– Principal Investigator, Dr. Laurie Chan, University of Ottawa

“What we have found is a food system that is utterly failing First Nations in this country. There are important barriers between the people and their healthy traditional food and the prevailing food system with the high prices of market food and limited availability and access is translating into scandalously high rates of food insecurity and equally high rates of chronic diseases and their risk factors such as obesity and diabetes. It is urgent to promote systemic change in the food environment and foster food sovereignty if we want to address the great health inequalities suffered by First Nations, particularly in this case, the nutrition-related health problems.”

– Dr. Malek Batal, Université de Montréal 

BACKGROUNDER:
The First Nations Food, Nutrition and Environment Study (FNFNES)

Over the past forty years, studies have been conducted among the Canadian population to understand changes in diets and to assess the environmental safety of foods. However, there has been a gap in knowledge concerning the safety and the nutritional composition of many First Nation’s traditional foods and diets. The First Nations Food, Nutrition and Environment Study (FNFNES) aimed to address that knowledge gap. Benefits for participating in this project included the opportunity to collect baseline data on the traditional foods used in an ecozone. This baseline data not only will help address the knowledge gap but will support First Nations who monitor food security into the future and will be useful for future studies on food safety, security and water quality.

The FNFNES collected data from 92 randomly selected First Nations south of the 60th parallel that are representative of each ecozone across Canada.

The 10-year study gathered information about:

  • The current use of traditional and store-bought food;
  • The amount of mercury that people accumulated in their bodies;
  • Food security issues;
  • The amount and type of environmental contaminants found in traditional foods;
  • The amount and type of trace metals found in household drinking water; and,
  • The amount and type of pharmaceuticals and their metabolites found in surface water.

The study used a community-based participatory approach in the planning, implementation, interpretation, and communication of research results. In addition, methodology workshops were held to obtain community input on the research methodology.

There are 5 major components to this study:

  • Household interviews on diet and lifestyle;
  • Traditional food sampling for nutrients and environmental contaminants;
  • Drinking water sampling for trace metals;
  • Hair sampling for mercury exposure; and
  • Surface water sampling for pharmaceuticals and their metabolites.

Each First Nation was responsible for their data collection, while funding, support and training was provided through the FNFNES. Professional nutritionists and dietitians were hired by the FNFNES as Nutrition Research Coordinators (NRCs) to provide local support and training throughout the data collection process. The NRCs also played a coordination role to ensure that First Nations were able to meet their data collection goals and obtain meaningful results.

Fast Facts from the FNFNES:

  • The FNFNES offers – for the first time – a body of coherent evi­dence on the human dimension of the ongoing environ­mental degradation affecting First Nation citizens and communities.
  • Many First Nations face the challenge of extremely high rates of food insecurity. Overall, almost half of all First Nation families have difficulty putting enough food on the table. Families with children are affected to an even greater degree.
  • The price of healthy foods in many First Nations is much higher than in urban centres and is therefore beyond the reach of many families.
  • The current diet of many First Nation adults is nu­tritionally inadequate, which is strongly tied to food insecurity and limited access to healthy food options.
  • Traditional food systems remain foundational to First Nations.
  • Traditional food access does not meet current needs. Over half of all adults reported that the harvesting of traditional food is impacted by industry-related activities, as well as climate change.
  • Traditional food is generally preferred to store-bought food, is of superior nutritional quality, and its inclusion significantly improves diet quality.
  • Traditional food has multiple core values for First Nations. These include cultural, spiritual and traditional values, along with enhanced nutrition and health, food security, ways of knowing and an ongoing connection to land and water.
  • The health of many First Nation adults is compromised with very high rates of smoking, obesity (double the obesity rate among Canadians), and with one-fifth of the adult population suffering from diabetes (more than double the national average).
  • There continue to be issues with water treatment sys­tems in many communities, particularly exceedances for metals that affect colour and taste, which limit the acceptability and use of tap water for drinking.
  • Pharmaceutical residues were found in surface waters in and around many communities, indicating potential sewage contamination.

BACKGROUNDER:
The Food, Environment, Health and Nutrition of First Nations Children and Youth (FEHNCY)

FEHNCY is a 10-year nationwide research study that will assess nutrition and environmental health issues in First Nations communities through partnerships and community participation. FEHNCY will investigate the relationship between the quality of built, social, and natural environments, and the nutrition and health of First Nations children and youth living on-reserve south of the 60th parallel. Results from the study will inform government policy and community program recommendations geared toward the improvement of First Nations children’s health. This study will contribute to capacity building within communities and Assembly of First Nations (AFN) regions.

Main study questions:

  • How healthy are First Nations children in Canada?
  • Are First Nations children living in healthy environments?

What will the study measure?

  • Dietary intake
  • Traditional food use
  • Exposure to contaminants
  • Clinical health indicators
  • Food and built environment
  • Housing conditions and indoor air quality

Funded by Indigenous Services Canada, this interdisciplinary study is being developed based on the findings of three other studies: the First Nations Food, Nutrition and Environment Study (FNFNES) (2008–2018); the First Nations Biomonitoring Initiative (FNBI) (2011-2012); and the First Nation Youth, Health and Environment (JES!-YEH!) pilot study (2014–2017), and realized in close collaboration with regional and local Indigenous partners. The proposed study received support via Resolution 04/2019 (Support for the Food, Environment, Health and Nutrition of Children and Youth FEHNCY) at the AFN Annual General Assembly in Fredericton, NB, in July 2019 and continues the collaboration between the AFN and partnering universities

The overall goal of the study is to provide the best evidence for government policy and community programming recommendations geared towards the improvement of First Nations child and youth health and wellbeing and to build intergenerational capacities within First Nations communities to address nutrition and environmental health issues.

FEHNCY Objectives
For First Nations children and youth aged 3 -19 years old living on reserve south of the 60th parallel, the proposed study aims to:

  1. Quantify the relationships between diet quality relative to food environment assets, opportunities, and barriers at the household and community level;
  2. Study the food environment dimensions related to accessibility, availability, affordability and quality, of both market and traditional food;
  3. Understand the relationships between the dimensions of the food environments (market and traditional food) and food security, diet, nutritional status, contaminant exposures and child health;
  4. Document social determinants of health including housing conditions and examine their associations with selected child health outcomes, including emotional and psychological wellbeing;
  5. Collect information on the status of IAQ and study the relationship between housing conditions, IAQ and child respiratory health;
  6. Measure child and youth exposure to several environmental contaminants as related to environments, nutrition, and child health;
  7. Incorporate traditional food systems and link local traditional knowledge to health programming at the household and community levels;
  8. Foster community mobilization and intergenerational capacity building for addressing environments and nutrition;
  9. Use IKT Exchange framework to identify and analyze policy options with communities, AFN and policy makers.

Timeline
Consultation with First Nations leadership, communities, and relevant interest groups started in April 2018 and is ongoing. These consultations served to consolidate the overall study framework and protocol with intersectoral partners, including the multiple contaminant exposures, nutrients, and child health outcomes to be included in the study. During this time, a FEHNCY Advisory Committee will be established to make high-level decisions such as changes to project methodology and budgetary considerations.

From April 1 to Dec 31, 2019, we will develop details of the instruments and communication materials, apply for ethics approval, develop a set of guiding principles for the operation of the project, develop a detailed action plan for communication of results, purchase and install instruments to outfit the mobile clinic, hire staff and conduct training with community researchers on administering sociodemographic, health and nutrition surveys, biological sample collection, conducting housing inspections and dust collection.

Data collection will begin in January 2020 by initiating community engagement in 2 pilot communities in order to test the methodology and instruments in preparation community engagement in the first region in September 2020. Six First Nations communities per study year will be randomly selected from each of the seven AFN regions from which 100 households will then be randomly selected (see Table 1. FEHNCY community allocation by region). One adult from each of these households will be asked to complete the household questionnaire and one child will be randomly selected to complete the individual component including diet, anthropometry, pulmonary function test and biological sample collection. Community mobilization and engagement activities and qualitative data collection including community mapping and key informant interviews, will continue throughout the time the FEHNCY team is in the community.

For further information: Michael Hutchinson, Senior Communication Advisor, Assembly of First Nations, 613-241-6789 ext. 244, 613-859-6831 (cell), mhutchinson@afn.ca; Lynn Barwin, Communications, University of Ottawa, 613-562-5800 ext. 7214, lbarwin@uottawa.ca

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