1 Special topics-Human Rights and DisabilityCalgary Ability Network By: Tenaya Price University of Calgary

2 Recap: Human Rights are…Human rights are understood as the inalienable fundamental rights to which a person is inherently entitled simply because he or she is a human being They are Universal (applied everywhere) They are Egalitarian (the same for everyone)

3 Purpose Our goal… Raising awareness to the public and community around human rights issues Working as a unified team to address issues at the community level for individuals with disabilities on many fronts, and across several domains To come together with each of our unique voices, and start a dialogue on the issues in our current system and the barriers that people experience in our sector

4 Special Topics Through a Disability LensFood insecurity Continuity of Care

5 What is Food Insecurity?Definition Food Security: Is a condition related to the ongoing availability of food. Food insecurity: Food insecurity is defined as a lack of access to affordable, adequate food through socially acceptable means *It is worrying about being unable to buy food due to lack of money; reducing the amount of quality food purchases because of a lack of money; and/or going without food because of a lack of income *Food is one of the basic human needs and it is an important determinant of health and human dignity *People who experience food insecurity are unable to have an adequate diet in terms of quality and quantity *It is a barrier to adequate nutritional intake *People who experience Food insecurity will consume fewer servings of fruits and vegetables, milk products, and vitamins than those in secure households

6 Food Insecurity and DisabilityFood Security is a global issue and is a social determinant of health Disabled people experience higher than average food insecurity Food insecure people experience diet deficiencies Food insecurities association with poverty it is relevant to person’s with disabilities People with disabilities are underrepresented in this area *Food is also one of the vital elements of human existence. Food consumption is the single most important determinant of good health, according to the WHO, and is pivotal to human security *People are more likely to experience have chronic disease and difficulties managing these diseases *There is a substantial amount of literature in regards to food security as a concern, right here in our city… *Food insecurities association or relationship with poverty are also closely related to disability- essentially they go hand in hand *Disability and poverty are said to be inextricably linked. This is to say that people with disabilities are more likely to be poor than their non-disabled counterparts *People with disabilities seem to be, again underrepresented in this area this could come down to the fact that studies lack a disability perspective or an understanding of food security through a disability lens *Also, the approach to food insecurity and disability is often approached from a more medical model approach and see it as a deficit or problem with the individual rather than a wider socio-economic disparities that affect the livelihoods, opportunities and self-determination of disabled persons. *I found a really great article that exemplified the issues with poverty and Disability: I will just read you a quote that I pulled from it, “Poverty is above all a symptom of imbedded structural imbalances, which manifest themselves in all domains of human existence. As such, poverty is highly correlated with social exclusion, marginalization, vulnerability, powerlessness, isolation and other economic, political, social and cultural dimensions of deprivation…It results from limited or no access to basic infrastructure and services, and is further compounded by people’s lack of access to land, credit, technology and institutions and to other productive assets and resources needed to ensure sustainable livelihoods” *It is a right not a commodity…

7 Barriers to accessing quality foodLower income (poverty) Paying higher prices for better quality food choices Living to far from where food is sold Not having transportation options or full mobility Not having knowledge or space for preparing food/storing it Cooking skills *Lower income (poverty) *Paying higher prices for better quality food choices *Living to far from where food is sold or limited shopping options in ones area *Not having transportation options or full mobility and or accessibility *Not having knowledge or space for preparing food/storing it *Cooking skills (part of independent living) –lack of building individual capacity

8 Social and Economic

9 Cost of Eating in AlbertaDemonstrated that an adequate income is essential to ensure reliable access to adequate food 49% of Canadians with low incomes are food insecure In Alberta, food insecure and persons with social assistance as an income, was 84% Enough incomes for adequate food AND for the other basic costs of living In Calgary in 2008, the percentage of income spent on housing was 71% *A report was done in the cost of eating in Alberta in 2008 *They found that the statistics clearly demonstrated that an adequate income is essential to ensure reliable access to adequate food *Half of Canadians (49%) with low incomes are food insecure *In Alberta the rate of food insecurity is even higher amongst those receiving social assistance as their key income, which was 84%, a rate much higher than the Canadian average which was 60% *They also found that lower household incomes did not have enough money to buy adequate amount of nutritious food AND pay for the other basic costs of living such as shelter *In Calgary in 2008, the percentage of income spent on housing was 71% and food was 27%...An amount, quite possibly that is higher now. *They also posited that, a lack of knowledge about unhealthy eating or poor budgeting are not the issues that limit power, but that lower income was the cause. However, there are also other factors for people with disabilities such as proper supports, accessibility, budgeting, and independent skills *In short the report found that household income was the major cause of being unable to meet basic needs, such as food *The issue wasn’t that food costs too much in Alberta, but that food was not affordable due to inadequate income *Will put on the website

10 Food Insecurity Young and women with disabilities ages (15-34) are more likely to be food insecure Middle aged women and men with disabilities (aged 35-49) are about three times as likely to experience food insecurity In 2007, 12.5% of all food bank clients in Canada have disability income support as their main source of income Over 50% of food bank clients in Canada of food bank users report having a disability or limitation *Young and women with disabilities ages (15-34) are more likely to be food insecure than their non-disabled counterparts *Middle aged women and men with disabilities (aged 35-49) are about three times as likely to experience food insecurity as a non- disabled counterparts *In 2007, 12.5% of all food bank clients in Canada have disability income support as their main source of income *Over 50% of food bank clients in Canada of food bank users report having a disability or limitation *Even when persons with disabilities have access to enough food, they may not have access to nutritious food; creating a higher risk of developing nutritional deficiencies

11 Food Banks (Calgary vital signs report)Found that food insecurity is on the rise in Alberta Accompanying this was an increase in the number of food bank visits 12.3% of AB households experience food shortages due to financial constraints 25% of insecure food households use food banks There has been a 52% increase in visits since the start of the recession in 2008

12 Food Banks Cont’d… Some believe that charity can divide us as a society into the powerful and the powerless The prevailing responses to food security tend to reproduce not reduce the issue of social disparities Over reliance on food can obscure whether or not recipients nutritional requirements are met This is not really an argument for or against food banks Purpose is to create or start a dialogue. *Some believe that charities (such as food banks) can divide us as a society into the powerful and the powerless, the self -sufficient and the shamed…It’s almost like a double edged sword *The prevailing responses to food security tend to reproduce not reduce the issue of social disparities *It is a cross between grappling with responding to immediate needs for food and addressing the root cause of the issue and the social inequalities that affect health statuses of people with disabilities *Often times the reliance on food donations ultimately serves to obscure whether or not recipients nutritional requirements are met *To deal with a tension between responding to immediate needs for food and addressing the social roots of these needs, we as members of the community and the disability field need to take into consideration the health and social disparities that exist *This is not really an argument for or against food banks and charity, but a way to highlight the issue as a social issue *Purpose is to create or start a dialogue and give a sense of what some of the research says about health and food inequalities

13 Food Insecurity CalgaryCommunity Kitchen Program of Calgary The Calgary Food Committee Calgary Horticulture society: Community resource network *Community Kitchen Program of Calgary: Operate from a self- empowering model that addresses the needs of marginalized Calgary citizens *They teach participants how to prepare nutritious meals, budget their finances -- making their income stretch by preparing cost effective, healthy meals, as well as providing a means to access nutritious food *Several programs: Calgary’s cooking…meet up once a month to cook nutritious meals *Issue is that many of their programs don’t take on an individual, membership and support must come through an agency *The Calgary Food Committee and “Calgary Eats”: Create a vision to create a sustainable and resilient food system for the Calgary Region *Offers a vision for Calgary’s food system, evaluates the current food system, examines the range of food issues, barriers and existing assets, and provides key baseline information identifying connections and gaps within the food system. *Not really addressing barriers, inequalities, or the low income sector *Action plan does not identify HOW we can change food insecurity in Calgary *Calgary Horticulture society: Community resource network: Their vision is to connect and support new and experienced gardeners; promote learning and successful gardening; to work with the environment to minimize our footprint;    *Although it is a gardening society, I thought it could be a great opportunity to expand as a community garden for people with disabilities and who live in low income and face food insecurity, and also because they donate regularly their produce to the Calgary Interfaith Food Bank

14 What others are doing… Vancouver “planted” A Community Food Network Toronto “The Stop” A Community Food Centre *The planted network in Vancouver through community gardens, collaborative kitchens, or other sustainable and equitable community solutions *They offer a mobile food market (for seniors and other vulnerable populations), community meals, and their soul kitchen (offers education) *The Food stop: The Stop strives to increase access to healthy food in a manner that maintains dignity, builds health and community and challenges inequality. *They also have many programs such as Community Advocacy: program that trains peer support workers to provide one-on-one assistance to community members to provide advocacy and assistance in accessing social services *The Community Cooking program teaches people how to prepare nutritious, culturally-diverse, and inexpensive meals in communal cooking groups that bring people together to learn, cook, eat, and socialize. *Our Civic Engagement programming supports community members to speak out about and work together on issues of poverty, hunger, and inadequate income in the community. *The Drop-In is a safe and welcoming space where community members can enjoy nutritious food, meet others, and access information on social issues and community resources.

15 Recommendations Community Gardens in all areas of the city in every neighborhood (accessible) Land sharing Local farmers offer produce at discounted prices once a week/month Education and Awareness

16 Policy Implications Governments must reduce food insecurity by increasing minimum wages and social assistance rates to the level where an adequate diet is affordable Governments must assure that healthy foods are affordable Providing affordable housing and childcare would reduce other family expenses and leave money for acquiring an adequate diet Better monitoring systems must be designed and implemented to produce up-to-date accounts of food insecurity Policies are from the social determinants report on health

17 Continuity of Care

18 Defined What is continuity of Care A health care termIt is concerned with the quality of care over time for an individual The patient and the physician relationship Care of a person with a Disability through their lifespan *Continuity of care is concerned with the quality of care over time. *A health care term *It is concerned with the quality of care over time for an individual *The patient and the physician relationship and the process by which the patient and the physician are cooperatively involved in ongoing health care management toward the goal of high quality, cost-effective medical care. *Care for a person with a Disability through their lifespan, that involves many different support systems

19 Continuity Continuity in the experience of careA multi-disciplinary approach The focus is on new models of service delivery Come together to enhance the patient-centeredness of care. *Continuity in the experience of care relates conceptually to patients' satisfaction with both the interpersonal aspects of care and the coordination of that care *From a provider perspective, the focus is on new models of service delivery and improved patient outcomes. A full consideration of continuity of care should therefore cover both of these distinct perspectives, exploring how these come together to enhance the patient-centeredness of care

20 Barriers and Issues Gaps in services Refusal of services/carePrivatization issues Certain populations being excluded i.e. complex needs, and mental health *Gaps in service: Particularly when it comes to transitioning, whether that be from youth to adulthood, or from institution to community living, or from residential *Refusal of services/care: I see this a lot while working with people with complex needs, whether it be behavioral or extra care needed for physical needs *Privatization issues: Privatization of services can and will see a decrease in quality services for people with disabilities *Certain populations being excluded i.e. complex needs, and mental health

21 Universal access Currently need to uphold what is in the Universal Health care act Treated equally, without marginalization and not based on income, but on need No system of “have not’s” *Currently need to uphold what is in the Canada Health Care Act which is, every Albertan should be entitled to appropriate health and medical services that ensure quality, accessibility, timeliness, and safety… there is danger in the privatization in services for people with disabilities *Treat people equally and not marginalize and not base care on income rather than need *Alberta Disabilities forum in their report for integrated care say they do not wish to see a class system of have and have not’s when it comes to the health and wellness of Albertans with disabilities.

22 Human Rights High quality health care is a basic human rightA universal health care protects the vulnerable *High quality health care services according to the Canadian Facts report are a social determinant of health *In addition to the social aspects of health, access to quality health care is a basic human right *The main purpose of a universal health care system is to protect the health of its citizens *It is especially effective in protecting its more vulnerable or low income citizens who cannot afford private health care insurance

23 Statistics Continuing issues to access to careThe bottom 33% of low income earners are 50% less likely to see a specialist when needed 50% more difficulty finding care on weekends 40% more likely to wait five or more days for care Related issues in medical coverage-also insufficient for people with disabilities on supported income such as AISH *Continuing issues to access to care *The bottom 33% of low income earners as compared to the top 33% of top income earners are 50% less likely to see a specialist when needed *50% more difficulty finding care on weekends *40% more likely to wait five or more days for care *There are also related issues in medical coverage which in addition to being a lack of universality it can also be an accessibility issue- *Canada is in the mid-range on health care spending but in the bottom range for total health care costs *Some medical coverage’s in Canada and in Alberta do not cover all the costs of drugs or home care costs, whereas other wealthy developed nations do. *Also insufficient for people with disabilities on supported income such as AISH

24 Person focused Patient-centered focus A fully integrated continuumUse of medical model ideologies as well as a social model are most beneficial *Current Health care system sees a lack of access to and a fragmentation of services *There needs to be an emphasis on a more person centered care model *One that is fully integrated on the health continuum from birth to end of life *Encourage the system to consider not just the medical model ideologies, but also the social or community based approach model as well, and see them as mutually beneficial

25 Benefits of Interdisciplinary ApproachesMost beneficial when everyone acts toward a common goal Results in a greater cluster of resources that are interconnected Shared knowledge and support is beneficial Breakdown Organizations and health professionals working in silos *The most beneficial collaboration in regards to supporting people with disabilities in their continuing care needs is when everyone acts toward a common goal and realize that no one profession, program or department can do it alone *Results in a greater cluster of resources that are interconnected *Shared knowledge and support is beneficial *Breakdown Organizations and health professionals working in silos, and more organizations can work closely together in supporting the person and their health needs, because after all that should be the point of service in the first place

26 Education and AwarenessPeople with Disabilities face attitudinal systemic barriers such every day-also true of the Health Care system Often unaware of the needs of people with disabilities Studies show people with disabilities are more vulnerable and less understood in the hospital More education around the specific needs of people with disabilities *I think education and awareness are an important piece of the success of the continuous care of a person, and the collaborative nature that is needed *People with Disabilities face attitudinal systemic barriers such every day-also true of the Health Care system *Often unaware of the needs of people with disabilities *Studies show people with disabilities are more vulnerable and less understood in the hospital *More education around the specific needs of people with disabilities

27 Recommendations Rebuild a delivery system based on improved coordination, cooperation, and integrated service delivery Government of Alberta must recognize the concept of the patient and include both health and community based care and support services, as all encompassing and integrated Involve people with disabilities in the development of policies, supports, and services that affect their lives

28 Recommendations cont’dHealth Policy must direct attention to existing inequities in access to health care and identify and remove barriers Increase public coverage's, especially for those in the low income and vulnerable sectors who may have higher medical needs

29 Questions/Discussion

30 References M., Rock (2006). We don't want to manage poverty': community groups politicize food insecurity and charitable food donations. Retrieved from: V., Hiranandani. Disability, Poverty and Food Sovereignty: Advancing the Human Security Agenda https://www.google.ca/search?client=safari&rls=en&q=Disability,+Poverty+and+Food+Sovereignty:+Advancing+the+Human+Security+Agenda+Vanmala+Hiranandani,+Phd.Dalhousie+University,+Canada&ie=UTF- 8&oe=UTF-8&gfe_rd=cr&ei=kYINU4WYJMzB8gfMzYDIBA Vital signs statistics. Retrieved 2014 from: Community Kitchen in Calgary, retrieved 2014 from: Calgary food committee. Retrieved, 2014 from: The Calgary horticulture society. Retrieved 2014, from: https://www.calhort.org/calgary-horticultural-society/about/our-values.aspx The food stop. Retrieved 2014, from: The planted network. Retrieved 2014 from: The cost of eating Alberta (2008). Social determinant s of health; the canadian facts . (2010). Independent living Canada. (2009). Health and wellness; persons with disabilities and access to (healthy) food. ADF. (2009). Health care system: The need for coordination, cooperation and integration . Collaborative research grant initiative: mental wellness in seniors and person with disabilities. Retrieved 2014, from: