Why focus on this topic?

In recent years, the broader food system and food environments in which Canadians live and work have evolved. Food environments are key intervention points to support healthy eating, while food system activities influence the nutritional quality of the food supply. Research in food environments and food systems has also evolved over the past decade, employing a wide array of methods and measures that can now be considered in monitoring. There is a critical need to update current approaches to surveillance by identifying indicators to appropriately monitor food environments and food systems and their impacts on the health of Canadians.

How is this research done?

The project was conducted in two phases: (1) an umbrella review of the literature on indicators for surveillance of eating patterns and practices, food environments, and food systems and an environmental scan of Canadian datasets; and (2) an exploratory survey to understand perspectives of Canadian researchers on indicator areas for national-level monitoring of food environments and food systems. An integrated Knowledge Translation and Exchange approach was taken to engage partners and collaborators at all stages of the project.
We also worked with national- and provincial-level partners in Canada to update their existing conceptual frameworks of surveillance indicators to monitor food and nutrition, food security, food environments, and food systems. This work was informed by an umbrella review that synthesized the range of existing indicators to monitor dietary patterns and behaviours, food environments, and food systems.

What did we find and why does it matter?

A total of 266 articles were included in the umbrella review. Most articles (n=198) were focused on indicators of eating patterns and practices, with emphasis on consumption by food groups. Articles focused on food environments (n=120) included a wide array of indicators to monitor food environment determinants, such as the availability and affordability of healthy food in retail outlets and density of fast-food chains in urban settings. The smaller body of literature on indicators of food system determinants (n=34) was primarily focused on the environmental impact of food supply chain activities. Academic researchers in Canada identified top indicator areas for consideration in national-level surveillance of food and nutrition in the domains of: (1) dietary behaviours and practices; (2) food environments; (3) policy environments; (4) social environments; (5) food system and supply; and (6) environmental sustainability. This project contributes to a better understanding of potential food and nutrition indicators that can be used to better inform decision-making for chronic disease prevention and health promotion.

Project Partners

This project was a collaborative partnership with Health Canada and the Public Health Agency of Canada.

Funding source

This project was funded by a Canadian Institutes of Health Research (CIHR) Health System Impact Fellowship, held by Dr. Lee.

The Public Health Agency of Canada (PHAC) were also sponsors of the project through the Fellowship.

Why focus on this topic?

Food security is an important determinant for the health and wellbeing of populations of British Columbians. Food security indicators are used to monitor variations and trends across the province using national, provincial, regional, and local data. Indicators inform policy and practice by demonstrating the current state of food security and household food insecurity in British Columbia, contributing to planning and evaluation of food security initiatives, and highlighting where further work is needed to improve food security in the province.

The British Columbia Centre for Disease Control developed the Food Security Framework and a set of indicators to capture the complex and multi-faceted nature of food security. Since the initial development of the Framework and indicators, conceptualizations of food security and the context in which Canadians live and work has substantially evolved. Global events have highlighted significant vulnerabilities in the Canadian food system with trickle-down impacts on food security, population health, climate, and equity. To better reflect the evolving priorities of communities in BC, there is a need to assess the Framework and food security indicators for alignment with developments in the field and the current context. 

How is this research done?

The purpose of this project was to conduct an evidence-informed reflection of the Framework and indicators focused on:

1. Deepening understanding of gaps within the current indicator areas;
2. Identifying areas of expansion and exploration for indicator areas and categories, with attention to potential restructuring the food security indicators; and
3. Providing potential value on how systems approaches may be applied to food security and food systems surveillance.

This project consisted of: (1) a gap analysis of the Framework and food security indicators; (2) deep dives of the literature to explore new or revised potential indicator categories and areas; and (3) a rapid literature review of systems approaches and novel data sources used in public health surveillance broadly.

What did we find and why does it matter?

This project provides an evidence-informed reflection of the Framework and food security indicators to update British Columbia Centre for Disease Control’s approach to surveillance of food security. The Framework and indicators were a strong reflection of current conceptualizations of food security in the literature, while also remaining localized to the BC context. Recommendations were provided to improve the structure of the food security indicators, suggest new indicator areas to fill gaps, and describe processes for engaging intended users and stakeholders of the framework to potentially consider application of systems theories and methods to surveillance.

Project Partners

This project was a collaborative partnership with the British Columbia Centre for Disease Control’s (BCCDC) Food Security team, under the department of Prevention and Health Promotion.