II Current approaches to health and food insecurity
III Community Food Centres Canada’s Approach
IV The Good Food Principles
VI The Good Food Principles and Health Equity
-- Submitted by Linor David, Program Manager, Community Food Centres Canada
Community Food Centres Canada (CFCC) believes that food can be a powerful tool to promote health and social inclusion. Through a combination of investment and supports CFCC works with organizations to build their capacity to impact on health, food security, and belonging. In 2014, CFCC developed a set of Good Food Principles, a framework that guides community food programs towards a community development and health equity approach to program delivery.
II Current approaches to health and food insecurity
In order to improve population health, it is necessary to address the social determinants of health, including food security. Diseases such as diabetes, cardiovascular disease, cancer, and osteoporosis are all identified as being diet-related (World Health Organization, 2015). Food insecurity also places a financial burden on the health care system: annual healthcare costs are 76% higher for severely food insecure households as compared with food secure households (Tarasuk et al., 2015). As a response to food insecurity, emergency food programs such as food banks distribute food. In Canada, an estimated 1.8 million people accessed a food bank in 2014 (Food Banks Canada, 2014). The earliest meal programs and food banks grew out of a religious, charitable response to hunger (Poppendieck, 1998). In many of these cases those in need were positioned as receivers versus givers, and for people using food banks, it is still not unusual to feel stigmatized or ashamed to be reliant on charity (Poppendieck, 1998, Tarasuk & Beaton, 1999). Although emergency responses to hunger can temporarily alleviate need, without larger scale changes to income, housing, and employment, food insecurity will not be solved. For CFCC, sharing and encouraging ways to address food insecurity in an empowering manner that calls on systemic change is at the root of our mission.
Across Canada, a patchwork of community kitchens, community gardens, affordable markets and other community food programs exist, where people gather to learn, eat healthy foods, and connect. Poverty and social isolation are linked, with lower income Canadians across age groups feeling a lower sense of community belonging and experiencing more social isolation and exclusion than higher-income people (Stewart et al, 2009). These programs offer low or no cost healthy environments where people can meet and grow their social network. Many of these small-scale community initiatives operate without core funding or ongoing supports. Working with community food programs to increase their impact on health and belonging is also a key way CFCC envisions addressing the interconnected health issues that low income communities face.
III Community Food Centres Canada’s Approach
Since 2012, CFCC has been developing resources and supports for community food programs and partnering in developing Community Food Centres across the country. CFCC grew out of the model of The Stop Community Food Centre, which began as a small church-run food bank and expanded into a multi-pronged intervention to address food insecurity, reduce social isolation, and build community engagement (Saul & Curtis, 2013). The Community Food Centre model has three pillars: 1 – increase access to healthy food to address the emergency food needs of people; 2 – provide opportunities to learn and share food skills like cooking and gardening which enable people to make changes to their diets and have better control over the foods they consume; and 3 – promote civic engagement to build community leadership and address systemic issues. While CFCC continues to support the growth and development of Community Food Centres across Canada, in order to have greater impact CFCC also works more widely.
CFCC provides training, resources and grants through a membership program called the Good Food Organizations (GFO). The GFO program works with community food programs to adopt an approach rooted in equity, social justice, and community development, framed by a set of Good Food Principles. There are currently 105 GFO member organizations representing the broad range of community food programming in Canada, from urban agriculture projects, community health centres with robust food programming, and university food banks. The program builds capacity but also creates a movement of shared identity and purpose. Lastly, CFCC has a wider knowledge exchange strategy that includes webinars and a website called “The Pod” where manuals, videos, and materials can be found.
IV The Good Food Principles
CFCC’s five Good Food Principles were developed in part to frame a community development approach to food program delivery as opposed to a charitable one. In the community development approach the community accessing the programs or supports are viewed as active participants with as much to give as they receive. Community members are involved through initial consultation, volunteering, and sharing skills and knowledge. The Good Food Principles form the backbone of a set of resources that help organizations assess how they are currently delivering programs and set goals for the future.
Principle 1. ‘Taking action from the individual to the systemic’, insists that working for change needs to happen at the individual, community and system-wide level. This means working across program areas to provide many points of connection for community members, from addressing basic needs to getting involved in the big picture issues that impact communities.
Principle 2. ‘Believing and investing in the power of good food’, centres food as a powerful lever of change and maintains that accepting handouts and serving unhealthy and unappetizing food is no longer good enough.
Principle 3. ‘Creating an environment of respect and community leadership’, recognizes that dignity needs to be at the root of services and that ways to empower and encourage community voices and participation need to be developed.
Principle 4. ‘Meeting people where they are at’, addresses access and equity. It calls on organizations to make programs open and accessible, based on the needs and capacities of those they are trying to serve.
Principle 5. ‘Aiming high for our organization and our community’ asserts that impactful programming and organizations need to be well resourced and it is essential to invest in fundraising, evaluation, and communications in order to build the necessary capacity to sustain programs.
V The Good Food Principles and Health Equity
In addition to community development, the Good Food Principles also address health equity. Health equity is defined as “The absence of avoidable or modifiable differences in health among populations or groups defined socially, economically, or geographically. These measurable health differences arise from underlying levels of social advantage/disadvantage, show a consistent pattern across the population, and are considered to be unfair.” (PHAC, 2014) The Good Food Principles address health equity through encouraging organizations to understand what barriers to health and services certain groups face and to develop accessible, relevant programs based on assets and needs. The Good Food Organizations membership program encourages organizations to form targeted interventions to improve the health of a particular group rather than blanket interventions which tend to leave out more marginalized groups. Through an emphasis on moving beyond individual problems into looking at systemic issues the Good Food Principles address the social conditions that lead to health inequities. Using the Good Food Principles helps organizations foreground systemic change, community leadership, and accessibility.
CFCC has found that organizations using the Good Food Principles have shifted their practices to include a health equity and community development lens when developing their programs. Our annual surveys find that the organizations we work with use the Good Food Principles as a tool to work with their board, volunteers, and staff on implementing change. The Good Food Principles are available in a poster form so that there is a physical reminder of the framework the organization is aspiring to.
We’ve heard that the Good Food Principles and associated resources and training from CFCC have led to tangible changes to policies and program delivery. In 2016, 88% of Good Food Organizations surveyed said they dedicated more staff or volunteer time to leading or contributing to education and advocacy initiatives that impact poverty and food security; 89% had made more fresh, healthy food available to program participants; and 81% had increased leadership opportunities for participants within their programs or the broader organization. Of particular value to health equity, 71% of respondents have increased their formal mechanisms to evaluate the extent to which their programs are serving the needs, priorities, and preferences of participants, and 63% have increased the material supports to enable low-income and marginalized people to participate in their programs. The Good Food Principles and associated resources provide an avenue for reflection for staff and board, and have been used as part of strategic planning.
The Good Food Principles have the potential to form a new framework for community food programs that disrupt the traditional charitable framework and use a community development and health equity approach instead. These aspirational principles are accompanied with practical training, resources, and facilitated opportunities to learn from other organizations in order to share promising practices and provide implementation tools. This shift has some very tangible benefits, such as the increase of healthy foods being served in programs, but it also increases communities’ power and motivation to address the systemic issues that underlie food insecurity and income inequity.
Health promoters in community agencies can use the Good Food Principles in a number of ways. Within their own organization the Good Food Principles can be employed as a lens to reflect on the current programming and set goals. Also, when working with community partners, the Good Food Principles and the associated program reflection guide can be included in the range of tools used to help partners assess their own programs. CFCC’s Good Food Organizations program accepts new members annually and is open to organizations currently running community food programs. For organizations looking for publically accessible resources, CFCC hosts regular webinars and has a knowledge exchange website called “The Pod” where information on the CFC model and on developing community food programs is available.
Although within health promotion it is understood that food security is a key social determinant of health, many food programs still run in isolation. Viewing community food programs as part of a larger population health intervention could help ensure that the key lens of health equity is applied to people when they most need it. Community food programs provide a crucial health intervention to a significant segment of the population, and understanding how to leverage that and share promising practices across fields can lead to better outcomes for communities.
The Pod http://thepod.cfccanada.ca/
Good Food Organizations http://goodfoodorganizations.ca/about/
Community Food Centres Canada’s Good Food Principles http://goodfoodorganizations.ca/wp-content/uploads/2016/08/GFO-Good-Food...
Community Food Centres Canada https://cfccanada.ca/
PROOF Food Insecurity Policy Research http://proof.utoronto.ca/
Beyond the Emergency: How to Evolve your Food Bank into a Force for Good. (2017) Community Food Centres Canada. https://cfccanada.ca/news/food-banks-force-for-change
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Public Health Agency of Canada (2014). http://cbpp-pcpe.phac-aspc.gc.ca/
Poppendieck, Janet. Sweet Charity?: Emergency Food and the End of Entitlement (1998). New York, NY: Viking.
Tarasuk, V.S. and Beaton, G.H. (1999). Women’s Dietary Intakes in the Context of Household Food Insecurity. The Journal of Nutrition 129(3): 672-679.
Saul, Nick, and Andrea Curtis. The Stop: How the Fight for Good Food Transformed a Community and Inspired a Movement. (2013). Brooklyn, NY: Melville House Pub., 2013. Print.
Stewart, M., Reutter, L, Makwarimba, E., Veenstra, G., Love, R, & Raphaelf, D. (2008). Left out: Perspectives on social exclusion and inclusion across income groups. Health Sociology Review, 17(1), 78–94.
World Health Organization (2015). Diet, nutrition and the prevention of chronic diseases: Report of the joint WHO/FAO expert consultation. Retrieved from http://www.who.int/dietphysicalactivity/publications/trs916/summary/en/