Village Hotel Changi, Singapore
2nd Edition of Public Health World Conference (PHWC) 2026
Speakers - PHWC2026
Arnel M. Borras
- Designation: Rankin School of Nursing, Faculty of Science St. Francis Xavier University, Canada
- Country: Canada
- Title: Health Inequities in Canada: A Critical Political Economy Analysis of Structural Determinants
Abstract
Abstract
Food insecurity and malnutrition remain among the most persistent global public health challenges, rooted in structural inequities across political, economic, and food systems. This presentation employs a critical political economy and discourse analysis, informed by a realist review of the literature, to examine how prevailing food narratives influence health policy, governance, and population well-being. Drawing on the Canadian experience as a case study with global resonance, the research interrogates how dominant paradigms frame food-related disparities—either as technical issues to be managed or as systemic injustices requiring transformation.
The study identifies seven interrelated discourses that inform public health thinking and policy responses: (1) Nutritionism—focused on nutrient composition and individual behaviour; (2) Household Food Insecurity—linking access to income and material deprivation; (3) Food Security—centered on the four internationally recognized pillars of availability, access, utilization, and stability; (4) Food Insecurity as a Social Determinant of Health—situating nutrition and access within broader social hierarchies; (5) Right to Food—asserting food as a legal and moral state obligation; (6) Food Justice—addressing racial, class, and systemic inequities across the food chain; and (7) Food Sovereignty—advocating democratic control, ecological sustainability, and community self-determination.
Among these, nutritionism, household food insecurity, and food security continue to shape much of contemporary public health policy and practice. While these perspectives have strengthened data systems and improved short-term programming, they often conceptualize hunger and malnutrition as matters of individual behaviour or supply efficiency. In doing so, they obscure the underlying political-economic forces such as labour precarity, income inequality, neoliberal reforms, financialization of food systems, and environmental degradation—that perpetuate unequal access and poor nutrition outcomes.
Conversely, the Food Insecurity as a Social Determinant of Health, Right to Food, Food Justice, and Food Sovereignty discourses expand the analytical lens from individual access to collective power and systemic change. They indicate how health outcomes are shaped by political and economic structures, calling for fair labour standards, redistributive policies, rights-based accountability, environmental stewardship, and participatory governance. Of these, the Food Sovereignty paradigm offers the most integrative and transformative vision—linking human rights, ecological integrity, and social justice within a unified public health framework.
Findings underscore the need for a rights-based, equity-oriented approach that integrates food governance with environmental care, economic fairness, and social inclusion. Advancing such transformation demands sustained collaboration among public health practitioners—including nurses—policymakers, civil society organizations, community networks, and international partners to translate evidence into action.
This research calls for leadership that transcends narrow clinical or nutrition-focused approaches to engage directly in policy reform and advocacy. By reframing food not merely as a sustenance but as a determinant of justice, dignity, and planetary health, public health professionals can help shape governance systems that centre equity, sustainability, and collective well-being.
Ultimately, this study contributes to the global dialogue on social justice and health equity by positioning food systems as a central arena of transformative policy—essential to building sustainable, inclusive, and equitable conditions for population health.
2nd Edition of Public Heal ...
Read More>>
