Étant donné l’absence de politiques publiques précises face au problème de l’insécurité alimentaire des ménages au Canada, les banques alimentaires restent la solution la plus courante, malgré les questions qui se posent au sujet de leur efficacité. En effet, parmi 371 familles à faible revenu de Toronto que nous avons interviewées dans le cadre de cette étude, 75 % avaient vécu de l’insécurité alimentaire, mais seulement 23 % avaient eu recours à une banque alimentaire; et, pour la plupart des utilisateurs de banque alimentaire, l’insécurité alimentaire était un problème chronique grave. Parmi les raisons qui font que les familles vivant de l’insécurité alimentaire n’ont pas recours à une banque alimentaire, notons une certaine réticence à demander la charité, mais aussi un accès difficile à ces banques pour diverses raisons. Ces résultats remettent en question le rôle que les gouvernements fédéral, provinciaux et territoriaux semblent donner aux organismes caritatifs comme moyens de réduire l’insécurité alimentaire, et soulignent la nécessité de politiques publiques claires en cette matière.
Abstract
In the absence of targeted public policy to address household food insecurity in Canada, food banks remain the dominant response, despite questions about their effectiveness. Interviews with 371 low-income Toronto families revealed that 75 percent had experienced some food insecurity, but only 23 percent had used a food bank; for most food bank users, food insecurity was a severe and chronic problem. Food-insecure families’ reasons for not using food banks indicated resistance and, in some instances, access barriers. These results draw into question the apparent reliance of federal and provincial/territorial governments on food charity to alleviate food insecurity and highlight the need for a public policy response.
INTRODUCTION
Household food insecurity, popularly referred to as “hunger,” is defined as the inadequate or insecure access to food due to inadequate financial resources. This problem is now routinely monitored in Canada, with the most recent estimates indicating that 5.1 percent of households were moderately food insecure and 2.7 percent of households were severely food insecure in 2007–08 (Health Canada 2010). Although research on determinants of food insecurity is limited, household food insecurity is correlated with low income, reliance on social assistance, and renting one’s dwelling (Che and Chen 2001; Tarasuk and Vogt 2009). Food insecurity is linked to poor dietary quality and heightened nutritional vulnerability (Kirkpatrick and Tarasuk 2008), increased risk of chronic health problems (Kirkpatrick, McIntyre, and Potestio 2010; Siefert et al. 2004), and exacerbations of health conditions that require special dietary management (Anema et al. 2009; Seligman et al. 2007).
Over the past three decades an extensive network of extra-governmental, community-based charitable food assistance programs has developed to help “the hungry,” and these efforts are routinely identified in federal government documents as a cornerstone of Canada’s response to food insecurity (Agriculture and Agri-Foods Canada 2008; Public Health Agency of Canada 2008). At the core of community food assistance efforts are food banks—voluntary, community-based initiatives that collect donated foodstuffs from the public and food industry and redistribute it to people “in need.” Food banks began to proliferate in the 1980s as communities mobilized to deal with local concerns about “hunger” arising in the context of an economic downturn (Riches 1987), but these initiatives rapidly became entrenched. Research conducted through the 1990s raised several serious questions about the capacity and effectiveness of food banks to alleviate hunger in Canada,1 but food charity continued to flourish in the absence of alternative responses.
Although food banks remain the purview of civil society, they receive considerable formal and informal government endorsement and support. People facing food shortages are directed to food banks on municipal government websites2 and referred by welfare caseworkers, health care providers, and other “front-line” staff. Politicians applaud the work of food banks and issue appeals to the public to donate to food banks to help needy families.3 There are also some examples of more direct government support for food banks. Food Banks Canada, the national association of food banks,4 has reported that 30 percent of its member organizations receive some form of government funding (Food Banks Canada 2010a). As part of the Quebec government’s strategy to reduce poverty and social exclusion, the right to food assistance that is sufficient and nutritious, and that can be obtained in a manner that maintains dignity was enshrined in law (Government of Quebec 2002), and provincial funds were subsequently committed to improve food assistance programs in that province (Government of Quebec 2004). The Province of British Columbia, through the Community Gaming Grants program (Ministry of Public Safety and Solicitor General 2011) and the Community Food Action Initiative (Provincial Health Services Authority 2008), provides grants to individual food banks and emergency food service organizations. The Nova Scotia Department of Natural Resources and the Department of Agriculture partner with hunting organizations to run the “Hunters Helping the Hungry” program, which allows hunters to donate deer and moose meat to food banks in Nova Scotia (Nova Scotia Department of Natural Resources 2011). In the absence of other deliberate policy interventions to address food insecurity, food banks appear to have become the de facto public policy response to household food insecurity in Canada.
A major disconnect, however, is that food banks do not appear to be used by most food-insecure households in Canada. This was first documented in population health surveys in the 1990s (McIntyre, Connor, and Warren 2000; Rainville and Brink 2001; Vozoris and Tarasuk 2003). The most extensive investigation, conducted via a food security supplement in the 1998–1999 National Population Health Survey, revealed that only 22 percent of food-insecure families had used food charity, and even among families reporting severe food problems, use of food charity was only 33 percent (Rainville and Brink 2001). Although more recent population assessments of food insecurity have not included questions about food bank use, in a 2006–07 study of 485 low-income families in Toronto, we found that only 28 percent of the 316 families who experienced food insecurity in the past year had received any assistance from food banks during this period (Kirkpatrick and Tarasuk 2009). The low rates of utilization could not be explained by issues of geographic proximity because these neighbourhoods were all well served by food banks (Kirkpatrick and Tarasuk 2010).
In light of the entrenchment of food banks in Canadian society and the apparent reliance of federal and provincial/territorial governments on these organizations to alleviate household food insecurity, research is needed to evaluate the actual and potential role of food banks in relation to problems of food insecurity in Canada. Drawing upon data from a follow-up study of low-income families in Toronto, this paper reports on our analysis of the factors related to food bank use and non-use. We examine household characteristics associated with food bank use and explore the responses given by families to explain why they had not used food banks in the 12 months prior to the interview.
METHODS
Study Design and Population
Analyses conducted for this study used data collected one year after the baseline study by Kirkpatrick and Tarasuk (2009). The study was approved by the Human Subjects Research Ethics Board at the University of Toronto. The baseline study design involved the random selection of 12 of the 23 high-poverty census tracts in Toronto as sites for recruitment. Interviewers, who themselves had experiences of low income, recruited families to participate by door-to-door sampling. Eligibility criteria required that families had at least one child 18 years of age or younger in the household, were living in a rented dwelling and had been there for at least one month, had sufficient fluency in English to complete an oral interview, and had a gross income at or below the mid-level of Statistics Canada’s five-category income adequacy scale (≤ $29,999, $39,999, or $59,999 if household 1 or 2 people, 3 or 4 people, or 5+ people, respectively). Quota sampling was used to ensure that approximately equal numbers of families living in subsidized housing and non-subsidized housing were included in the study. Data were collected by means of a structured oral interview with the household member who had primary responsibility for food shopping and management. Respondents from a total of 501 families were interviewed at baseline, reflecting a response rate of 62 percent. Sixteen families were subsequently excluded because their incomes were found to exceed the threshold for eligibility. Thus the final sample was 485. Of these families, 76 percent (N = 371) completed a second interview approximately one year later between November 2006 and April 2008.
Similar to the baseline survey, at follow-up we collected basic demographic information, sources and amount of income, and usage of community food programs in the past 12 months. Programs included food banks, community gardens, community kitchens, and a subsidized fruit and vegetable box program based in Toronto. Families who reported no use of food banks were asked: “Why didn’t you or anyone in your household use a food bank in the past 12 months?” The question was open-ended, and responses were recorded verbatim by the study interviewer. Due to the situating of this question within the lengthy survey questionnaire, responses were not further probed.
Families who had used food banks in the past 12 months were asked about their food bank use in the past 30 days, and those who reported no use in the past 30 days were similarly asked an open-ended question probing why they had not done so.
Household food security was assessed over the past 12 months and past 30 days using the Household Food Security Survey Module (HFSSM) (Bickel et al. 2000), which is an 18-item questionnaire. The questions are asked in sequence, as they describe increasingly severe household food circumstances ranging from worry that food would run out before there was money to buy more, to adult or child experiences of not eating for a whole day. All questions ask the respondent whether the experience described in the question occurred in the past 12 months and tie the experience to constrained household finances. Food security status was classified according to Health Canada criteria (Office of Nutrition Policy and Promotion 2007): moderately food-insecure households have answered enough questions affirmatively to indicate compromises in the quality and quantity of their food intake, and severely food-insecure households have indicated reduced food intake and disrupted food patterns. We additionally used the marginal food insecurity category to recognize the heightened vulnerability of families in this group.5
A 30-day measure of food insecurity was incorporated into the scale so that all questions describing food deprivation or reduced food intake also had a sub-question that asked whether the experience happened in the past 30 days and how often in the past 30 days. An affirmative response to any of these questions indicated food shortage in the past 30 days.
Analyses
We constructed a multivariate logistic regression model to examine the relationship between food bank use and characteristics anticipated to influence the decision or ability to use food banks, including household food security status, income, receipt of welfare payments, single motherhood, having young children, education level, and recent immigration. These demographic characteristics have been repeatedly associated with household food insecurity in the Canadian population (Che and Chen 2001; Health Canada 2010) and were linked to food insecurity in the current study population at baseline (Kirkpatrick and Tarasuk 2009). We conducted the logistic regression analysis with SAS 9.2 using survey commands to account for the clustering effect of neighbourhood in the survey design and adjusting for receipt of a housing subsidy to reflect the recruitment quota. The outcome variable was food bank use, dichotomized to indicate whether a family had used a food bank in the past 12 months or not. This variable was chosen as opposed to some measure of the frequency of food bank use because there were only 20 families in the sample who had used a food bank every month or almost every month over the past year. Thus, the logistic regression model relates household characteristics to a decision/ability to use a food bank at least once in the past 12 months.
We utilized data from the baseline interview to examine how change in food bank use (new use at follow-up or no longer using at follow-up) related to change in severe food insecurity status. The decision to examine change in severe food insecurity status was informed by the results of the multiple regression analysis explained above, which indicated that families in more desperate circumstances were more likely to have used a food bank. Examining change in severe food insecurity status in relation to change in food bank use allowed us to gain an understanding of the temporality of the relationship between severe household circumstances and food bank use.
We conducted a content analysis of participants’ responses to the question probing reasons for nonuse of food banks. The coding of responses was inductive and iterative, with initial content-based codes repeatedly refined to better capture the range of responses recorded. Where more than one idea was expressed in a response, the response was broken down into sentences to allow more than one code to be assigned. Codes were compared to one another to identify broader conceptual categories and themes within the data. To enhance reliability of the coding scheme, the assignment of codes, categories, and overall themes was reviewed by members of the research team, including one of the survey interviewers.
The results from this analysis yielded six categories, which fit into two mutually exclusive overall themes. Although the responses of all households in the study population were coded, we were primarily interested in the reasons given by households that did not use food banks and that were experiencing food insecurity (i.e., households that were marginally, moderately, or severely food insecure; n = 199); thus results are presented for these households.6 To examine whether the reason(s) respondents gave for not using food banks differed by household characteristics, we conducted chi square analyses after responses were categorized. Responses were examined by household food insecurity, single mother household, dichotomized income (above/below sample median), education, receipt of welfare, and report of food bank use at the baseline interview.
We also examined food bank use in the past 30 days among respondents who indicated they used a food bank in the past 12 months, coding the reasons why families who had previously used a food bank had not done so in the past 30 days and juxtaposing these responses against their food security over the past 30 days.
RESULTS
Study Population Characteristics
The demographic characteristics of the families in this study are summarized in Table 1. Most were reliant on income from employment, welfare, or a combination of government transfers (e.g., national and provincial Child Benefits, GST credits, Employment Insurance), and 75 percent of families had incomes below the after-tax low-income cutoff (LICO; Statistics Canada 2010). More than half were lone mother households. The majority of study participants were not born in Canada (data not shown), but only 16 percent had immigrated within the past five years.
Consistent with baseline findings, at the time of the follow-up study visit, almost all families expressed concern about meeting food needs or being unable to do so. Specifically, 30 percent of families were severely food insecure, 32 percent were moderately food insecure, and 13 percent were marginally food insecure. Additionally, in response to the question “In order to buy just enough to meet the needs of your household, would you have needed to spend more than you did in the last 30 days, or could you have spent less?”, 91 percent of families indicated they would have needed to spend more money.
Food Bank Use and Associated Household Characteristics
Only 23 percent of families (n = 84) reported using a food bank in the past 12 months, and most of these families had used a food bank six or fewer times (n = 54). This low prevalence of food bank use in the follow-up study population was consistent with the baseline study (Kirkpatrick and Tarasuk 2009), but food bank use had changed for some households: 31 households did not use a food bank at follow-up who reported use at baseline, and 30 households newly reported using a food bank who had not done so at baseline. A total of 54 families reported food bank use at both baseline and follow-up.
Results of the multivariate logistic regression analysis showed that the odds of using a food bank in the past 12 months at follow-up increased with severity of food insecurity (Table 2). Additionally, independent of food insecurity, decreasing income and receipt of welfare were positively associated with food bank use, and recent immigration was negatively associated with food bank use. These results are consistent with the characteristics associated with food bank use in the baseline study population (Kirkpatrick and Tarasuk 2009).
Consistent with the results in Table 2, we observed that households who reported newly using a food bank at follow-up had a higher prevalence of severe food insecurity over both years and a higher prevalence of new severe food insecurity (Table 3) compared to families who remained non-users of food banks over two years. It did not appear that discontinuation of food bank use was motivated by a reduction in severe food insecurity, however,
Table 1 Study Population Household Characteristics (N = 371)
Logistic regression model adjusted for variables in table, number of adults and children in household, receipt of housing subsidy, and clustering effect of neighbourhood.
b
Income means adjusted for number of adults and children in household.
c
Income OR refers to a $2,000 decrease in income.
Source: Calculated by authors.
as the prevalence of severe food insecurity status remained high among those who reported no use of food banks in the past 12 months at follow-up compared to those who remained using food banks (Table 3). Also important to note is the high prevalence of persistent severe food insecurity among food bank users, indicating that continued food bank use did not appear to reduce the likelihood of repeated severe food insecurity.
Reasons for Not Using Food Banks
The reasons participants from food-insecure families (N = 199) gave for not using food banks fell into six categories that could be summarized under two broad themes. Respondents were either “choosing not to use food banks” or they had been unable to use a food bank because of “barriers” (Figure 1). Although participants from severely food-insecure families were more likely to report barriers than
Table 3 Relationship between Severe Food Insecurity and Food Bank Use over Two Years (N = 371)
Severely Food Insecure
Not at Either Interview (%)
No Longer at Follow-Up (%)
Newly at Follow-Up (%)
At Both Interviews (%)
Food bank use in past 12 months
None at baseline or follow-up (n = 256)
74.2
6.3
7.4
12.1
Baseline, not at follow-up (n = 31)
35.5
6.5
12.9
45.2
Not at baseline, newly at follow-up (n = 30)
40.0
3.3
13.3
43.3
Both interviews (n = 54)
37.0
13.0
9.3
40.7
Notes: Numbers in parentheses are sample sizes for the rows. Cells denote row percentages. Due to rounding, numbers do not sum to 100 percent.
Source: Calculated by authors.
Notes: Percentages are mutually exclusive for overall themes but not for underlying categories (i.e., more than one reason provided). Four respondents (2 percent) did not answer the question.
Source: Calculated by authors.
Figure 1 Food Insecure Families’ Reasons for Not Using Food Banks (n = 199)
those in less insecure families, most participants’ responses fell into the “choosing not to use” theme, irrespective of the level of food insecurity (Figure 2).
What follows is a detailed examination of the four categories of response that comprise the “choosing not to use food banks” theme, followed by a discussion of the two categories under the “barriers” theme (Figure 1). Additionally, when statistically significant, results from the chi square analyses are presented for the examination of category of response in relation to household characteristics (food security status, lone motherhood, receipt of welfare, recent immigration status, education, income, and reported use of food bank at baseline).
Theme One: Choosing Not to Use Food Banks
Unsuitable Food
“[Food banks] don’t give me the food I need— there’s no point in going.”
(Respondent (R) 2225)
Twenty-two percent of families described feeling that their food needs were unmatched with what was provided at food banks, and the poor quality of foods that were offered made it not worthwhile for them to use food banks. Respondents specified that food
Source: Calculated by authors.
Figure 2 Reason for Not Using Food Banks by Food Insecurity Status
banks did not have fresh foods, healthy foods, or foods that met their dietary restrictions (e.g., Halal). They also described receiving rotten fruit/vegetables, “junk food,” foods that were past their “best before” dates, and/or only canned foods—in short, foods that they did not want to eat. The following two quotes illustrate the nature of responses in this category:
I don’t like tinned food and that’s what they give out. There are no nutritious foods, and they give out only expired products. My neighbours got sick from eating expired tinned salmon.
(R2274)
Half the food at the food bank is stuff I don’t want. I feel bad being picky, but I would borrow money instead [of going to a food bank]. My children wouldn’t eat the food, and the vegetables are not fit to feed an animal. The meats are disgusting and there is too much junk food.
(R5176)
This category of response was more often indicated by participants from households headed by a single mother compared to those that were not (26 percent vs. 17 percent; p = 0.0388) and from households reliant on welfare compared to those that were not (31 percent vs. 17 percent; p = 0.0003). The proportion who gave a response in this category did not differ for other household characteristics.
Identity
A smaller proportion (12 percent) of families described their perceptions of whom or what food banks are for and distanced themselves and/or their need from that person or situation; because they did not feel food banks were for them, they did not go. For example, one respondent said, “I’ve never used a food bank. It’s for people who have more need—I feel more privileged than people who use food banks” (R2251). Others also stated that they felt food banks were for a specific population, for example, people who are homeless, welfare recipients, or unemployed. Some respondents also had the perception that their use of food banks would take away the benefit of doing so from someone in greater need: “Those things are for people who don’t have anything. I don’t like to take from people who don’t have anything” (R3020).
Participants from households that did not receive welfare were more likely to have given a response that fit into this category than those from households that did receive welfare (16 percent vs. 3 percent; p = 0.001). No other differences were observed for other characteristics.
Degradation
“Social customs dictate our behaviour—we cannot think of using a food bank.”
(R2620)
Eleven percent of families described food banks as something they did not want to use because of feelings of degradation. These feelings seemed to stem from perceptions that using food charity was socially unacceptable or out of line with family values, or from poor past experiences at food banks. For example, one respondent explained, “We don’t beg or borrow or steal. These family rules passed [on] from my father. ’Whatever we have, we do with’” (R3778). Others explicitly talked about feelings of shame attached to using a food bank: “I’m self-conscious. I would be ashamed of myself to not have it together. I wouldn’t want anyone to see me going—it would make me feel awful. I don’t want to be seen as facing rock bottom” (R2308).
A response that fit into the “Degradation” category was more often given by participants from households that did not receive welfare compared to participants from households that did receive welfare (13 percent vs. 6 percent; p = 0.0155). No differences were observed for other characteristics.
Insufficient Need
“We don’t need the food bank, we manage by ourselves.”
(R2395)
The most common response, given by 38 percent of food-insecure families, was that they had insufficient need to use a food bank and were able “to manage” without going to one. For example, one respondent said, “We didn’t need to use the food bank. We squeak by, we still have enough to eat” (R4267). Another said, “[We] don’t go [to the food bank]. We can survive; we still can buy food” (R5064). Respondents also described their lack of need relative to a more desperate point at which a food bank would be necessary: “I don’t think it’s to the point to need the food bank” (R2663). Additionally, 15 respondents gave a simpler response of “didn’t need to.” Since these responses were not probed for clarification of meaning, we cannot elaborate on what respondents meant by terms like “need,” “enough,” or “the point” at which a food bank would be used.
These responses indicate that participants did not view food bank use as a way to alleviate the experiences captured in their responses to survey questions about food insecurity. Implicit in their responses (and explicit in some) was the assertion that food bank use would only occur at a time of greater desperation than respondents had faced. Important to highlight was that respondents were not necessarily indicating a lack of food insecurity, but rather an absence of the need to use a food bank, which seemed to be constructed as a point of desperation where food banks would be turned to as a “last resort” (R1228).
Participants who said they did not need a food bank tended to be from households that were in less desperate circumstances. Households that were marginally or moderately food insecure, had incomes higher than the median, and that were not led by single mothers were more likely to give this type of response than households with opposing characteristics (p < 0.05 for all comparisons). While these findings suggest that families who said they did not need a food bank had less severe food problems, it is important to note that all families in this group were, at best, worried about not having enough to eat and, at worst, repeatedly reducing their food intake. Thus, we interpret these findings to indicate greater resistance to food bank use among households with less severe circumstances.
Theme Two: Barriers
Access
Nineteen percent of participants indicated that they had tried to use a food bank in the past or had been interested in doing so, but had been unable. Barriers mentioned were schedule conflicts with limited food bank operating hours, long line-ups, being turned away when food banks were too busy, not being allowed to get assistance because of food bank eligibility criteria, and the lack of transportation necessary to get to a food bank. For example, one respondent said, “Last time I tried to go, I had no money for rent and bills. I had receipts. I was told that I was not eligible because I had just got paid” (R2321). Another said, “I don’t have time. They’re not open when I am off work” (R4245). Others described the invasive intake and screening process required to use a food bank as a barrier to food bank use: “I went last Tuesday. I was told to make an appointment and to bring all my documents in order to use the food bank. I decided not to ’register’ myself” (R2343).
There was a borderline significant difference in the proportion of households that gave this response by welfare receipt: those who received welfare were more likely to have given this response than those who did not receive welfare (25 percent vs. 16 percent; p = 0.0589).
Information
“I don’t know where they are and I don’t know how to find out about them.”
(R3538)
Eighteen percent of study participants did not have the necessary information to allow them to use food banks. Some were unfamiliar with what food banks were and how they operated, and others did not know the location of food banks or when they were open. Other respondents questioned whether they would be allowed to use a food bank.
Families who were experiencing severe food insecurity were more likely to have given lack of information as a reason for not using food banks than households that were marginally or moderately food insecure (25 percent vs. 16 and 10 percent; p = 0.0478, for comparison of severe vs. moderate and marginal).
Food Bank Use in the Past 30 Days
Of the 84 families who had used a food bank in the past 12 months, 38 (45 percent) had used a food bank in the past 30 days. Of those who did not use a food bank in the past 30 days (N = 46), reasons for not doing so fell into three categories outlined above: (a) no need to use a food bank in the past 30 days (37 percent); (b) access barriers in the past 30 days (28 percent); and (c) unsuitable food as the reason for not using in the past 30 days (35 percent). In the latter category, respondents felt that it was not worthwhile to go back to a food bank because of the poor quality and quantity of food given out. For example, respondents stated,
When I go, I never see anything I can eat.
(R7074)
Cans are dented and the food may be spoiled. The food doesn’t look edible.
(R2677)
I don’t like to use them because they give me garbage—the food is expired and unhealthy.
(R4224)
Access barriers that prevented respondents from using a food bank in the past 30 days were food bank closure, being turned away, and schedule conflicts with limited operating hours.
An important observation was that of the 46 families who had not used a food bank in the past 30 days but who had used a food bank in the past year, almost half had experienced food shortages in the past 30 days: 48 percent of families had cut the size of their meals or skipped meals, 30 percent had experienced hunger but had not eaten, and 39 percent had eaten less than they felt they should. Taken together with the qualitative responses, these findings provide evidence that lack of need was not the salient reason why families who had used a food bank previously did not return in the past 30 days.
DISCUSSION
This study yields two important insights into the actual and potential role of food banks in relation to problems of household food insecurity. First, most food-insecure families in our study population were not using food banks, either because they did not see use of food banks as a way to address their needs or because food banks were not available to them. Though our results suggest that families turned to food banks when their circumstances were desperate (as indicated by severe food insecurity, lower income, and the receipt of welfare), many families with apparently high levels of need were not using food banks. Some identified logistical barriers to food bank use, but many spoke of the mismatch between the assistance food banks offered and their perceptions of their needs. For these reasons, families who had used food banks in the past 12 months did not do so in the past 30 days, despite evidence of food shortages in this period.
Second, among families who used food banks, there was no evidence that food bank use alleviated food insecurity. The majority of food bank users were severely food insecure. At baseline and follow-up study visits, 41 percent of households reported that they used a food bank and also experienced severe food insecurity over both years, which suggests that their food bank use was insufficient to ameliorate this severe condition. These results are consistent with an earlier study that documented a high prevalence of food insecurity among families using foods banks (Tarasuk and Beaton 1999).
Although our study design afforded a rare glimpse at the intersection of household food insecurity and food bank use, this research is not without limitations. The use of an open-ended question allowed study participants to offer their own explanation for not using food banks, but the absence of audio recording and the lack of probing by the interviewer limited the richness of what was recorded. Additionally, our focus on low-income families in Toronto means that the prevalence of food bank use in our sample is not reflective of the food-insecure population in Canada. Of note, however, is that earlier studies in Canada with population-based samples have shown a similarly low prevalence of food charity use among food-needy individuals and families (McIntyre, Connor, and Warren 2000; McIntyre et al. 2002; Rainville and Brink 2001; Vozoris and Tarasuk 2003).
Our study participants’ descriptions of food banks reflect their interactions with specific agencies and therefore cannot be generalized to all food banks in the country;7 however, problems of poor food quality and limited quantity have been documented in other studies that captured low-income individuals’ feelings about food banks (Hamelin, Beaudry, and Habicht 2002; Hamelin, Mercier, and Bedard 2008, 2011; Hobbs et al. 1993; Lightman, Herd, and Mitchell 2008). These problems have also been identified in studies of food bank operations (Tarasuk and Eakin 2003, 2005; Teron and Tarasuk 1999). Concerns about food quality and quantity reflect the very nature of food banks in Canada and have been documented since their inception. Most food banks rely on voluntary staffing and donated food, which allows for little control over hours of operation and the quality and quantity of food available for distribution. Food Banks Canada (2010a) has reported that almost half of its member food banks have no paid staff. Most food banks give out five days’ worth of food or less and restrict assistance to once a month (Food Banks Canada 2010b). Additionally, in 2010, 35 percent of its members reported running out of food, 50 percent had cut back the amount of food they provided to their clients, and 12 percent had turned away clients who had come seeking assistance (Food Banks Canada 2010b).
Some of the barriers to food bank use identified by our study participants could be addressed by modifying food bank operations. For example, food banks could make people aware of their services through outreach activities, increase the accessibility of their services (e.g., by extending food bank hours or providing assistance with transportation), and provide clients with more variety, more choice, and better quality food assistance. Alternative program models could also be developed to provide food assistance to needy families in less stigmatizing ways. However, such changes require resources, and this system is defined by a reliance on donations and volunteer support.
It is common practice for food banks to accept donations of food that cannot be sold from producers, manufacturers, and retailers,8 resulting in the distribution of foods deemed unacceptable or undesirable by the general public. This practice is enabled by the “Good Samaritan Laws,” which were enacted in the 1990s in most provinces and territories and establish that individuals and corporations that donate food are not liable for any injury or death that result from consumption of such food. Food safety is a concern, as indicated by Agriculture and Agri-Food Canada’s recent contribution to Food Banks Canada to support the development of a food safety program,9 and by Health Canada’s publication of guidelines for food banks on handling foods of unknown origin and quality (Health Canada 1999). Thus, food bank volunteers and operators are charged with the enormous task of managing food donations with a diversity of potential risks. A study of food bank operations in southwestern Ontario documented food bank volunteers having to spend considerable amounts of time separating inedible foods from edible ones, repacking foods, and making foods “presentable” (Tarasuk and Eakin 2005).
Studies indicate that food bank workers are concerned about the nutritional adequacy of the assistance they provide (Rock 2006; Tarasuk and Eakin 2003). Efforts have been made by individual food banks and national and provincial food bank associations to improve the food distributed by partnering with agricultural bodies, expanding the food-sharing system,10 and increasing efforts to gain monetary donations for food purchasing, but these initiatives are limited by their dependence on the charitable goodwill of donors.
Food bank resources could be augmented by more direct financial or in-kind contributions by the federal and/or provincial governments. Both the United States and the European Union have programs in place that involve the purchase and distribution of market and surplus commodity foods to augment the donated food supplies of domestic charitable food distribution programs.11 However, studies in the United States have reported that only a small proportion of the food distributed through food banks comes from this program (Bhattarai, Duffy, and Raymond 2005; Hoisington, Manore, and Raab 2011), and consistent with the findings from our study, studies of food pantry users in the United States have found a high prevalence of food insecurity among food pantry users (Bhattarai, Duffy, and Raymond 2005; Daponte et al. 1998; Duffy et al. 2002; Martin et al. 2003). The potential for food bank resources to be significantly improved were Canada to implement a surplus-redistribution program is unclear, as is the impact that such a program would have on food insecurity in Canada.
Alternatively, the federal government could create tax incentives to stimulate greater charitable contributions to food banks by individuals and corporations. Food Banks Canada (2010a) has proposed a tax incentive program for corporate food donors and agricultural producers.There are now private member’s bills before the Ontario (2010) and Nova Scotia (2011) legislatures seeking tax credits for donations from farmers in these provinces. Such tax credits could be seen as a “win-win,” potentially improving the quality of food available for distribution by food banks while rewarding food producers and manufacturers for good corporate citizenship. However, we would argue against the direct or indirect investment of public monies in charitable food assistance initiatives in the absence of evidence that this model of intervention can effectively address problems of household food insecurity.
While food bank operations could undoubtedly be improved with a greater investment of public funds, it is important to recognize that the prevalence of household food insecurity in this country is much greater than what the existing infrastructure of charitable food assistance programs can handle. In our study population, for every family who made use of a food bank, there were at least two others with equivalent food needs who did not seek assistance. Moreover, we found no evidence that the families who used food banks received enough help to avoid further hunger even in the short run. These findings suggest that an enormous expansion of operations would be necessary in order for food banks to have any discernible impact on the prevalence and severity of household food insecurity in Canada.
Even if the resources could be found to improve food bank operations, this would not address the resistance that so many families expressed to seeking food charity. Some participants were explicit in their distaste of receiving charity, but the claims of others that they did not need to use a food bank despite having described an inability to meet food needs were also a sign that families were averse to using food charity except perhaps at a time of extreme desperation. In a country where it is the norm for citizens to select and purchase the foods they want to eat, it is unlikely that receipt of food charity will ever be made more palatable through efforts to improve food bank operations.
The results of this study raise serious concerns about the apparent reliance of federal and provincial/territorial governments on food charity as a de facto response for Canadians facing food shortages and argue against further investments in this sector. There is a need for a targeted public policy response to household food insecurity. We would suggest that this response be income based, recognizing that food is one of several unmet needs in food-insecure households.12 An income-based response also has the advantage of being non-stigmatizing, fostering social inclusion and enabling families to manage their food needs independently. It is imperative, however, that any intervention to reduce the prevalence and severity of food insecurity in this country be explicitly designed and evaluated against these outcomes. Income transfer programs like the National Child Benefit Supplement, while effective in preventing some households from falling into poverty, have not been designed to impact household food security status and their effects on this outcome remain unknown. Given the depth of poverty associated with severe food insecurity in this sample and the very high prevalence of food insecurity among families reliant on Ontario Works (welfare) (Kirkpatrick and Tarasuk 2009, 2011), any income-based intervention needs to be designed to alter the circumstances of those living on incomes well below conventional poverty thresholds.
CONCLUSIONS
This is one of the first studies to examine the intersection of food insecurity and food bank use in Canada, and it highlights the low prevalence of food bank use among food-insecure families. Without this perspective, there is an illusion that food banks are an available and utilized response for anyone facing food shortages. The expressed reasons for not having used a food bank in our study population showed both resistance and inability to use food banks. Taken together with the evidence of recurrent food insecurity among food bank users, these findings suggest that a food charity model cannot be relied upon to alleviate household food insecurity, raising important questions about the continued positioning of food banks as an available response for food-insecure families and highlighting the need for a public policy response to food insecurity in Canada.
Footnotes
1
Through the 1990s, studies were conducted to assess the nutritional vulnerability of food bank users (Jacobs Starkey, Kuhnlein, and Gray-Donald 1998; Jacobs Starkey, Gray-Donald, and Kuhnlein 1999; Jacobs Starkey and Kuhnlein 2000; Tarasuk 2001; Tarasuk and Beaton 1999; Tarasuk et al. 1998) and to explore issues of stigma associated with obtaining food charity (Hobbs et al. 1993; Tarasuk and Beaton 1999). Examinations of food bank practices raised concerns about the nutritional adequacy of the assistance provided (Irwin et al. 2007; Jacobs Starkey 1994; Kennedy, Sheeshka, and Smedmor 1992; Teron and Tarasuk 1999) and the disconnect between charitable food provisioning and client needs (Tarasuk and Eakin 2003), exposing the limitations inherent in a voluntary, donor-driven system of food assistance largely reliant on industry “surpluses” (Tarasuk and Eakin 2005).
2
Examples include the City of Hamilton 2011 Food Access Guide (Public Health Services 2011), City of Brantford Food Bank and Food Cupboard Calendar (City of Brantford 2012), and Region of Peel listing of food banks (Peel Public Health 2011).
3
Examples include announcements from Minister of Agriculture Gerry Ritz (Agriculture and Agri-Foods Canada 2011) and Ontario premier Dalton McGuinty (CBC News 2010).
4
Food Banks Canada was established to support the work of food banks in Canada. Members include the ten provincial food bank associations and their affiliated members. Food Banks Canada estimates that its member food banks and affiliated agencies serve 85 percent of individuals seeking food assistance in Canada. Food Banks Canada programs include facilitating the donation of large volumes of food from corporate partners, education and awareness campaigns and food safety campaigns, as well as research and policy reports (Food Banks Canada 2011a). Of note is that Food Banks Canada is not responsible for coordinating or harmonizing food bank operations.
5
Marginal food insecurity is a designation used to distinguish households that have answered no questions affirmatively on the scale (food secure) from those just below the moderate food-insecurity range. Though not used for monitoring food insecurity, there is growing evidence that households that answer one question affirmatively on the HFSSM are significantly different from households that answer no questions affirmatively (Coleman-Jensen 2010). They share characteristics with moderate and severe food-insecure households such as low income, and also have poorer physical and mental health.
6
As was expected, most households that were food secure simply stated that they did not need to use a food bank in response to the question probing reasons for nonuse in the past 12 months.
7
It is important to note that though individual food banks and food cupboards can be members of larger food bank agencies, operations tend to be determined at the level of the individual food bank. This results in highly variable operations across food banks. For example, food banks may differ with regard to eligibility criteria, intake process, number of times patrons can use their services, amount of food given out at one visit, and number of hours they are open per month or week.
8
Invited donations listed on the Food Banks Canada website include the following: non-perishable food close to the best before date, incorrectly labelled foods, mis-printed packaging, damaged and imperfect items, and bulk ends; outdated promotional items, discontinued products, special runs, packs where Purchase Orders have been cancelled, or other inventory to be cleared out; incorrectly weighed or measured foods that cannot be resold; and product returns or shipping errors that require pick-up (Food Banks Canada 2011b).
9
On 2 April 2010, Agriculture and Agri-Food Canada announced the investment of more than $850,000 for a food safety training program for Food Banks Canada (Agriculture and Agri-Foods Canada 2010).
10
“Food sharing” refers to the practice of provincial and national food bank associations of collecting large industrial donations and distributing them to food banks regionally.
11
In the United States, the Emergency Food Assistance Plan (TEFAP) is administered through the federal government in conjunction with State Distributing Agencies, who are responsible for the distribution of the food to community-based food organizations (United States Department of Agriculture 2011). In the EU, the “Food Distribution programme for the Most Deprived Persons of the Community” (MDP) has involved the purchase of surplus stocks and market foods for distribution to member states for local distribution to organizations working directly with the “least fortunate people of our society” (European Commission 2011).
12
In this study population, compromises in housing quality were concomitant with food insecurity. Almost half of families lived in crowded housing and one-fifth lived in housing in need of major repair (Kirkpatrick and Tarasuk 2011).
This study was funded by CIHR operating grants (IGP-74207, MOP-77766, MOP-81173) and SSHRC CURA: Neighbourhood Change and Building Inclusive Communities from Within. Rachel Loopstra is supported by a CIHR CGS doctoral award.
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