Food Insecurity Issues For Preschool Children

In Southern Alberta:

A Regional Assessment October 2004

by

Chinook Kids Food Security Coalition

Acknowledgements

Regional Assessment Project Team: Westwind School Division Fort Macleod Society for Kids First Womanspace Resource Centre Chinook Health Region: Population Health Department Wellness & Community Health Department

Project Team Contributors:

S. Cahoon N. Hatch L. Penner H. Caldwell H. Komar R. Reach B. Curran D. McKenna R. Renwick S. Donahue C.J. Meyer S. Scovill T. Forbis

Thank you to those community agencies and stakeholders who agreed to take part in the telephone surveys. Your input and contributions were greatly appreciated. We hope that by working together, we can all find ways to ensure children in our region are well-nourished; food secure and well prepared to develop into healthy well adults. Thank you also to Shawna Berenbaum, University of Saskatchewan and Eunice Misskey, Qu’appelle Health Region for sharing information and materials on their Voices on Food Insecurity Project. Contact Information:

Stasha Donahue Chinook Kids Food Security Coalition/CHR Population Health Department Phone: (403) 553-4451

Lessons Learned: It is hoped that this study will provide information which supports and builds on the strengths and positive strategies of young families living with food insecurity and aids in eliminating some of the systemic barriers which may hinder families from adequately feeding their children.

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Executive Summary This qualitative assessment was undertaken to discover the concerns, situations, and coping strategies of families with young children who may be struggling with food security issues within the Chinook Health Region. By sharing their experiences and insights, these families along with professional care workers and concerned community stakeholders, provide a pragmatic framework for recommendations toward lessening food insecurity. Summary from Key Informants (Community Stakeholders) Key informants identified a number of perceived issues for low-income families with children 0-5 years of age related to food security. Inadequate income was frequently cited as a reason for inability to provide healthy foods in several of the questions. Coping strategies identified frequently included assistance from relatives and food banks. Parents experienced negative feelings about their inability to cope. In some cases, key informants indicated parents experienced negative reactions from food bank service providers. Parents also cope by replacing healthy food choices with cheaper less nutritious options and going without other items in their lives. Lack of transportation limited families’ abilities to access programs and services. Lack of knowledge on healthy food choices and options was also cited as an issue for low-income families with children 0-5 years of age. Summary from Participants

• most common strategy to cope with lack of food in families is to eat at ‘grand-parents’ home for supper, then other available relatives or friends

• many families use food banks where available, both for hampers or various supplies that are available (most common complaint was the quality of the food, little variety of produce and mostly past the best before date, many families have to throw out moldy food items)

• many families, especially single moms, have transportation issues. They cannot get to the free food, they have difficulty getting groceries and hauling children about

• many single moms make sure that their children eat first; themselves second • nutrition: fast food seen as an inexpensive way to cope, Ichiban type noodles very

common and many lack fruits/vegetables • stigma is an emotional hardship for many to cope with on top of food insecurity

issues, though some do not have any difficulty accepting help • many single moms coping with “dead beat dads” • many young single moms coping with housing issues, need more budgeting/

practical skills • provide voucher services mid-month to help stretch out resources • volunteer services for food bank deliveries • dental care is a real difficulty on low income • transition times from relocation to school or work very difficult • student families on low income have difficulties balancing everything • LDS (Mormon) member families make use of Bishop’s Storehouse/Warehouse

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Introduction Poverty affects about one in five children in Canada and in southern Alberta. In the Chinook Health Region (CHR), this rate is consistent though some communities have been noted to have higher than regional rates of child poverty. Children who live in poverty are at risk for a range of negative effects including food insecurity. Food security is widely described as the condition in which all people at all times can acquire safe, nutritionally adequate and personally acceptable foods in a manner that maintains human dignity. Food Security can be addressed on three different levels (Kalina, L, 2001): Stage 1: Short Term Relief These actions provide immediate and temporary relief to hunger and food issues. These activities are often completed with little involvement from those experiencing food insecurity. (Examples: food banks, soup kitchens) Stage 2: Capacity Building These actions are often more costly in terms of time and manpower and require commitment from those experiencing food insecurity, but are steps to empowering those experiencing food insecurity. (Examples: community kitchens, community gardens, food buying clubs) Stage 3: Redesign Redesign actions are broader in scope and require a long-term commitment from representatives of the entire food system, including, in particular, those marginalized by the system. As such, redesign actions are often the most costly, time-consuming and difficult to mobilize communities to pursue. Redesign actions focus on addressing problems thought to be underlying food insecurity. This is often thought of as working “upstream” to create system change. (Examples: food policy, social advocacy to address poverty). “It is movement along these three stages that measures success, not being at a particular stage.”

Food Security Continuum – Laura Kalina, 2001 Food insecurity refers to the absence of aspects of the above definition and frequently involves deprivation and insufficiency. It is also a predictor of nutritional deficiencies (e.g. anemia), poor growth and development, childhood obesity and the development of chronic disease in later life such as diabetes. All of these contribute to health and social costs in our communities and society as a whole. In 2002, an assessment of food security for school aged children was conducted in the Chinook Health Region. Almost 4,800 students in grades 4 to 12 were surveyed. Results indicated that 11% (528 students) said they did not have enough to eat most of the time in

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the last 3 weeks. Three percent (3%) said their families could not afford to purchase enough food and 4% were hungry because the family had insufficient funds for food. Five percent (5%) said that they often worry about having enough food. Factors that contribute to child hunger include:

• Growing gap in income between rich and poor families • Stagnant and decreasing family incomes • Inadequate minimum wage level • High cost of housing • Reduction of social assistance allowance and other government transfers

Following release of results, presentations were made to school boards in the region. A regional coalition was then formed to further identify issues and possible action strategies for children’s food security. One of the issues identified was the lack of information on food security for preschool aged children. Given that these years are crucial for healthy growth and brain development, it was determined that an assessment of this age group was needed. After reviewing literature and available tools, the project team decided to conduct an assessment modeled after one done in Saskatchewan. Voices on of Food Insecurity, a collaborative project of the University of Saskatchewan and Regina Qu’Appelle Health Region was conducted in March 2003. Methods This assessment involved information gathering from two groups: 1) Community stakeholders who work with low income families with children 0-5

years of age and, 2) Low-income families with children 0-5 years of age. To simplify the data collection process, 9 communities indicated by CHR Population Health Information to have lower income levels were selected as sites for data collection. These communities were the same as those included in the school aged food security assessment conducted in 2002/2003. Based on population data, quotas were set to assist in recruiting representative numbers of low-income families to participate in the assessment. Public Health Nurses and other community partners were asked to assist by referring families who wished to participate. In exchange for participating, families were given $15 grocery certificates. Face-to-face interviews were then conducted by a contracted interviewer at a time and place convenient for the family. Seventy-three (73) families took part in the assessment. Community stakeholders were identified by Public Health Nurses and project partners working in the communities. Telephone interviews were conducted by project team members and Population Health Department staff. Fifty-nine (59) community stakeholders took part in the assessment.

Limitations and Challenges Due to the method of sampling low-income families with children 0-5, results cannot be generalized to the population in the region. The results do however provide an insight to the issues, challenges, and coping strategies young families face. Recruitment of families for participation in the assessment also proved challenging. Several families lacked access to a telephone, had their line disconnected or relocated during the information gathering period. Occasionally, the method of recruitment produced participants whose income and/or family composition were not compatible with the target population. However, these participants were asked to speculate on or to describe the situations of anyone they knew who may be facing food insecurity problems and had small children. The participants with only one infant child also had some difficulty answering the questions and were asked to speculate on what the future might bring in terms of feeding their child. In areas where participants from the supplied lists were difficult to find, interviewees were asked if they knew of anyone who fit the criteria and who might be willing to participate. This method of recruiting provided access to participants who had less direct contact with Public Health Nurses or related programs in their communities. With regard to community stakeholders, challenges also arose in terms of scheduling telephone interviews. Several participants cited they were unable to participate due to work/time constraints. Due to the sensitive nature of the topic, a few community stakeholders refused to participate. The survey tool also proved to be somewhat confusing and questions repetitive in the minds of respondents. Part One: Results Perceptions of Others

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Fifty-nine (59) community stakeholder key informants from Cardston, Crowsnest Pass, Fort Macleod, Lethbridge and Raymond took part in telephone interviews. A list of possible key informants was developed with assistance of local Public Health Nurses and partner groups associated with the Chinook Kids Food Security Coalition.

I was asked if soaking egg shells in water would be a source of calcium for children

-Community key informant

From these communities a total of 63 surveys were completed, however 4 surveys were excluded from the analysis as the respondents did not have direct contact with young families in low-income communities.

When asked to indicate what signs you see that there are young children in your community who are not receiving enough nutritious food, the most common response categories were as follows:

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• 44% (n=26) child’s physical appearance (e.g. underweight, pale) • 41% (n=24) see inappropriate food in lunches and preschoolers familiar with fast

foods • 22% (n=13) children or parents asking for food or going without

Respondents were then asked to estimate how widespread the problem was (low, moderate/high or very). Response on this question was inconsistent. Thirty-seven percent (37%) indicated they felt the problem to be “low” whereas 34% indicated they saw the problem as being “very” widespread. This inconsistency may be due to lack of understanding of the question-e.g. “widespread” as a term. Respondents were then asked to identify how severe they felt the problem to be. Fifty one percent (51%) estimated the problem to be “severe” with only 2% responding “not severe”. In response to the question what trends have you seen in recent years, 61% indicated worsening trends. Respondents were then asked to identify barriers families face in providing food for their young children. The top 3 grouped response categories were as follows:

• 27% (n=16) lack of adequate income and food costs • 19% (n=11) lack of knowledge about nutritious food • 17% (n=10) transportation

Respondents were then asked questions about their perceptions of food security concerns in the context of income management. When asked what financial issues are affecting the ability of families to feed their young children, the most common grouped responses were:

• 48% inadequate income (minimum wage/low income, SFI, unemployment) • 14% high cost of living and food • 14% lack of knowledge (e.g. budgeting and nutritious food buying)

When asked what strategies young families use to stretch their food money, the most frequent grouped responses were:

• 29% specific food purchase/use modifications-filler foods, cheap foods, water down formula, etc.

• 24% food banks/emergency food hampers • 22% go without food or other expenditures

Respondents were then asked regarding perceptions of young families in poverty - how do they cope when they are short of food?

• 27% use food banks/churches or Bishop’s warehouse1 • 21% go without food or other expenditures • 19% ask friends/family/neighbours for help

1 The Bishop’s Warehouse is an LDS (Mormon) church food bank charity that is used exclusively for LDS members who are in financial need.

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Community stakeholders were then interviewed using questions designed to elicit responses related to food acquisition. In response to the question what difficulties do young families face when shopping for nutritious food, the following were the most common grouped responses:

• 15% cost of nutritious food • 14% lack of knowledge (i.e. What is nutritious with regard to fast food

marketing?) • 12% lack of transportation

When asked to indicate behaviours which may suggest parents are worried about their ability to feed their children, the following were the most common grouped responses:

• 17% emotional/mental health concerns (e.g. depression/anger) • 8% try to hide the situation • 5% voice their concerns and/or seek assistance

Stakeholders were then asked what methods of obtaining food families resort to. The top three responses were:

• 27% food banks • 12% seek support from family • 12% illegal acquisition- i.e. theft/poaching

Eighty–three percent (83%) of stakeholders indicated they perceived that families had negative feelings about the above methods. Questions were then asked with regard to food management. When asked to what “extent” young children receive foods that are poor nutritional quality, 24% reported “moderate” or “extensive” amounts. Further to that, stakeholders were asked what reasons parents would have for giving such foods. The following were the most frequent responses:

• 19% lack of knowledge • 16% restricted income/food costs • 16% time constraints/lack of time

Community stakeholders were then asked to share their opinion regarding how knowledgeable they felt parents are about the nutritional needs of their young children. Thirty-nine (39%) percent indicated “low level of knowledge”. In response to the question, “how aware are parents of the food programs available in this community” 37% indicated they felt them to be “very aware” and 27% “somewhat aware”.

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Existing Programs and Services The last set of questions was related to existing programs and services in their community. A list of the most common responses can be found below. Programs and services provided by interviewee’s organization addressing nutrition for vulnerable children 0-5 years of age:

• Community Kitchens (17%, n=10) • Better Beginnings- i.e. coupons (10%, n=6) • Good Food Box (5% , n=3)

In conclusion, stakeholders were asked to identify what gaps they saw in programs and services for children aged 0-5 years of age as well as what additional services they thought would help this group of children. Most common responses are again listed below. Gaps 22% indicated this age group is difficult for providers to access 19% feel that they are not able to connect with those most in need 14% indicated lack of knowledge/life skills for parents 12% indicated lack of transportation for low income families 12% communication gaps between service providers What would help? 33% nutrition /parenting/life skills education for parents 24% more Community Kitchens 10% improved communication among service providers Part Two: Real Life Experiences This section provides a profile of the participants and an exploration and analysis of the experiences, circumstances, strategies, and barriers faced by families with young children as they try to meet their food needs. Profile of Participants Demographic information was collected on all the participants. Sixty-nine of the participants were mothers of at least one preschool child, two were grandmothers, one was a father, and one was an aunt. Sixty-four (64) participants were between the ages of 20-39 years, six were less than 20 years, and three were between the ages of 40 and 59 years. (It should be noted, however, that narrower ranges within the age categories would have made it possible to discern the age of the participant when she had her first child.). Fifty-eight (58) of the participants had a partner, while 15 were single. Information on income level, main source of income, education levels, and family structure was also gathered. Table 1 indicates that 50% of participants had income levels of $1,600/per month or less. The consistency and nature of the income was definitely

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affected by the participant’s current employment, family structure and size, and living arrangements. We can further describe lone-mother families with different family structures: 1) lone-mother families living alone, 2) lone-mother families living with family and 3) lone-mother families living in a shared household (S. Yanicki, 2004).

NOTE: Lone-mothers living alone had less overall income than those with family or household support.

Table 1: Monthly household income of participants

Monthly Income Number and Percentage of Participants Under $800 7 10% $800-1,200 10 14% $1,201-1,600 19 26% Over $1,600 33 45% Do not know/ choose not to answer 4 6%

Table 2. Number and percentage of participant with 1 or more pre-school children

Number of Children Less than 5 years old

Number and Percentage of Participants

0 (participant pregnant) 3 4% 1 child 41 56% 2 children 22 30% 3 children 7 10% Table 3. Number and percentage of participants and level of education

Education Level Number and Percentage of Participants Less than high school 22 30% High School (Gr. 12 or GED) 15 21% Some post secondary 25 33% University degree 11 15% Vocational training 1 1%

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Table 4. Number and percentage of participants and source of income

Income Source Number and Percentage of Participants Social Assistance 9 12% Wages 48 66% Disability or Old Age 1 1% Other (i.e. Self Employment) 15 21% Table 5. Number and percentage of participants and age range

Age Range Number and Percentage of Participants Less than 20 years 6 8% 20-39 years 64 88% 40-59 years 3 4% Table 6. Family structure of lone-mother families

Family Structure Number and Percentage of Lone-Mother Families

Living alone 6 40%

With family 8 53%

Shared household 1 7%

Quotes from Interviews: Lived Experiences

The semi-structured format of the interview guide offered a starting point to discuss major concerns and lived experiences from the participants. Major themes emerged from the data such as family support, coping, income management, dietary concerns, program support and barriers. Interviewer Comments

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“The time I spent with the participants left me with sentiment that most of the people with food insecurity issues that I spoke with are concerned and capable individuals. They have met their circumstances with creativity and resilience, and would welcome any opportunity to improve their situations for their children’s well-being. They valuethe support of community programs but are at times caught in the discontinuity between differing levels of programs and/or access to formal social support. Food insecurity stems from a number of different factors and cannot be separated from the context that people live in. Some 220 pages of dialogue were generated from the transcripts of the interviews. The following quotations from the participants highlight major themes and elucidates the urgency of their day to day reality”. (N.B. The following quotations are taken directly from taped interviews)

nterviewee Comments

amily Support:

“My dad was laid off and we went through hard times. My parents know what it is like and if they can help, like sending us some money, they will. Same with XXXX’s parents. They are very helpful too. We know that if we need to borrow $20 for milk we can. We have to pay it back but…so working on paying everybody back is the hard part. And everybody has been understanding about it too which is wonderful. We’ve always had the family support, like Christmas we didn’t have to buy anybody presents other than the kids. Nobody expected any…we were having hard times.”

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Coping:

I: How do you cope with that? “You just accept it. It’s just part of being in that minority group. Sometimes you can try and argue with the assistance but because they’re cutting back there no, nothing that they can really do…To get a job then they start garnishing you because of your job. So what is the use of getting a job when they are going to take money off?” I: So you are in the same position as before you got the job. “Yes, it deters people from find a job.” I: Except then you have to find child care to go along with it. “Yup, the after transportation, gas money, money for the insurance, tires, if something goes wrong. It all starts the ball rolling. So usually instead of making any wages, you just want the waters to be calm so you don’t do anything. That the thing to then, when that happens you’re just stuck there. You don’t go any where, you’re just stuck. I think that is why our people resort to stealing…that the only way they can make it.”

Program Barriers: Dental

I: Do you have any support for anything like that? Child, Alberta. I can’t recall what the program is but you can get different levels of support or coverage through the Alberta government. “No…the health unit used to have a dental…for the two oldest they were able to get their check-ups…and toothbrushes. I used to love those toothbrushes, I just can’t find them anywhere so…The youngest, he was able to get one check-up in before they closed (They closed the program?)…yah, it is too bad because that made us, that showed us that he has cavities, he needs to go get a check-up and now it is harder to do that…you don’t know when you should bring them in (and just a check-up is pretty expensive)…so I try to, it is not always healthy…”

Fast Food:

I: Biggest concerns about feeding? Speculate? “…cost, it is cheaper to go to XXXX and I know a lot of people that do that. (It is cheaper to go to fast food restaurant?) yah, than to make…meat, etc. It is cheaper to go and buy a $2.99 crappy meal…and that is the thing, it is easy, the kids are happy and then you don’t have to make dinner. Hopefully, I am going to try to avoid that…time, money…I’m going to try to avoid it because if they never get it they never want it…try to do what we can to get real food.”

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Mom Feeds Children First and Not Eating Properly While Pregnant: Mom Feeds Children First and Not Eating Properly While Pregnant:

I: Is there ever a time when there is not enough food? “…when it was really bad, when it was just myself When I was by myself I was trying to find a job because I was on social assistance… I: was that before you had the kids? “No, in November…I did a budget, my bills at the time were really cheap …and being by myself I had the child cheque coming in so I would use that for groceries and then the food bank. By that time I had him so there was another mouth to be…there were time when I would did go and I didn’t eat anything because I wanted it for the girls (And you were pregnant at the time?) “Yah, I just kind of loaded up on my vitamins and stuff.” I: strategies? Anything you are proud of? “…dole it out proportions…school snacks…don’t buy it unless I need it…but the kids taste change and you buy it and they don’t like it anymore..” “…daughter asking it she can drink milk because I have said it was so expensive…if we run out we go without…

Part Three: Recommendations Food security and healthy eating is a necessity for healthy growth and development. Despite perceptions of poverty and food insecurity being issues for third world nations, the issue and related effects is a concern in Canada and southern Alberta as well. Policy makers, service providers and community members need to discuss the issue and identify appropriate strategies and policies enabling all children and young families’ access to healthy eating-regardless of income.

Some of the issues that emerged from this assessment were those identified in other similar assessments and studies. Many of the issues are linked and interconnected to others. The complex nature of food security implies the need for a variety of approaches that both address root causes (e.g. poverty) and offer assistance to those in need. Strategies and policies at the local, provincial, national and international levels, which address social determinants of health such as poverty, housing, employment etc., need to be revised and/or enhanced to reflect the current situation for Canadians in both urban and rural settings.

“…the general public who aren’t on assistance or who aren’t struggling financially tend to turn a dead ear to all of that. They don’t want to hear it. It is too ugly for them. They just pretend like it is not happening.”

- Face-to-face Interviewee

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Based on information obtained through this assessment, the following recommendations in the context of young food insecure families in south western Alberta have been made. Awareness of Food Security Programs and Services Many families who are affected by food insecurity are unaware of existing programs and services that can assist them in enabling healthy eating for their families. Service providers need to ensure program information is communicated such that it meets the needs of the audience in need. Disseminating information to front line family and social service providers, child care providers, pre-school providers and others who work with young families will ensure the referrals can be made more easily. Communication and cooperation between community agencies and groups are essential to ensure the best possible service provision for young families and children. Food Bank Services Both key informants and interviewees indicated that food banks are a source of relief for food insecure families. The first food bank in Canada appeared in 1981. Today there are over 635 food banks across the country with an additional 2000 agencies and groups helping hungry people nation wide. Thirty-nine percent (39%) of food bank recipients are children. Estimates suggest that almost 60% of households accessing food banks are families with children. In Lethbridge, the Interfaith Food Bank hamper statistics indicated high use by children. Food hampers for May 2004 were 819/month helping 1,240 adults and 1,014 children…food supplements for May 2004 were 1,010 helping 1,580 adults & 1,377 children (Interfaith Food Bank, 2004). Overall, most food bank recipients receive social assistance; many others are working poor, receiving disability or income support such as Employment Insurance.

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Food banks rely on donations for their supplies and therefore are often unable to provide hampers that meet the nutritional needs of young families and children in terms of infant feeding supplies, fresh fruit and vegetables, meat and dairy products. Additionally, food banks do not offer standardized food hampers thus the nutrition quality can often be poor, e.g. potato chips, donuts, Oreo cookies. Partnerships with other groups in the community could enable food banks to obtain produce from community gardens and/or the local agricultural community. Partnerships with Nutritionists and Public Health agencies can serve to enhance food bank capacity to deliver programs and services.

“Food Bank. Absolute last resource. I have done that once last year…I lost my job when I was pregnant. I quit and stuff and welfare wouldn’t help us because my EI was coming in… It was a tough time.”

- Face-to-face Interviewee

Food banks are considered short term relief services in the food security continuum. Though recipients can receive assistance from food banks, does not address root causes of food insecurity nor does this typical form of assistance alone serve to build capacity and networks among recipients.

Regardless, food banks are in a unique position to facilitate development of skill building programs for vulnerable children and their families. Additionally, the LDS church contributes resources like a food bank through the Bishop’s Warehouse. Food bank directors need to work with others to expand options and supports they offer to young families including programs such as community kitchens, parenting support etc. Transportation and child care needs also need to be considered. Advocacy for adequate income, transportation, and child care is a responsibility food bank users need to become aware of and skilled in. Transportation and Childcare

I: Community kitchen group? “…transport is a problem. I haven’t quite taken the bus yet. So I might take part…” - Face-to-face Interviewee

Lack of transportation wanutritious foods by both and community stakeholdyoung families who experaffected by poverty. transportation and child access to food supplies ankitchens and gardens. Stcollaboratively developedchild care barriers are oveallocations for such expen

transfer payment programs such as Supports For IndepInsurance (Parental Leave) appears to be warranted. Overall, quality early childhood education and care sernational strategy to reduce poverty. Early Childhood Efoundation for learning for all children, supports the spromotes equal opportunities for women in the labouNational Campaign to Reduce Child Poverty in Canadthan 70% of young children have mothers in the paid laages 0-12 years have access to regulated child care spmoderate to low-income families from enrolling their Federal, provincial and local policy makers need to universally accessible, high quality Early Childhood developed. Local service providers and young families nand programs and become involved in the development p Transportation and physical access to support and pAgain, costs and inadequate income pose barriers and nethrough innovation and long-term policy changes. Locall

“That is the point when I get upset and cry and make him go talk to the bishop and see if we can get food from the church. Which he hates doing. It has been so long with the same need feeling like we have been a burden forever.”

- Face-to-face Interviewee

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s cited as a barrier to obtaining face-to-face survey respondents er key informants. Most often,

ience food security are also those Inadequate income limits care options thereby limiting d programs such as community

rategies and policies need to be such that transportation and rcome. Review and revision of ditures enabling access through endence (SFI) and Employment

vices are lacking in a long-term ducation and Care strengthen the ocial needs of all families, and r market. Campaign 2000, A

a reports that even though more bor force; only 12% of children aces. High costs prevent many children in regulated programs. work together to ensure that a Education and Care program is eed to advocate for such policies rocess.

rograms are repeated concerns. ed to be examined and addressed y, cities and municipalities need

to acknowledge their responsibility in providing access to transportation for community members. In rural settings, transportation needs are often overlooked despite lack of formal services and or resources. Community groups and agencies need to discuss options while advocating for development of appropriate and sustainable transportation policies at the local, provincial and national levels. In the absence of long-term changes related to child care and transportation, food security service providers need to consider and allow for overcoming these issues in their program development and budgeting. Partnerships and/or strategic alliances that may help to overcome these barriers need to be explored and nurtured. Adequate Income

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I: What would make it easier to feed your kids? “Probably being able to afford more. …Once I start working and stuff that will probably go back to normal…when I know what I am getting each month i will be easy to budget but there are things that I can’t afford…like my youngest birth certificate”

t

- Face-to-face Interviewee

Young families who experience food insecurity are also those affected by poverty. Regardless of the source-wages or transfer payments from programs such as SFI (Supports for Independence) AISH (Assured Income for the Severely Handicapped) or EI (Employment Insurance), information gathered from young families and stakeholders suggests that adequate income is a growing concern-not only with regard to food security, but other areas as well –e.g. housing, child care and transportation. Despite Alberta being one of the richest provinces in Canada, minimum wage

remains one of the lowest in the country at $5.90/hour. Most often, minimum wage earners are women, young people, students and part-time workers. With rising costs of living including housing, utilities/energy and transportation, minimum wage is not a livable option for young families. As indicated in the Toronto Charter for a Healthy Canada the after tax and transfer income gap between rich and poor grew from 4.8:1 in 1989 to 5.3:1 in 2000. Communities and service providers need to advocate government and relevant Ministries for a living minimum wage that reflects current economic realities as well as enables all families’ access to basic necessities. Transfer payment programs such as SFI, AISH and EI must also be reviewed and adjusted to reflect current realities. Affordable Housing Young families affected by food insecurity often have issues in other areas including access to affordable housing. Lack of affordable housing weakens a family’s ability to

provide for other necessities including healthy nutritious foods. In 1996, 43% of Canadian tenant households spent more than 30% and 21% of Canadian households spent more than 50% of their income on rent. By 2000, the situation improved slightly with 40% spending more than 30% of gross income on rent (Statistics Canada, 2004 ). Inadequate housing also poses a challenge in terms of food storage and preparation. Lack of working appliances and/or refrigeration/storage units is a reality for many low-income families, and limits their ability to prepare and store nutritious foods and limits acquisition of fresh foods for their children. Communities need to discuss affordable housing options with civic and municipal decision-makers. Provincial and federal governments need to allocate sufficient funding to address the issues at the community level. Social Exclusion/Stigmatization

Most often those affected by food insecurity live in impoverished conditions. Poverty is a key contributor and outcome of social exclusion. Social exclusion based on socio-economic disparities reduces the ability of individuals and families to participate in community and develop social networks. Frequently, those who are excluded face barriers to accessing health and social services and programs. The actual experience of dealing with social exclusion and inequality tends to be stressful and results in negative psychological effects and poorer health (Wilkinson, R., 1996). Collaboration and Coalition Building Many of the recommendations above have examinstrategies and policy change. Inherent in this, as waction, is the notion of collaboration and coalition builcommunity level. Coalition building is not as simple atime and management of risk on the part of formal orgdecision-making and ownership which for some orgovernment, may pose a risk in terms of perceived lack Regardless, food security and related social determinanintertwined and require multi-faceted and collaborativtranslates into a commitment of adequate organizationalocal human service agencies and groups. Coalitionsprovincially and nationally where dialogue and dinitiatives are most likely to occur.

“Food comes first, make sure everybody, we have enough food in the house, then the bills, then anything else, like me to go to the eye doctor…that gets put off and off. And off long enough, it has been three years and I’ve got to go.”

- Face-to-face Interviewee

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ed specific issues and relevant ell as other forms of community ding. Most often this occurs at the s perceived and often requires both anizations. Coalitions imply equal ganizations, particularly those of of control.

ts of health are very complex and e multi-sectoral approaches. This l time and resources on the part of are needed not only locally, but evelopment of long-term policy

Building Local Capacity -Sustainable Food Security Strategies As mentioned, food security can be viewed on a continuum. Stage 1 relates to immediate and temporary relief of hunger and food issues. Stage 2 deals with capacity building and Stage 3 relates to system redesign or policy change. Inherent in all stages or strategies is the importance of building community capacity to address food security and related issues. Capacity building can be referred to as increasing the knowledge, skills and confidence of a group to take action on an issue. This implies identifying existing assets and skills rather than re-inventing the wheel. Time and resources should be allocated to build capacities throughout food security initiatives in any given setting.

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“The clear and indisputable cause of hunger is poverty – not waste, not laziness, and not mismanagement. It is simply people not having enough money to buy food for themselves and their families” (Kalina, L. 2000).

“I’ve called social service. I have called the mental health unit and I told them that I will act like I am losing my mind to get a free voucher for anything. Just tell me what to do and I will do it. I am desperate. And they said, ‘you know what, there is nothing we can do.’

- Face-to-face Interviewee

With regard to developing healthy public policy, communities affected by policy must be involved. This is necessary to make the link between public policy and lived experience. As communities become involved in public policy and gain an understanding for the process, they become

better equipped to influence the policies that address issues such as food insecurity. For this reason, capacity building strategies are essential for building food security through public policy as well as local initiatives. Community organizations and health care providers can offer support to groups by acting as facilitators and resources vis-a-vie the traditional expert role. Trust and egalitarian relationship building must be a priority for professionals wishing to address food security effectively in their community.

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Summary The pre-school years are those where healthy growth and development is of prime concern. Based on information provided by both data sources, we have gained insight on the issue of food security for low-income families with children 0-5 years of age. Food security is connected to a range of other factors such as income, housing and transportation. Inadequate income appears to be the fundamental factor for food insecure families. In order to effectively address food insecurity for young families, community involvement is critical. Strategies must take into account barriers to participation in programs such as transportation and child care. In the long-term, policies affecting income, housing, childcare, and social exclusion must be examined in partnership between practitioners, researchers, decision-makers and the “experienced”-those who have life experience to share and draw from.

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References Alberta Housing Coalition. www.albertahousingcoalition.ca Canadian Centre for Policy Alternatives. www.policyalternatives.ca/ Hunger Count Reports – Canadian Association of Food Banks www.cafb-acba.ca Kalina, Laura (2001) Building Food Security in Canada - 2nd Edition. 2001 Kamloops: Kamloops Foodshare McIntyre, Lynne (2004) Food Insecurity. Cited in Raphael, Dennis (Ed.) 2004. Social Determinants of Health: Canadian Perspectives. Toronto: Canadian Scholar’s Press Roberts, W., MacRae, R., & Stahlbrand, L. (1999) Real Food For a Change -- How the simple act of eating can: boost your health and energy, knock out stress, revive your community, clean up the planet. Toronto: Random House of Canada National Campaign to Reduce Child Poverty in Canada. www.campaign2000.ca Raphael, Dennis (Ed.) 2004. Social Determinants of Health: Canadian Perspectives. Toronto. Canadian Scholar’s Press Raphael, D. & Curry-Stevens, A. (2003).The Toronto Charter for a Healthy Canada. Toronto: York University School of Health Policy and Management and the Centre for Social Justice. On line at http://quartz.atkinson.yorku.ca/draphael. Statistics Canada (2004) “Owner households and tenant households by major payments and gross rent as a percentage of 2000 household income, provinces and territories”. www.statcan.ca/english/Pgdb/famil65a.htm. Wilkinson, R. (1996) Unhealthy societies: The afflictions of inequality. New York: Routledge. Cited in: Raphael, Dennis (Ed.) 2004. Social Determinants of Health: Canadian Perspectives. Toronto: Canadian Scholar’s Press Yanicki, S.(2004) “Social Support and Family Assets in Low-income, Lone-mother Families Participating in a Home Visitation Program” M.Sc. Thesis submitted to University of Alberta.

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APPENDIX A

Available Food Security Services within the Chinook Health Region

Cardston Cardston Elementary School Breakfast & Hot Lunch Program Cardston Junior High School Lunch Program Cardston High School Breakfast & Lunch Program Coaldale Coaldale Food Bank Tuesday & Friday 9:30 am – 1:30 pm St. Joseph’s School Breakfast Program Coalhurst Coalhurst School Breakfast Program Cowley Livingstone School Lunch Program for needy Crowsnest Pass Crowsnest Pass Food Bank Society Tues/Wed 6-8 pm & Thurs 11 am – 2 pm Fort Macleod Salvation Army Food Bank Thurs 1-3 pm F.P. Walshe High School Snack Program Granum Granum School Breakfast as needed & Lunch provided Hillspring Hillspring School Lunch Program – 2/week or as needed Iron Springs Huntsville School Snack & Lunch Program - monthly Lethbridge Community Kitchens Operate September thru June Interfaith Food Bank Mon – Fri 9:30 – 11:45 am & 1-3:30 pm Lethbridge Food Bank Mon – Fri 10 am – noon 1-3:30 pm

Hampers available 6 times per; Supplement hampers available daily

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The Salvation Army Emergency food Lethbridge Community College Emergency food for LCC students by Food Bank app’t only Lethbridge Soup Kitchen Mon – Sat noon meal @ 12 – 1 pm Good Food Club 2nd Thursday of the month pick up

$10/box or individual grocery orders @ wholesale cost

Lethbridge Community Garden 26 Ave 43 St N - $5/yr membership Lethbridge Homeless Shelter Evening meal @ 7 pm Free coffee & tea all day Woods Homes Youth Shelter 312-3rd St S, Lethbridge

3 meals/day for teens living @ shelter; avg stay is ~15 days

Harbour House 3 meals/day for women living @ the shelter;

Breakfast food provided for women to make their own

Native Women’s Transition House 520 – 18th St S; 3 meals/day served for

women staying @ shelter Galbraith School Breakfast Program Gilbert Paterson School Breakfast, Snack & Lunch as needed Matthew Hamilton School Lunch provided for needy students St. Mary’s School Breakfast & Lunch Program as needed Wilson Middle School Breakfast Program Magrath Magrath Elementary Breakfast, Snack & Lunch as needed Mountain View Mountain View Food Bank Nobleford Noble Central Snack Program

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Picture Butte Picture Butte Interfaith Food Bank Tues & Thurs 10 am – noon Dorothy Dalgliesh School Breakfast, Snack & Lunch Program St. Catherine’s School Breakfast & Snack Program Pincher Creek Canyon School Lunch Program St. Michael’s School Snack Program Taber Central School Breakfast Program

Gaps in Services

Emergency Food Providers • Fall short of dairy, fruit, vegetables & meat • Food & Nutrition quality can be poor • Limited hours & poor accessibility • Many communities/towns do not have emergency food services – Barnwell,

Blairmore, Cardston, Coutts, Coleman, CowleyLunbreck/Livingston, Vauxhall/Enchant, Milk River, Foremost, Glenwood, Hillspring/Glenwood, Ironsprings, Lomond, Magrath, Monarch, Nobleford/Barons/Granum, Pincher Creek, Raymond/Stirling, Shaughnessy, Standoff, Taber, Warner, Wrentham

Good Food Club

• Available in Lethbridge only – other communities could participate but transportation costs are an obstacle

Community Garden

• Available only in Lethbridge and Fort Macleod • Only one location in town • Accessibility is an issue for many

Community Kitchens

• Not available in all communities due to lack of facility or person to facilitate Pre-Natal/Post-Natal Services

• Better Beginnings provides milk, eggs and vitamin/mineral supplements to pregnant women and new mothers but there is a lack of food security support for pre-school children

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APPENDIX B

Lethbridge Costing Example

Lethbridge, Alberta Family of Three (Mother on Min Wage with 1 child in Childcare & 1 child in school): Expenses Per Month: $ Amount Nutritious Food Basket—Family of 3 (Feb 2004) $101.15/week $404.60Average Rent (Oct 2003 for 2 bedroom unit) $637-$747 Electricity $60Gas $20-180Phone $26.92Water/Garbage/Sewage $64.14Transportation (Adult: $49.50/mo/Child: $21.75/mo)

$71.25Childcare Costs (per one child) $539.81-$531.38 Total: $1823.72-$2085.29Income Per Month: Full Time Work on Min Wage (2080 hrs/yr x $5.90) $1022.67Child Tax Benefit (AB—2 children) $190.57Child Benefit Supplement $233.82School Supplies Subsidy $4.00-15.00Childcare Subsidy $300-$475Transportation Program $49.50GST Credit (Single with 2 children) $0 38 Total: $1838.56-$2024.56 Difference: $14.84-$60.73 Sources:

• AB Agriculture Nutritious Food Basket Price Report, Feb 2004. Alberta Agriculture, Food & Rural Development.

• Weighted Average Rent, October 2003. Canada Mortgage & Housing Commission.

• AB Works: Financial Summary. Aug 2004. Government of Alberta. • National Child Benefit, March 2004. Canada Revenue Agency. • The City of Lethbridge – Bus, water, sewage • Energy Rate Summary & Natural Gas – Regulated Rates. Alberta Energy.

September 2004-10-04 – Gas & Electricity • Childcare Stats – Southwest AB Child & Family Services Authority. Day Care

Programs/Resources for Children with Disabilities. August 2004. • Telus Communications, August 2004 – phone costs.

APPENDIX C

Key Informant Survey Tool

FOOD SECURITY RESEARCH PROJECT

PHASE 1 - KEY INFORMANT TELEPHONE INTERVIEW-Interview Guide Community Interviewer Initials:______

Hello. My name is _________________ and I am working with the Chinook Health Region on a food security assessment. We are trying to identify issues related to food security for low-income families with children 0-5 years of age. You have been identified as someone who works with this group in your community and may have knowledge of these issues. All of the questions are based on your perceptions and observations. The interview will take approximately 10 – 12 minutes, would you be willing to take part in this brief telephone survey?

Interviewer-please circle appropriate response based on your information • Demographic data of interviewee: Gender: M or F • Background: Health Sector Education Sector Community Service (Non-profit, Social Work, Ministerial)

Definition: Food Security is widely described as the condition in which all people at all times can acquire safe, nutritionally adequate, and personally acceptable foods in a manner that maintains human dignity. First I want to ask you some questions regarding the extent of food security for low-income families with children 0-5 years of age. Again these are based on your perceptions and observations in ___________________(name community). TARGET POPULATION’S FOOD SECURITY ISSUES What signs do you see that there are young children in your community who are not receiving enough nutritious food? (paraphrase if need be - symptoms, indications etc.) How widespread is this problem? (Likert 3-scale is fine, can’t use finer tuning here) How severe? What trends have you seen in recent years? (changes over time, (small, none, large?)

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Now I would like to ask you questions regarding food security issues for low-income families with children 0-5 years of age. Again these are based on your perceptions and observations in ___________________(name community). ISSUES: LIST TOP 3 only!! What “barriers” do families face in providing food to their young children? (“problems” “difficulties”) WITH REGARDS TO INCOME MANAGEMENT…(TOP 3 responses only) What financial issues are affecting the ability of families to feed their young children enough nutritious food? (based on Canada’s Food Guide) What strategies do young families use to stretch their food money? How do they cope when they are short of food in their household?

WITH REGARDS TO FOOD ACQUISITION…(TOP 3 responses)

What difficulties do young families face when shopping for nutritious food? What types of behaviours do you see which may suggest parents are anxious or worried about their ability to feed their children? What types of comments do you hear which may suggest parents are anxious or worried about their ability to feed their children? What methods of obtaining food do families resort to? How do you think they feel about this? (positive, neutral, negative?) WITH REGARDS TO FOOD MANAGEMENT… (TOP 3) What indications are there that young children are not getting enough food? To what “extent” do young children receive foods that are of poor nutritional quality? What reasons would parents have for giving such foods?

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In your opinion, how knowledgeable are parents about the nutritional needs of their young children? In your opinion, how aware are parents of the food programs available in __________________?(list community) …NOW I am going to ask you some questions regarding existing programs and services in your community. What programs and services does your organization provide that deal with nutrition for vulnerable children 0-5 years of age? What other programs and services exist in ________________(list community) for vulnerable children 0-5 years of age who may not be receiving enough nutritious food? What gaps do you see in programs or services for children aged 0 – 5 years? What additional services do you think would help this group of children?

- END OF QUESTIONS - Thank you for your participation. For your information, a new provincial network addressing Food Security in Alberta has recently launched a web site. It provides information on Growing Food Security in Alberta, go to http://www.foodsecurityalberta.ca

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APPENDIX D

Face-to-Face Interview Guide

CHINOOK FOOD SECURITY ASSESSMENT PROJECT

Participant #____________ Community Code:________

1) What food does your infant/child(ren) usually eat? 2) How do you decide what to feed your infant/child(ren)? 3) What do you think may keep your from feeding your infant/child(ren) the foods

you want? All families, mine included, have issues or concerns about food and feeding our children. We are interested in what you have as concerns with food and feeding your children… (Interviewer note: This statement did not seem appropriate in many interviews and was adjusted for the circumstances.) 4) What are your biggest concerns about getting food for your infant/child(ren)? 5) What are your biggest concerns about feeding your infant/child(ren)? 6) Is there ever a time when there is not enough food to feed your infant/

child(ren)? What do you do if there is not enough food to feed your infant/ child(ren)?

7) Have you had the chance to use any programs in your community? Which

ones? 8) What would help you most to feed your infant/child(ren) the way you would

like to feed them? 9) Some people have suggested services that may be of use to those people

with infant and children under five years. Would you use these services?

• Garden programs • Food Delivery Services • Grocery Store – Local Healthy Food Store • Community Kitchen Group • Good Food Box Program • Other?

10) Do you have any other comments or concerns about feeding your infant/

child(ren) that you feel we should know about (that you would like to share)?

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DEMOGRAPHIC INFORMATION

1) How many people usually live in your household? How many adults? How

many children? 2) How old are the children? 3) What is your relationship to the preschooler(s)? 4) Which age category do you fit into?

a) Less than 20 years old? b) 20 – 39? c) 40 – 59? d) Over 60?

5) What is your marital status?

a) Have a partner b) Single

6) How much income does your household receive per month from all sources?

a) under $800 b) $800 - $1200 c) $1201 - $1600 d) over $1600 e) Do not know/choose not to answer

7) What is your household’s main source of income (choose only one)?

a) Social Assistance Plan b) Wages c) Disability or Old Age Pension d) Other e) Do not know/choose not to answer

8) What is the highest education level your have obtained?

a) Some public school/high school b) Grad 12 or GED c) Some university or college education or trade school d) University degree e) Any other special training