“Troubling resurgence of scurvy” is not a headline many people had on their 2024 bingo card.
After all, hypovitaminosis C, as scurvy is formally called, is traditionally viewed as a deadly scourge of 16th-to-18th-century sailors, who spent months at sea without access to fresh food.
Yet, in recent weeks and months, a series of unrelated stories have thrust scurvy back into the news. Most recently, researchers in the northern Saskatchewan community of La Ronge diagnosed 27 people with scurvy, and they only tested 51.
On the surface, this is a shocking bit of data. But it’s a reminder of the biblical adage, “seek and ye shall find.” If you go looking for health problems, you will find them, especially in isolated, low-income populations.
The people tested had concerningly low levels of vitamin C, so technically they had scurvy, but there is little indication that they had serious symptoms. This is not a situation comparable to a British naval expedition in the 1740s, when two-thirds of a ship’s crew might die of scurvy. Still, that doesn’t mean the findings should be dismissed out of hand.
The real issue is not really vitamin C deficiency. It’s actually much more serious. The research undertaken by the Northern Inter-Tribal Health Authority is a reminder that poverty and food insecurity are serious problems, especially in rural and remote communities, and none more so than isolated Indigenous communities. (Just under 80 per cent of those diagnosed with scurvy in La Ronge were Indigenous.)
But saying people are poor and need help putting food on the table doesn’t make headlines. Saying they have scurvy does.
Just weeks before the La Ronge story emerged, the Canadian Medical Association Journal published a case study of a 65-year-old Hamilton woman diagnosed with scurvy. She did have serious symptoms, including fatigue, leg pain, gum issues, and skin lesions.
The woman was severely deficient in vitamin C because she lived on a diet of canned soup, canned tuna, white bread and processed cheese, and smoked half a pack of cigarettes a day. (Smoking, among other things, depletes vitamin C.)
Dr. Sally Engelhart of Mount Sinai Hospital in Toronto, who was lead author of the paper, offered a far more sophisticated diagnosis than scurvy though, saying this is “a complex example of food insecurity manifesting as an uncommon diagnosis” and that scurvy “should not be considered only an archaic diagnosis of 18th-century seafarers.” She urged other physicians to be on the lookout for scurvy, because this is likely a tip-of-the-iceberg case.
Evidence that the problem of scurvy is more widespread than it seems came in a study published in the Journal of the American Academy of Orthopaedic Surgeons in July, which found that the number of pediatric scurvy cases in the U.S. rose to 26.7 per 100,000 children in 2020, up from 8.2 per 100,000 in 2016, representing more than a tripling of cases.
There is no doubt many Canadians – chief among them isolated elders and children living in poverty – have scurvy (and many other ailments that come with malnutrition) because they are struggling to get by in an environment where food prices are soaring and their incomes are remaining stagnant. According to Statistics Canada, as of 2022, 16.9 per cent of Canadian households are struggling with moderate to serious food insecurity, a sharp increase from 12.9 per cent in 2021; one in 10 Canadians is also living in poverty.
Food Banks Canada, in its recent Hunger Count 2024 report, says that food-bank use has soared to record levels, with more than two million visits recorded by food banks in March of this year, almost double the number from five years earlier. If you tested those who depend on food banks to feed their families, you would no doubt find more than 27 cases of scurvy. But looking for scurvy is exactly what we should not do.
The important message here is not that we need to go looking for vitamin C deficiency, or give low-income Canadians vitamin C supplements. The solution to scurvy is tackling food insecurity more broadly, and that means addressing everything from impossibly high food prices in the North, to poverty related to housing costs in cities. People don’t have scurvy in the 21st century because they need to eat more oranges, but because they need decent paying jobs, affordable housing, reasonably priced food and better income redistribution.
In a world where billionaires rule, we’ve become inured to rampant inequity, which is a modern scourge as deadly as scurvy.