Food insecurity in Nunavut has gotten worse since the introduction of the Nutrition North program in 2011, according to a study published today in the Canadian Medical Association Journal.

The study, published by researchers from the University of Toronto, determined 46 per cent of households in Nunavut were experiencing food insecurity in 2016, up from 33.1 per cent in 2011, when Nutrition North was introduced.

Nutrition North is a federal government subsidy program provided to retailers and suppliers that offsets the cost of a variety of perishable and nutritious food items shipped to the North by air.

The study raises questions about the effectiveness of Nutrition North, though it doesn't conclude the program is at fault.

"What the study really says is that [food insecurity in Nunavut] is getting worse despite this program and we really need to figure out more about what is causing that, and what are the effective solutions to prevent food insecurity to keep getting worse," said Andrée-Anne Fafard St-Germain, the study's lead author.

"That's a step forward, I think. Even though we can't answer that question, I think the study still brings forward that it's not getting it done on its own and something needs to be done about it," she said.

University of Toronto researchers Valerie Tarasuk and Tracey Galloway also contributed to the study.

Defining a 'food insecure' household

The study analyzed Nunavut-specific data from Statistics Canada's Canadian Community Health Survey from 2007 to 2016, which left the researchers with a pool of 3,250 Nunavut households across the 10 most populated communities. Study participants were drawn from this pool.

Tracey Galloway, a researcher from the University of Toronto, contributed to the study, which asked respondents a variety of questions to determine whether their household was food insecure. (Elyse Skura/CBC)

The surveys asked respondents a variety of questions to determine whether their household was food insecure.

Those questions ranged from whether people were worried about running out of food, to whether they were compromising on the quality of food they were buying. They also asked whether families were skipping meals, or going a whole day without food, because they couldn't afford it.

If a household said "yes" to any of 18 key questions that zeroed in on severe lack of nutrition, they were classified as being food insecure.

The study also hypothesizes why food insecurity rose after the introduction of Nutrition North. The authors suggest when Nutrition North replaced the old Food Mail program, it cut subsidies to essential non-food items, like clothing, household supplies and personal care products.

This, the authors argue, spiked the prices of those items and left less money available to households for food.

The authors also suggest Nutrition North's model of providing subsidies directly to retailers — in an effort to contain costs through market competition — is counterintuitive to the market in the North where there is little competition to begin with.

However the study doesn't present evidence to support those hypotheses or conclude those factors contributed to the rise of food insecurity in Nunavut.

'Only half a picture'

In an accompanying commentary also published in the CMAJ today, James Ford argues Fafard St-Germain's work "paints only half a picture."

Ford — a researcher at the University of Leeds in the United Kingdom, who has led projects focusing on the impact of climate change on Indigenous peoples in Canada's far North — says the University of Toronto team didn't take into account other factors which would lead to increased food insecurity.

Men haul sections of whale skin and blubber, known as muktuk, near Barrow, Alaska. In accompanying commentary to the study, a researcher says the data doesn't take into account other sources of food insecurity, such as fewer young people hunting for food. (Gregory Bull/The Associated Press)

The data used to inform the study doesn't account for reduced access to traditional food and how fewer young people go hunting, Ford said. It also doesn't account for overcrowding in homes. Ford suggests food insecurity rates would have increased even without Nutrition North.

No data on impact of traditional hunting

Fafard St-Germain agrees the picture is incomplete, explaining the data her team used is all that's available, and data on the impact of traditional hunting on food insecurity, among other factors, just doesn't exist.

"If we think of all these other factors that contribute to food access, and particularly traditional food access, we can imagine that food insecurity is a lot worse than what we're capturing here," she said.

"I think this study also really brings the question that we need to collect a lot more information. Not necessarily at the household level, but of trends and things that are going on in the territories in general, because there is a lack of data."

Ford and colleagues Dylan Clark and Angus Naylor, who also signed off on the commentary, shared the study's concerns over the effectiveness of Nutrition North in Nunavut in improving food security.

"The absence of price caps, program accountability and transparency, and limited responsiveness to community needs have been noted to undermine the ability of the program to meet its goals."

Prices have gone down, feds argue

In an email to CBC News, the federal government said Nutrition North has succeeded in reducing prices of eligible foods, and increasing the amount of perishable food available.

"Between April 2011 and March 2018, the cost of the Revised Northern Food Basket for a family of four was on average 1.02 per cent, or approximately $19 per month, lower than in March 2011," a spokesperson with Crown-Indigenous relations and Northern Affairs Canada said.

"According to Statistics Canada, food prices elsewhere in Canada increased by approximately 10.5 per cent during the same time period."

In an interview with CBC's Marketplace earlier this year, Labrador MP Yvonne Jones — who's responsible for Nutrition North — acknowledged that Nutrition North alone is not enough to fix food insecurity.

"The problem has been thinking that Nutrition North alone could fix food insecurity," said Jones. "There has to be an accumulation of programs and services that accompany it, and this is where governments in the past, in my opinion, have failed."