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HEART AND STROKE FOUNDATION REPORT ASKS: WHAT’S IN STORE FOR CANADA’S HEART HEALTH?

New Report Reveals Big Inconsistencies in Price and Accessibility of Healthy Food Across Canada

TORONTO - The Heart and Stroke Foundation’s Annual Report on Canadians’ Health reveals startling discrepancies between the cost and accessibility of basic healthy food within provinces and across the country. Depending on where you live, some Canadians are often paying more than double to almost six times the price for the same basic healthy food.

The Foundation is calling on governments to monitor and periodically report on the price of core staples to help create a level playing field for all Canadians and for food manufacturers, retailers and marketing boards to explore food pricing and promotion inconsistencies within and between communities in Canada.

“Many provincial governments regulate the price of alcohol across provinces, but healthy food is subject to significant price variations from one community to the next,” says Stephen Samis, Director of Health Policy, Heart and Stroke Foundation of Canada. “You have to wonder why we control the price of alcohol but allow such price inconsistencies for healthy food – and not just in remote regions of the country – but even between larger metropolitan areas.”

A national poll conducted by the Foundation found that almost half (47%) of Canadians report going without fresh fruit, vegetables, dairy products, whole grain products, lean meat or fish because they are too expensive. Further, 68% of Canadians identified price as “extremely” or “very” important when choosing which items make it into their grocery cart.

The wide price variations in healthy foods from one community to the next is even more disturbing when compared to the relatively stable price of pop, chips and cookies.

“Healthy eating is a key factor in preventing heart disease,” says Dr. Beth Abramson, Heart and Stroke Foundation spokesperson and cardiologist. “This report by the Heart and Stroke Foundation should serve as a wake-up call that healthy eating is in danger of being out of reach for many Canadians, a problem which may only get worse given the current downturn in the economy.”

In October, 2008 the Heart and Stroke Foundation recruited volunteer shoppers in 66 communities nationwide to purchase a list of food based on Health Canada’s National Nutritious Food Basket. This basket was originally created as a measure of food security – a term referring to the availability of healthy food and one’s access to it. The Foundation adapted the food basket for this study to feed a family of four for one week. To ensure consistency, the leading national brands by dollar share on a 52-week average were chosen according to AC Nielsen data. Shoppers were asked to choose a national or regional grocery chain in their community that was not considered a discount grocery store. All shopping was conducted between October 15 and 25, 2008. This first-ever cross-country shop revealed some dramatic variations in the price of basic healthy food from milk and lean ground beef to apples and potatoes.

COST OF HEALTHY FOOD – AT WHAT COST TO OUR HEALTH?

The following charts reflect the four basic food groups as defined by Canada’s Food Guide and show the top five communities with the highest and lowest prices for some of the foods purchased in the Foundation’s survey.

Fruit and vegetable prices fluctuate wildly

Extreme cost variations were also found across the country and even within a province. For example, 6 apples ranged from $1.71 in Edmonton to $5.02 in Calgary. In Ontario, where apples are grown regionally, the cost varied from 90 cents in Peterborough to $5.49 in Dryden. And in a country where apples are grown in multiple regions, these price variations are suprising. A 2.7 kg bag of potatoes ranged from $1.50 in Toronto to $2.15 in Whitehorse, YT to $6.95 in Yellowknife, NWT.

Product

Apples (6 medium)

Potatoes (2.7 kg)

National Avg.

$3.50

$4.25

Communities with the highest prices

 

  1. Rankin Inlet, NU ($7.64)
  2. Dryden, ON ($5.49)
  3. Grande Prairie, AB ($5.24)
  4. Thompson, MB ($5.16)
  5. Calgary, AB ($5.02)
    AVG TOP 5 = $5.71
  1. Rankin Inlet, NU ($8.19)
  2. Yellowknife, NT & Melfort, SK ($6.95)
  3. Swift Current, SK & Dryden, ON ($5.99)
  4. Corner Brook, NL, Woodstock, Peterborough, Vaughan & Chatham, ON ($4.99)
  5. Invermere, BC & Brandon, MB ($4.98)
    AVG TOP 5 = $6.22

Communities with the lowest prices

 

  1. Peterborough, ON ($0.90)
  2. Toronto, ON ($1.00)
  3. Edmonton, AB ($1.71)
  4. Corner Brook, NL ($1.91)
  5. Brandon, MB ($2.02)
    AVG LOW 5 = $1.51

 

  1. Toronto, ON ($1.50)
  2. Whitehorse, YT ($2.15)
  3. Amherst, NS & Saint John, NB ($2.99)
  4. London, ON ($3.29)
  5. Kitchener, ON, Jonquiere, QC, Montreal, QC; The Pas, MB, Nanaimo \ & Vancouver, BC ($3.49)
    AVG LOW 5 = $2.68

Source: Heart and Stroke Foundation

Going Against the Grain

Some of the most disturbing data is reflected in the price variations in grain products. For example, a package of whole-wheat pasta that cost $2.00 in Barrie, Ont, was $7.90 in Regina, SK and $11.37 in Dawson, Yukon. A bag of brown rice ranged from $2.19 in Toronto to $7.76 in Winnipeg to $11.99 in Rankin Inlet. These represent approximately four-fold and six-fold increases in prices. 

Product

Whole Wheat Pasta (900 g)

Brown Rice (1 kg)

National Avg.

$5.48

$4.99

Communities with the highest prices

 

  1. Dawson, YT ($11.37)
  2. Kelowna, BC ($8.38)
  3. Fort McMurray, AB, Winnipeg, MB, Brooks, AB, Thompson, MB, & Swift Current, SK ($8.14)
  4. Prince Albert & Regina, SK ($7.90)
  5. The Pas, MB ($7.66)
    AVG HIGH 5= $8.69
  1. Rankin Inlet, NU ($11.99)
  2. Fort McMurray, AB ($8.09)
  3. Calgary, AB ($7.99)
  4. Winnipeg, MB ($7.76)
  5. Dryden, ON ($7.64)
    AVG HIGH 5 = $8.69

Communities with the lowest prices

 

  1. Barrie, ON ($2.00)
  2. North Bay, ON ($2.19)
  3. Windsor, ON & Saint John, NB ($2.29)
  4. Peterborough, ON ($2.69)
  5. Jonquiere, QC ($3.18)
    AVG LOW 5 = $2.47
  1. Vaughan & Toronto, ON ($2.19)
  2. Digby, NS & Gander, NL ($2.29)
  3. Peterborough, Kitchener & Chatham, ON ($2.43)
  4. North Bay, ON ($2.49)
  5. Kingston, ON ($2.50)
    AVG LOW 5 = $2.38

“Previous research funded by the Heart and Stroke Foundation[1] has shown us that, independent of any other heart disease risk factor, diets rich in fruit, vegetables and whole grains may decrease your risk of heart disease by as much as 30 percent,” says Dr. Marco Di Buono, Director of Research, Heart and Stroke Foundation of Ontario.

Dairy Products show wide variation

n the case of both milk and cheese, the average cost of these two staples in the five communities with the highest prices is more than double the average price in the five communities with the lowest prices. 

Product

 1% Milk (4 L)

Cheddar Cheese (520 g)

National Avg.

$5.26

$9.15

Communities with the highest prices

 

  1. Rankin Inlet,  NU ($11.89)
  2. Gander, NL ($7.90)
  3. Wolfville, NS ($7.58)
  4. St. John’s, NL ($7.54)
  5. Bridgewater, Halifax, Digby, Sydney & Amherst, NS ($7.23)
    AVG TOP 5 = $8.43
  1. Thunder Bay, ON ($14.61)
  2. Dawson, YT ($14.37)
  3. Winnipeg, MB ($13.57)
  4. The Pas, MB ($13.50)
  5. Saskatoon, SK ($13.31)
    AVG TOP 5 = $13.87

Communities with the lowest prices

 

  1. Vancouver & Delta, BC ($3.49)
  2. Prince Albert, SK ($3.83)
  3. Chatham, Kitchener, Scarborough, ON ($3.97)
  4. The Pas, MB ($3.99)
  5. Dryden, ON ($4.08)
    AVG LOW = $3.87

 

  1. Charlottetown, PEI, Montreal, QC & Barrie, ON ($4.99)
  2. Vancouver, BC, Melfort, SK & Yellowknife, NT ($5.87)
  3. Jonquière, QC & North Bay, ON ($5.99)
  4. Quebec City, QC ($6.29)
  5. Regina, SK ($6.49)
    AVG LOW = $5.93

Source: Heart and Stroke Foundation

Trying to Make Ends Meat

Meat and alternatives also experience wide fluctuations. In both cases, products found in the highest priced communities were more than twice as expensive as the average cost in the lowest priced communities.  

Product

Lean Ground Beef (1 kg)

Peanut Butter (1 kg)

National Avg.

$7.18

$5.27

Communities with the highest prices

 

  1. Ottawa, ON ($13.21)
  2. Rankin Inlet, NU ($11.99)
  3. Digby, NS ($10.25)
  4. Rimouski, QC ($9.10)
  5. Chibougamau, QC ($9.02)
    AVG HIGH 5 = $10.71
  1. Rankin Inlet, NU ($8.49)
  2. Invermere, BC ($8.39)
  3. Dawson, YT ($8.29)
  4. St. Catharines, ON ($7.58)
  5. Kelowna, BC ($6.99)
    AVG HIGH 5 = $7.95

Communities with the lowest prices

 

  1. Barrie & Timmins, ON ($4.14)
  2. North Bay & Sudbury, ON ($4.39)
  3. Kingston & St. Catharines, ON ($4.41)
  4. Montreal, QC ($4.74)
  5. Peterborough, ON & Whitehorse, YT ($4.99)
    AVG LOW 5 = $4.53
  1. St. John’s, NL ($2.99)
  2. Regina, SK ($3.29)
  3. Kitchener, ON ($3.99)
  4. Whitehorse, YT; Melfort, SK, Vancouver, BC, Yellowknife, NT & Delta, BC ($4.27)
  5. Rimouski, QC ($4.29)
    AVG LOW 5 = $3.77

Source: Heart and Stroke Foundation

Overall, fruit, vegetables and dairy accounted for almost 40% of the cost of the grocery bill almost everywhere in the country, except Nunavut and the NWT where they accounted for closer to 50% of the grocery bill. These price variations may help to explain why almost half of Canadian adults and 70% of Canadian children don’t consume the minimum recommended servings of vegetables and fruit from Canada’s Food Guide and one third of Canadian children aren’t consuming the recommended servings of milk products.[2]

“This can only encourage unhealthy eating behavior that will ultimately lead to obesity and risk factors for heart disease,” says Dr. Beth Abramson. The situation is even worse for Canada’s First Nations people and Inuit, many of whom live in isolated communities. For example, the Foundation shopped for food on a First Nations reserve in Bearskin Lake in Northern Ontario. The data on the reserve were not included in the national figures because many items were either extremely expensive or unavailable.

In Bearskin Lake, four litres of milk was $15.70 (compared to $3.49 in Vancouver); and a package of whole wheat pasta was $8.68 (compared to $2.00 in Barrie, Ont.). Other high cost items included: $10.99 for six oranges; $7.45 for six apples; and $10.88 for a 2.7 kg. bag of carrots. Many healthy foods including chicken legs, frozen fish, fresh tomatoes, fresh broccoli, canned corn, canned peas, frozen mixed vegetables, potatoes and brown rice weren’t available in Bearskin Lake.

The overall grocery bill in Bearskin Lake was $216.15, which is stunningly high when a third of the items on the Foundation’s list were not available. By comparison, the overall grocery bill was $173.72 in Jonquière, Que, $179.59 in Sydney, NS and $185.44 in Toronto− communities in which all items were available.

Accessibility an issue

In addition to significant inequalities in the price and affordability of healthy foods, the Heart and Stroke Foundation’s study found that many Canadians can’t even find healthy food where they usually do their grocery shopping.

For example, dried beans and frozen spinach were unavailable in almost one in three grocery stores where the Foundation shopped. One in five stores had no un-breaded frozen fish. Surprisingly, fresh chicken legs could not be found in more than 10% of the stores shopped.

“Difficulty accessing basic, healthy foods is particularly problematic for Canadians who are consciously trying to reduce their risk of heart disease and stroke through healthy eating,” says Dr. Beth Abramson.

Inexpensive chips and pop found in almost every community

The wide price variations in healthy foods from one community to the next is even more troubling when compared to the relatively stable prices of pop, chips and cookies − foods Canada’s Food Guide recommends we consume less frequently. The Foundation included such items in the shopping cart to compare their affordability and accessibility. These unhealthy snacks are the only items that showed little price variation across the country.

Product

Pop (2 L)

Chips (235 g)

Cookies (350 g)

National Avg.

$1.87

$2.79

$3.49

Communities with the highest prices

 

  1. Rankin Inlet, NU ($8.99)
  2. Dawson, YT ($4.14)
  3. Chibougamau, QC ($2.29)
  4. Ottawa, ON ($2.19)
  5. Hamilton, ON ($2.14)
    AVG HIGH 5: $3.95
  1. Rankin Inlet, NU ($5.49)
  2. Invermere, BC ($3.99)
  3. The Pas, MB ($3.79)
  4. Dawson, YT ($3.67)
  5. Swift Current, SK; Brooks & Calgary, AB; Kelowna, BC; Thompson & Winnipeg, MB & Dryden, ON ($3.39)
    AVG HIGH 5 : $4.07
  1. Rankin Inlet, NU ($6.19)
  2. Swift Current, SK; Brooks, AB; Kelowna, BC; Thompson, MB; Calgary, AB; Winnipeg, MB & Dryden, ON ($4.32)
  3. Vancouver, BC ($4.19)
  4. Invermere, BC ($4.05)
  5. The Pas, MB & Grande Prairie, AB ($3.99)
    AVG HIGH 5 : $4.55

Communities with the lowest prices

 

  1. Scarborough, ON ($0.99)
  2. Vancouver, BC ($1.03)
  3. Montreal, QC ($1.04)
  4. Edmunston, NB ($1.06)
  5. Saint John, NB ($1.35)
    AVG LOW 5: $1.09
  1. Whitehorse, NT ($2.47)
  2. Vancouver & Delta, BC; London, ON; Melfort, SK & Yelllowknife, NT ($2.49)
  3. Scarborough, Barrie, Windsor, North Bay, Kingston, Timmins, Sudbury & Ottawa ON; Edmunston & Saint John, NB; Gander & St. John’s, NL; Digby, Amherst, Sydney, Wolfville, NS; Summerside, PEI; Fort McMurray, AB & Vancouver, BC ($2.50)
  4. Toronto, ON ($2.67)
  5. St. Catharines, Peterborough, Vaughan, ON & Grande Prairie, AB ($2.69)
    AVG LOW 5: $2.56
  1. Montreal, QC ($1.99)
  2. Edmunston & Saint John, NB; Gander, NL & St. John’s, NL & Summerside, PEI ($2.69)
  3. Delta, BC ($2.72)
  4. Digby, Amherst, Sydney, & Wolfville, NS ($2.89)
  5. Whitehorse, YT ($2.97)
    AVG LOW 5: $2.65

Source: Heart and Stroke Foundation

The Nutritious Food Basket is meant to determine whether all Canadians have access to food that will help them meet the recommendations in Canada’s Food Guide. Eating according to the guide is the first big step to healthy lifestyles that will prevent the rise of chronic diseases such as obesity and risk factors for heart disease.

“And for many Canadians, such as my patients who are actually living with heart disease, heart-healthy eating goes even further. The Foundation’s survey suggests the cost of food my heart patients may require is higher than the cost of basic healthy food in the Food Basket,” says Dr. Abramson. 

Food – National Average

Heart Healthy Alternative – National Average

Pasta
$3.77

Whole Wheat Pasta
$5.39

Rice
$4.71

Brown Rice
$5.09

Margarine containing trans fat
$2.79

Margarine, Trans Fat Free
$3.29


Source: Heart and Stroke Foundation

WHAT ARE CANADIANS GOING WITHOUT?

The Heart and Stroke Foundation surveyed more than 1,400 Canadians who are the primary grocery shopper in their household (age 25 and over) to gauge the impact of cost on their buying habits, as well as their thoughts about food prices and accessibility.

The survey found that four out of 10 Canadians (42%) report that they “occasionally” have to go without buying a particular type of food because of its cost. Even more concerning, one in five Canadians surveyed (19%) report not buying a particular type of food “almost every time” they shop because of cost.

What foods are Canadians most likely to have to skip? Almost one-quarter of Canadians (23%) occasionally went without lean meat and poultry. This was followed closely by fruit and vegetables, when one in five Canadians (20%) left it on the shelf.

Even if money is not an issue, many Canadians cannot always find healthier food options. The Foundation asked Canadians across the country about the selection of different food items in the stores where they usually shop and they told us:

  • One in seven rarely or never have a selection of fresh fish to choose from.
  • Four in 10 rarely or never have a selection of extra lean cuts and types of meat and poultry.
  • Three in 10 rarely or never have a selection of low-fat milk, cheese or other lower-fat dairy products.
  • Nearly two in 10 rarely or never have a selection of fresh fruit and vegetables, with the same proportion reporting only a limited (or no) selection of whole-grain products.

“Canada has long been regarded as the breadbasket of the world, yet we have difficulty ensuring that affordable and accessible nutritious food is available to all Canadians,” says Stephen Samis from the Heart and Stroke Foundation.

Who do canadians think should take responsibility?

The majority of those polled by the Heart and Stroke Foundation thought food manufacturers, food retailers and governments could all play a major role in improving Canadians’ access to affordable, healthy food. There was also overwhelming support for specific forms of government regulation, education and intervention. 

Canadians recommend that governments:

Regulate the price of nutritious foods to ensure they are equally affordable in all regions of Canada

86%

Make public education about nutrition an important part of governments’ health programs and efforts

93%

Raise the income of poor Canadians so they can afford more nutritious foods

84%


Margin of error is +/- 2.6% 19 times out of 20, Environics Survey

The Heart and Stroke Foundation is concerned about Canadians’ access to healthy and affordable food and has taken a number of steps to address this issue. For example, the Foundation:

  • recently developed a Position Statement Access to Affordable, Healthy and Nutritious Food (Food Security)
  • co-funded a national Chair in Public Health with Canadian Institutes of Health Research. This new Chair will explore factors contributing to poor nutrition, obesity and associated chronic diseases and ways of addressing these factors to improve health.
  • is currently calling for proposals from researchers to conduct an international review of the evidence on how agricultural subsidies, pricing policies and tax incentives and disincentives affect the cost of various types of food and their impact on health
  • is active at the community level in many local and provincially-based coalitions addressing issues related to low-income Canadians and food security
  • informs Canadians about the importance of healthy eating and its connection to our health through our educational materials and our website heartandstroke.ca

Heart and Stroke Foundation Recommendations:

The Foundation believes that governments can take action to improve Canadians’ access to healthy and nutritious foods by:

  • monitoring and periodically reporting on the price of core staples in the national nutritious food basket
  • researching why there is so much inconsistency in the price of healthy foods within and across provinces
  • expanding and enhancing the federal Food Mail program, a combined program of Indian and Northern Affairs Canada (INAC), Canada Post and Health Canada, which provides nutritious perishable food and other essential items to isolated northern communities at reduced postal rates, to ensure affordable pricing of nutritious foods across all regions of Canada (especially remote and northern locations).

The Foundation believes that food manufacturers, food retailers, marketing boards, (commissions or agencies) should:

  • promote more equitable food pricing and promotion within and between communities in Canada

The Foundation also believes that Canadians can:

  • make vegetables and fruit a priority as much as possible
  • choose frozen healthy food when fresh is not available
  • reduce the amount of high sugar, high fat snacks in favour of healthier alternatives
  • support and encourage government policies and programs that will reduce poverty and address other barriers to healthy eating
  • support sustainable community programs such as community kitchens and gardens that promote the availability and affordability of fresh, locally and regionally grown foods
  • learn more about healthy eating at heartandstroke.ca

Log onto www.heartandstroke.ca/reportcard to view an online map and prices per community.


 

[1] Iqbal R, Anand S, Ounpuu S, Islam S, Zhang X, Rangarajan S, et al. Dietary patterns and the risk of acute myocardial infarction in 52 countries. Results of the INTERHEART study. Circulation 2008;118:1929-37.

[2] Statistics Canada, 2006. Research Paper. Nutrition findings from the Canadian Community Health Survey: Canadians' eating habits 2004. Catalogue no 82-620-MIE - No. 2. Available online at: http://www.statcan.gc.ca/pub/82-620-m/82-620-m2006002-eng.pdf