If you have a disability, your risk of experiencing food insecurity is more than double that of your fellow Canadians without a disability. That’s true even after holding constant other factors like age, education, immigration status, and housing tenure. This is shocking but sadly not surprising. This is also a policy choice.
Food insecurity is most common among households with inadequate financial resources. Let me put that more bluntly: food insecurity is largely a problem of not having enough money. We already know that the poverty rate for working-age adults more than doubles when looking at just those of us with disabilities. When money is really tight, cutting back on food is a common strategy and one that, in the moment, feels less risky than other alternatives like falling behind on rent.
Many forms of disability can come with dietary needs that are more expensive to meet. Even when income might be enough to cover an average basket of groceries, persons with disabilities may go without enough of the types of foods they need to be healthy.
Disability doesn’t have to be an automatic risk factor for poverty and food insecurity. In Canada, kids and older adults with disabilities don’t seem to experience the same spike in risks of poverty (or food insecurity) compared to their peers without disabilities. Why? Because Canada now has robust (if imperfect) systems of income security for our youngest and oldest community members.
We should think of food insecurity as the early warning signal for severe household financial stress. That signal is flashing red for working-age adults with disabilities. There is responsibility and blame enough to be shared by all political parties at federal and provincial levels alike for how we got here. But there are concrete steps that could be taken to reduce food insecurity for working-age adults with disabilities in Canada by increasing the adequacy of income supports and reducing the administrative hurdles to get that help.
At the federal level, the long-promised Canada Disability Benefit has proven to be a disappointment. It could readily be improved to be a more meaningful form of support for adults with disabilities. At the provincial level, not all provinces offer a last-resort income assistance (welfare) program specifically for adults with disabilities. Where they do, provincial income assistance rates are far too low to meet even the poverty line, let alone maintain a standard of living the average Canadian would recognize as acceptable or dignified. Provinces should all ensure that systems are in place within their welfare programs to properly recognize and offset the additional costs of disability. All provinces should be increasing and indexing their income support programs for adults with disabilities.
Then there are the additional provincial supports—such as access to extended medical coverage and income supplements for medically necessary diets that are also part of provincial welfare systems. These add-ons to basic income assistance require clients to invest a lot of additional effort to apply and prove eligibility, just to get unjustifiably meager help. For example, an adult with diabetes on income support can jump through hoops—involving forms and medical appointments—to request an additional $81 per month for a diabetes-compliant diet in Ontario, or $60 in B.C. It’s not nearly enough money to ensure food security and not nearly enough money to justify the administrative burdens involved.
Income assistance (welfare) is already deeply stigmatizing and heavily policed, but access to each additional support (like special diet allowances) just adds to the stigma and policing. Too many of our systems of support are set up to exclude and police the small risk that someone might get a meager benefit they weren’t entitled to, even though political narratives significantly overstate the actual rates of fraud in practice. We should worry, at least as much, about the clear evidence that stigma and policing discourage people from getting the benefits they are eligible for.
At the federal level, much of the policing of access to disability-related benefits has been handed to the Canada Revenue Agency (CRA). For example, access to the Registered Disability Savings Program, the disability top-up to the Canada Workers Benefit, and the Canada Disability Benefit all rely on the CRA to certify disability by accepting or rejecting an application for the Disability Tax Credit (DTC). Those are programs that can increase the financial resources of persons with disabilities and maybe reduce some risk of food insecurity. The tax agency won’t accept certification of disability under another federal or provincial program. Instead, to get the CRA certificate, there is a lengthy form that must be completed by a doctor or other selected medical professionals, whose fees must be paid out of pocket by the applicant.
A cottage industry of DTC consulting firms has sprung up in response, promising help to navigate the system in exchange for hundreds of dollars in fees. Whenever an industry pops up to help individual (and especially lower-income) clients use a government program, you know something is amiss.
The DTC is a non-refundable tax credit that offers modest relief on federal taxes owing to tax filers who hold a certificate for the credit. However, nearly half (46 percent) of those with severe or very severe disabilities who claim it don’t actually save any money on their taxes, either because their income is already too low or their taxes have been offset by other tax measures. Their main rationale for applying for the DTC is to get access to other programs and services.
The disability community has been calling for reform for years. Administration of the DTC has been adjusted over the years, for example recognizing new forms of impairment or new medical practitioners. The CRA has made modest changes at the margins to reduce barriers to access, but it has ignored too many of the recommendations of its own Disability Advisory Committee.
To reduce administrative burdens and improve access to benefits, Canada does need a portable and nationally-recognized certification of disability like other countries have. In the short term, the DTC will continue to fill that function. But we shouldn’t be asking CRA tax agents to adjudicate disability. The tax collector just isn’t equipped to play the role of a social service agency. In the short term, a review of applications for the DTC certificate could be delegated to another federal body that has more specialized expertise in disability programs, Service Canada. The Income Tax Act could be amended to remove the overly proscriptive definition of disability for the DTC to simply reference the certificate issued by Service Canada. Service Canada, in turn, would have more flexibility to recognize when disability has already been established by, for example, a provincial program, Veteran’s Affairs, or the Canada Pension Plan Disability benefit. There is no clear reason why disability needs to be defined in detail in the tax code when it can be more accurately defined elsewhere.
The medical community has a role to play here as well. Medical professionals should not charge fees for completing disability forms that are so high that low-income patients can’t afford to get the benefits they need. More health-care providers can replicate the success of social prescribing initiatives and embedded services to help patients access benefits. When health-care providers join forces with for-profit disability consulting firms, their professional associations should ask whether this is consistent with their standards of care and ethics.
The Canada Disability Benefit is going to be too small and reach too few Canadians with disabilities to end the disparities in food insecurity and poverty. It should be enhanced. There may be fiscal room to be generated by a review of the existing and complex set of tax measures related to disability and caregiving. But just putting more money into programs with burdensome rules isn’t a solution. We need adequacy and accessibility. Governments should tackle the administrative burdens. These are the hoops, the fees, and the surveillance that persons with disabilities face just to get access to the programs we know they need and that we have a moral duty to provide. The warning lights are telling us the current system isn’t working.
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