Since 1998, the Simcoe Muskoka District Health Unit (SMDHU) and other Ontario Public Health Units (PHUs) have been mandated to monitor food affordability using the Nutritious Food Basket (NFB) by relating the cost of the NFB to household incomes. The NFB is a survey tool that measures the cost of basic healthy eating as represented by current national nutrition recommendations and average food purchasing patterns.
In 2019, Health Canada updated the National Nutritious Food Basket (NNFB) survey tool, from which Ontario derives its food costing survey. In 2020, Ontario Dietitians in Public Health (ODPH), in consultation with Public Health Ontario, adapted the NNFB for use in Ontario.
A series of activities were undertaken to create tools for monitoring food affordability in Ontario (MFAO), including a jurisdictional scan, literature review, product availability market evaluation, consultations with practitioners and policy-makers familiar with NFB assessments, and review of previous methods. Validity and reliability research was further done to support using online data collection procedure as a proxy for in-store data collection for stores that offer online pricing.
Between May 16 and June 24, 2022, twenty-seven PHUs participated in pilot testing the new costing tool using a hybrid model of in-store and online data collection. Depending on the results of the pilot study, the costing process may change slightly in 2023. Regardless, NFB data obtained in 2022, while not comparable to previous years, is of high quality and can be used as an advocacy tool to address the issue of household food insecurity (HFI).
The survey process involves the selection of a representative sample of food stores that reflect the local urban and rural population mix in a health unit area and socioeconomic status (2016 deprivation quintiles). Every effort is made to include a balance of “regular” and “budget” grocery stores from all the major supermarket chains in the area, and to ensure that stores chosen for the survey come from a balance of lower, middle and higher-level economic areas of the region. No convenience stores or “big box” stores requiring private membership are included in the survey sample.
In May/June 2022, Simcoe Muskoka District Health Unit staff conducted the NFB survey in Simcoe County and in the District Municipality of Muskoka separately. Surveyors visited a pre-determined sample of 14 grocery stores and recorded the price of the same 61 foods in each store.
The foods surveyed included a variety of relatively inexpensive and widely consumed choices from Canada’s Food Guide that can be used to prepare a whole week’s worth of healthy meals and snacks. They include:
- Vegetables and fruits
- Breads, cereals and other grain-based foods
- Milk and other dairy products
- Meats, fish and poultry
- Canned beans and other meat alternatives.
The list of NFB foods that are surveyed is not intended as a “prescriptive” list of items that must be eaten by everyone to maintain health. It only represents one example of a “basket” of foods that can be used to determine benchmark figures for the cost of healthy eating in a region.
All food prices are entered into the cost averaging spreadsheet developed by Ontario Dietitians in Public Health, in consultation with Public Health Ontario. An extra 5% is added to account for coffee, tea and additional food items used as ingredients in meal preparation such as spices, seasonings, condiments, soups, and baking supplies. The resulting food basket cost is based on the average cost of each food item across all grocery stores sampled. The food basket excludes food items with little nutritional value such as soft drinks, potato chips and other processed convenience foods high in sugar, fat and/or salt. Infant formula and baby foods are also not included, and neither are non-food items such as laundry detergent, toothpaste, toilet paper and soap.
Survey results are used to calculate the monthly cost of a NFB for households of different compositions and income sources. In 2022, these include:
- A “reference family” of four (a man and a woman each aged 31-50 years; a boy aged 14-18 years, and a girl aged 4-8 years) with income from Ontario Works, or minimum wage work, or median income (after-tax)
- A single parent household (a woman aged 31-50 years, a boy aged 14-18 years, and a girl aged 4-8 years) with income from Ontario Works
- A single parent, aged 31-50 years with income from Ontario Works, or the Ontario Disability Support Program
- An individual over 70 years of age with income from Old Age Security/Guaranteed Income Supplement
- A married couple with income from the Ontario Disability Support Program
- Living Wage scenarios (to come)
The cost of the NFB plus apartment rent figures from the Canadian Mortgage and Housing Corporation Ontario Market Rental Report are then compared with income from the sources previously mentioned to get an indication of whether these income sources are adequate to cover food and rent costs.
Nutritious Food Basket results and income scenarios can be found here.
It is important to note that it is NOT appropriate to use local NFB results to calculate what individuals and families should be paying for food. NFB figures are an average of food costs from across the whole region and do not represent food costs in any one community. Food costs and other circumstances can be quite different from one community to another in Simcoe Muskoka.
The mix of stores and the approach to store selection may differ from one public health unit to another. For this reason, it is inappropriate to make comparisons of the NFB data across PHUs.