Shoppers at a grocery store in Saskatoon, in December, 2023. About 28 per cent of people in Saskatchewan were living in food-insecure households in 2022, based on data by Statistics Canada.Liam Richards /The Globe and Mail
Doctors in Saskatchewan have identified 27 cases of scurvy, a disease caused by a severe vitamin C deficiency, in the province’s north, renewing concerns of growing poverty and food insecurity in rural and remote regions of Canada.
Scurvy, a disease remembered for afflicting sailors in centuries past, can lead to symptoms of weakness, fatigue and joint pains and, in more serious cases, swollen and bleeding gums and the loss of teeth. It can be treated with supplements or the consumption of vitamin-rich foods, such as oranges and rose hip, but can be life-threatening if left untreated.
Testing for scurvy is not done routinely across the country but doctors in La Ronge, about 240 kilometres north of Prince Albert, decided to study its prevalence after an increasing number of patients presented with vitamin C deficiencies, said Nnamdi Ndubuka, a medical health officer with the Northern Inter-Tribal Health Authority. The authority partnered with the Lac La Ronge Indian Band and Dr. Jeff Irvine, a physician in La Ronge, to investigate.
Fifty-one blood samples – all but one taken in 2023 and 2024 – were examined and 27 were found to have below recommended levels of vitamin C. Paired with findings recorded of the patients’ physical exams, these cases were determined to be scurvy. All patients are 20 and over, and about 79 per cent are Indigenous.
Rachel Engler-Stringer, a professor of community health and epidemiology at the University of Saskatchewan, said these cases are a clear signal that poverty and food insecurity are deepening problems across Canada. She said there is no reason to believe that this cluster of cases is exceptional but rather the “tip of an iceberg.”
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“We have not come to terms with the problem and now we’re really starting to see the consequences,” Prof. Engler-Stringer said, noting that the proportion of families experiencing some level of food insecurity has been growing consistently over two decades and was further exacerbated by the COVID-19 pandemic.
She said that when people are struggling financially, fruits and vegetables are often the first items on a grocery list to be crossed out for more filling, and cheaper, foods such as pasta. And people living in rural and remote communities are at the greatest risk of food insecurity, Prof. Engler-Stringer said, because of higher prices and weather-dependent supply chains.
The community’s focus now is to provide education and awareness on healthy diets and how to consume more vitamin C, for example by eating more frozen vegetables, Dr. Ndubuka said. A smoking-cessation program to reduce the risk of scurvy is being implemented and he said the team is advocating for greater food-insecurity programming and subsidies.
Tammy Cook-Searson, Chief of the Lac La Ronge Indian Band, said she is grateful for the study because there would be no awareness otherwise. “It’s better to know than not to know,” she said. “At least we’re aware and we can do something about it.”
About 28 per cent of people in Saskatchewan were living in food-insecure households in 2022, based on data by Statistics Canada, which defines food insecurity as inadequate or insecure access to food because of financial constraints. The province had one of the highest rates in Canada, alongside Prince Edward Island at 28.6 per cent and Nova Scotia at 28.9 per cent. Quebec was the lowest at 15.7 per cent.
The Cost of Healthy Eating in Saskatchewan report, released in 2022, also highlights the added strain on rural and northern communities. It found that the provincial average cost for a family of four to buy groceries, based on the National Nutritious Food Basket, was $291.58 a week, whereas the average for Northern Saskatchewan was $358.79 a week. In the Far North it was even higher at $464.37 a week.
“This is a clear social problem,” said Prof. Engler-Stringer, who added that the provincial and federal governments have a role to play in solving this problem. “If we have people in our communities who are in this kind of financial situation, that they’re not able to consume even very basic amounts of vegetables and fruit, we need to decide as a society what is important to us.”