school-based feeding programs - food secure canada · school-based feeding programs a good choice...

P R E P A R E D B Y I N F O R M A T I O N P A R T N E R S H I P , V I C T O R I A , B C | J U L Y 2 0 0 0

School-based Feeding ProgramsA G O O D C H O I C E F O R C H I L D R E N ?

P R I N T E D I N C A N A D A | G R A P H I C D E S I G N - C A S P E R CO M M U N I C AT I O N S - C A S P E R CO M @ H O M E . CO M | P H OTO G R A P H Y - G E T T Y I M A G E S , I N C .

School-based Feeding ProgramsA G O O D C H O I C E F O R C H I L D R E N ?

A Key Informant Study and Literature Review

Prepared by

David I HayInformation Partnership1650 Chandler AvenueVictoria, BC V8S 1N6

tel: 250 592 2220fax: 250 592 2310e-mail: [email protected]

Commissioned by

Childhood and Youth DivisionHealth Promotion and Programs BranchHealth CanadaOttawa, Ontario

July 2000

The opinions expressed in this publicationare those of the author and contributors anddo not necessarily reflect the official viewsof Health Canada or the Government of Canada.

C A N A D I A N C A T A L O G U I N G I N P U B L I C A T I O N D A T A

Hay, David I., 1959-School-based feeding programs : a good choice for

children?

Issued also in French under title: Programmes scolairesde nutrition : un bon choix pour les enfants?Includes bibliographical references.ISBN 0-9686793-0-7

1. School children—Food—Canada. 2. Children—Nutrition.3. Food relief—Canada. 4. Public welfare—Canada. I. Title.

LB3479.C33H39 2000 371.7’16 C00-900267-7

Contents

Acknowledgements ............................................................... i

Executive Summary .............................................................. ii

Findings ............................................................................ 1

Research Context ......................................................... 4

Hunger ..................................................................... 10

Nutrition .................................................................. 12

Other Issues .............................................................. 13

Potential Roles for the Federal Government .................... 16

Recommendations ............................................................. 17

End Notes ........................................................................ 21

Appendix A — Background ................................................. 27

Appendix B — Informants .................................................. 30

S C H O O L - B A S E D F E E D I N G P R O G R A M S — A G O O D C H O I C E F O R C H I L D R E N ?

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ACKNOWLEDGEMENTS

I would like to thank John Topping,Graham Riches, and Cecilia VanEgmond for the assistance theyprovided me throughout this project.Thanks also to Robyn Hyde Lay andMarla Hanson for their help withresearch assistance.

I would also like to thank the peo-ple I consulted during this reviewfor their contributions to the project

(their names are listed in the at-tached appendix). In particular, Iwant to thank the following peoplefor the generosity of their time andfor the materials they provided:Herb Barbolet, Lise Bertrand,Lydia Dumais, Corinne Eisler,Debbie Field, Phyllis Godfrey,Lynn McIntyre, Martha O’Connor,Dan Offord, Yvonne Racine,and Valerie Tarasuk.


i i School-based Feeding ProgramsA GOOD CHOICE FOR CHILDREN?

EXECUTIVE SUMMARYFood security is not assured for allCanadians. For a number of reasons,many families are unable to ad-equately meet their food needs.School-based nutrition and feedingprograms (hereinafter referred to asschool food programs) have been oneresponse to this problem. Haveschool food programs been a soundresponse? What do we know aboutthe delivery and outcomes of schoolfood programs?

This paper offers an analyticalassessment of school food programsas a sound policy response to foodinsecurity. The paper discusses thefindings from interviews with keyinformants and from a review ofrelevant research literature. Aconcluding section with recommen-dations closes the paper.

FINDINGSResearch Question 1: Are school-based nutrition programs a soundsocial policy response for children?

The evidence available at this timedoes not clearly demonstrate thatschool-based nutrition programs area sound social policy response forchildren. More evidence is needed toadequately assess the contributionof these programs to alleviatinghunger, enhancing nutrition andcontributing to the healthy develop-ment of Canadian children andfamilies. It is possible that schoolfood programs could be one of manyelements in a comprehensive strat-egy to alleviate hunger and enhancenutrition. There are some indica-tions, however, that school foodprograms can have unintendedadverse consequences, such asdependency and stigmatization.

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i iiResearch Question 2: What role,if any, should the federal govern-ment assume in supporting theseprograms?

Without adequate evidence of theimpact of these programs, the fed-eral government should not supportfurther development of school foodprograms. Possible roles for thefederal government related to foodprograms are discussed furtherbelow.

RECOMMENDATIONS1. The federal government shouldshare with provincial and communitystakeholders information and re-search conducted into school foodprograms. This would help to stimu-late additional research with thegoals of:

! Creating outcome targets and keyindicators of levels of hunger,nutrition and food security forchildren and adults;

! Building appropriate evaluationframeworks, including outcometargets and key indicators, toevaluate and assess currentprograms;

! Identifying, documenting, anddisseminating innovative ap-proaches to improve food security.

2. The federal government can makea number of contributions on abroader scale to reduce hunger andenhance nutrition for Canadians.These contributions can be madewithin the already establishedfederal program and policy frame-works listed below:

! Population Health

! Healthy Child Development

! Income Security

! Food Security

! Social Policy Leadership

Population Health and Healthy ChildDevelopment provide the context forpriority policy directions in the

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ivareas of Income Security and FoodSecurity. Social Policy Leadership isimportant to demonstrate federalcommitment to these policy direc-tions.

Population Health

Strategies to reduce hunger andenhance nutrition among childrenand families need to be situatedwithin a guiding framework thatestablishes a common understand-ing of where we are and where wewant to go. The population healthframework is supported by substan-tial national and internationalresearch, it is comprehensive andmulti-sectoral, and it has alreadybeen adopted by governments. Thepopulation health framework recog-nizes the interdependence of thecauses of ill health – individualcharacteristics and endowments, thephysical environment, and socialand economic factors. The popula-tion health framework could help toemphasize the need for school food

programs as a way to reduce hungerand enhance nutrition.

Healthy Child Development

The policy directions outlined inBuilding a National Strategy forHealthy Child Development, sup-ported by the federal, provincial,and territorial governments, shouldbe more fully developed and inte-grated with priority income securityand food security initiatives (seebelow), then used as an implemen-tation framework at the communitylevel to ensure relevance to particu-lar local needs.

Income Security

Adequate income security is themajor contributing factor to thealleviation of hunger and the im-provement of child and family nutri-tion. Recent policy research outlinescomprehensive and sound incomesecurity proposals, and they shouldbe fully assessed.

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vA commitment to the followingelements of an income securitypolicy is essential:

! adequate and equitable incometo be defined and agreed uponby Canadians;

! a legislated commitment by gov-ernment to ensure the provisionof adequate and equitable income;

! adequate and equitable incomelevels for all families, whatever thesource of family income;

! mutual accountability of govern-ments and citizens to ensureadequate incomes.

Food Security

Building on Nutrition for Health: AnAgenda for Action, and using thefood security framework developedin Canada’s Action Plan for FoodSecurity, the federal governmentshould make funds available for thedevelopment of local, regional andprovincial food security policies. Todevelop these policies and strate-gies, all governments must work

together, taking into account cur-rent mechanisms such as the SocialUnion Framework Agreement andfederal/provincial/territorial divi-sions of responsibilities. There areparticular needs for the following:

! comprehensive food securityassessments, including levelsof hunger and nutrition;

! development of food securitycouncils to ensure ongoingdialogue, activity, monitoring,and accountability;

! community economic developmentinitiatives in the food sector,including food producers, distribu-tors, marketers, retailers, educa-tors, and promoters.

Social Policy Leadership

It is imperative that the federalgovernment:

! demonstrate a commitment andprovide leadership in incomesecurity and food security;

! provide support for programs,research and information that

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v iallows the public to be informedabout and participate in policydevelopment;

! provide meaningful opportunitiesfor ongoing, broad-based citizenparticipation, discussion anddecision-making;

! promote the democratization ofsocial policy development, imple-mentation, administration,assessment and accountability.

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School-based Feeding ProgramsA GOOD CHOICE FOR CHILDREN?

Assessing the soundness of schoolfood programs as a social policyresponse raises two importantquestions:

What is meant by ‘sound’?

What problems are school foodprograms intended to address?

The soundness of school food pro-grams is assessed in this paperthrough a discussion of the issuesraised under the first researchquestion posed by Health Canada(See Background, Appendix A). Thediscussion provides an overall con-text to the assessment. It is also

important, however, to list a morespecific set of elements in order toidentify the soundness of the foodprograms themselves. Generally,sound programs are those with thefollowing characteristics:

! developed in response to clearlydefined needs.

! designed to meet clearly articu-lated goals and objectives.

! managed efficiently andeffectively.

! evaluated in terms of clear, directand relevant program outcomes.

These elements are critical for anadequate assessment of the sound-

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ness of any school food program.1

Unfortunately, most school foodprograms lack one or more of theseelements, making proper assess-ments difficult.2 In particular, theneed for school food programs hasnot been adequately determined ordemonstrated.3

School food programs have tendedto be implemented in response to afairly informal, and sometimesanecdotal, assessment of a school’sor community’s social and economicsituation.4 Most school food pro-grams have begun as a response toperceptions of hunger and inad-equate nutrition among low-incomechildren.5 Although the programgoals are not always explicit, theimplementation of school foodprograms is meant to reduce hungerand enhance nutrition among theparticular population of childrenwho are considered to be at risk ofpoor outcomes.6 However, theexplicit goal statements of school

food programs usually refer to thedelivery of the programs and not toenhancing health.

One example of a school food pro-gram with program delivery as thegoal is in British Columbia, wherethe government operates a schoolmeal program throughout the prov-ince.7 This program was initiated in1992 because the BC governmentrecognized that hunger was a poten-tial consequence of child and familypoverty, and that hunger hinderedchild development. The overallpurpose of the program “is to pro-vide meals to students who come toschool hungry.”8 The objectives ofthe program are to “provide ...meals to children in need, promote ahealthy school environment ... [and]promote nutrition education.”9

The program criteria, purpose andobjectives contain no statementsabout reducing hunger or enhancingnutrition. Evaluations of programs

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usually assess outcomes in relationto program objectives; thereforeexamining the contribution ofschool food programs to hungerreduction and nutrition enhance-ment may be inadvertently over-looked.10 There is a real need toevaluate programs to assess theireffectiveness in reducing hunger orenhancing nutrition.

As school food programs have devel-oped, their goals have shifted.11

Programs that began simply to feedchildren now address multiple goalssuch as nutritional adequacy for allchildren, nutritional education,positive socialization, school at-tendance, family time-stress,community mobilization, partner-ships and social support.12 Onesuggested reason for this shift isthat programs have been unable todemonstrate reductions in hungerand enhanced nutrition.13

Some experts view the multipleor shifting goals of school foodprograms positively, but others donot.14 One critic suggests thatprogram designers, administratorsand advocates need to rememberthe original purpose of schoolfood programs—to reduce hungerand enhance nutrition amonglow-income children—and thatthis should serve as the primaryand explicit objective of schoolfood programs.

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RESEARCH CONTEXT

Canada’s InternationalCommitments

Among the multitude of Canada’sinternational commitments, thefollowing five are particularly rel-evant for the purposes of thediscussion in this paper:15

· United Nations Universal Declara-tion of Human Rights (1948)

· United Nations InternationalCovenant on Economic, Social andCultural Rights (1966/1976)

· United Nations Convention on theRights of the Child (1989/1991)

· World Declaration on Nutrition/Nutrition for Health: An Agenda forAction (1992/1996)

· World Food Summit Plan of Action/Canada’s Action Plan for FoodSecurity (1996/1998)

Following World War II, politiciansrecognized the need for a mix ofpolitical, civil, social and economicrights as the foundation for human-

ity and a new world order.16 Theserights were expressed in the Univer-sal Declaration of Human Rights thatwas adopted by the United Nationsin 1948. In 1966, the United Na-tions further specified these rightsin the Covenant on Civil and Politi-cal Rights and the Covenant onEconomic, Social and CulturalRights. Canada ratified the Covenanton Economic, Social and CulturalRights in 1976, giving the weight ofinternational law to statements suchas Article 11: “The State parties tothe present Covenant recognize theright of everyone to an adequatestandard of living ... includingadequate food, clothing, and hous-ing.”17 Canada also ratified the UNConvention on the Rights of theChild, in which Article 27 stipulatesthat “every child has the right to anadequate standard of living,” and itoutlines the responsibility of gov-ernment, if necessary, to “takeappropriate measures to assistparents to ensure these rights are

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met, specifically in terms of nutri-tion, clothing and housing.”18

In 1992, Canada was a signatory tothe World Declaration on Nutrition,in which countries affirmed that“access to nutritionally adequateand safe food is a right of eachindividual,” and that nutritionalwell-being “must be at the centre of... socio-economic developmentplans and strategies.”19 Further, bysigning the Declaration, Canada wascommitted to “set measurable goalsand timeframes for action on nutri-tion and food issues.”20 Canada’sresponse to the World Food Summitof 1996, Canada’s Action Plan forFood Security, outlined a detailed setof actions to ensure that “foodinsecurity in Canada and abroad isreduced by half no later than theyear 2015.”21 Canada’s commitmentsto food security are concisely sum-marized in Canada’s Action Plan forFood Security, which states:22

“Canada has endorsed numerousinternational declarations andconventions which clearly recog-nize the right to adequate foodand the fundamental right ofeveryone to be free from hunger,including the Universal Declarationof Human Rights and the Interna-tional Covenant on Economic,Social and Cultural Rights. Thisright was recognized and reaf-firmed in the Rome Declaration onWorld Food Security and the WorldFood Summit Plan of Action of1996. Most recently, Canada co-sponsored a resolution affirmingthis right at the 1998 Commissionof Human Rights.”

Given the number of commitmentsthat Canada has made over the past50 years and its level of wealth anddevelopment, it is surprising thatfood insecurity is a problem in thiscountry.23 Unfortunately, thesecommitments have not been suffi-cient to ensure food security for allCanadians.24 Particular politicalagendas and economic imperativesare just some of the reasons ana-

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lysts have attributed to this gapbetween promises and outcomes.25

These same analysts and othersexpect greater efforts from theirgovernments to attain social andeconomic security, including foodsecurity. They believe that Canadi-ans’ social rights have been erodedas a result of the obvious lack ofaccountability of federal, provincial,and territorial governments to theseinternational commitments.26 Onthe positive side, however, one ofCanada’s obligations under thesecommitments is the periodic reviewand public reporting of its socialpolicy mandate. These reviews, andothers conducted outside of govern-ment, have been used by manynon-governmental organizations(NGOs) for education and advo-cacy.27 Representatives from theseNGOs have viewed the United Na-tions as a high-profile internationalforum that offers an opportunity forconcerned citizens to report tosympathetic ears, creating, at the

very least, a bad media image forCanada and potentially, pressure forchanges to improve food security.More favourably, periodic reviews byUN bodies require governments toexamine their social policy mandatesand to provide public documentationabout their legislative commitments.

School Food Programs and Domes-tic Social Policy Commitments

In collaboration with provincial/territorial governments and Aborigi-nal communities, the federal govern-ment has developed a number ofunilateral and shared (federal/provincial/territorial) strategies inhealth, social policy and incomesecurity related to the issues ofhunger and nutrition, including thefollowing:

Federal Initiatives

! Community Action Programfor Children (1995)

! Canada Prenatal NutritionProgram (1995)

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! Nutrition for Health: An Agendafor Action (1996)

! Centres of Excellence for Children’sWell-Being (1997)28

! Canada’s Action Plan for FoodSecurity (1998)

Federal/Provincial/TerritorialInitiatives

! Strategies for Population Health:Investing in the Health ofCanadians (1994)

! Building a National Strategy forHealthy Child Development (1997)

! National Child Benefit (1997)

! National Children’sAgenda (1997)29

It is important to note the inclusionof the following program elementsin these strategies: populationhealth, children at risk, incomesecurity, nutrition, food security,and policy action. A brief discussionof these elements follows.

In 1994, the population healthapproach was endorsed by the

federal, provincial, and territorialMinisters of Health in the report,Strategies for Population Health:Investing in the Health of Canadians.30

The report summarizes and discussesthe determinants of health whichare defined as the multiple factorsthat contribute to the health ofpopulations.31 The population healthapproach serves as a framework toguide the development of policiesand strategies to improve the healthof the population.

Both the reports Nutrition forHealth: An Agenda for Action andBuilding a National Strategy forHealthy Child Development explicitlyground their policy directions in thepopulation health framework.32

These documents also place impor-tance on ensuring adequate healthopportunities for vulnerable or at-risk populations, especially children.Two of Health Canada’s programs,the Community Action Program for

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Children (CAPC), and the CanadaPrenatal Nutrition Program (CPNP),are intended to address the needs ofchildren who are at risk.33

The National Child Benefit (NCB) is afederal/provincial/territorial incometransfer program designed, in part,“to help prevent and reduce thedepth of child poverty.”34 Poverty isrecognized as causing a “greater riskof suffering from inadequate nutri-tion ... [and] poor school achieve-ment” for low-income children.35

The National Children’s Agenda isanother federal/provincial/territorialinitiative that, when it comes tofruition, is intended to address thedevelopmental needs of childrenacross various areas of governmentresponsibility, including health,social services, justice and educa-tion.36 The government has listedpolicy initiatives like the NCB andprograms such as CAPC and the CPNPas examples of foundational compo-nents of the emerging National

Children’s Agenda. The agenda isintended to serve “as a far-reaching,long-term action plan for coordinat-ing and advancing actions in a widerange of children’s issues.”37 Onestrength of these program and policyinitiatives is their recognition of theneed for sectoral integration of thedeterminants of health and well-being. This recognition createsopportunities for further integrationand consolidation of strategies. Thisis important because at present, itis not completely clear how theseinitiatives are intended to comple-ment, rather than contradict,each other.

Given their stated import, someweaknesses of these initiatives mustbe noted. For one, there is onlymodest involvement of the non-governmental social policy commu-nity in their development. As well,with the exception of the NCB, CAPCand CPNP, many of the action state-ments in the initiatives are, at best,

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statements of goals with no mecha-nisms for implementation, monitor-ing or accountability.

It is also worth noting that while allof these programs and policy state-ments directly or indirectly mentionthe importance of food security, thealleviation of hunger, and nutritionalenhancement, none suggest that ameans to address these issues isthrough the delivery of food viaschool-based programs. Thus, whileit is clear that Canada’s domesticsocial policy commitments include ahealthy food supply and a healthypopulation, there is not a commit-ment to food programs per se.

Government SpendingOn Social Programs

Over the last decade, there havebeen substantial and wide-rangingreductions in government spendingon social programs correspondingwith the demise of the Canada

Assistance Plan and EstablishedPrograms Financing, and the intro-duction of the Canada Health andSocial Transfer.38 Between 1993 and1996, all provinces received approxi-mately 20% less in health, educa-tion, and social services financing—a reduction of more than $6 billion.This created many changes in thedelivery of these services, in manyinstances reducing their availability,accessibility and adequacy. As aresult, the public has come to viewthe social safety net as increasinglyineffective.39

One consequence of these socialprogram changes is that levels ofpoverty and inequality have in-creased.40 Statistics Canada reportedthat “the total incomes of thepoorest 20 per cent of Canadianshad dropped dramatically because ofa combination of lower earnings andcuts to cash transfers from govern-ments.”41 Other observers note thatprior to the early 1990s, a combina-

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tion of federal and provincial incometax and cash transfer programs suchas pensions and employment insur-ance contributed to the relativestability of income distributionamong Canadians.42 Governmentprograms helped to offset the in-creasing inequalities in income fromemployment and investments43 andthe general stagnation or decline ofaverage family income since the late1980s.44

Because provincial governmentshave depended on the federal gov-ernment for transfer payments tofund programs, their ability tomaintain—let alone enhance—social programs has also de-creased.45 As a result, almost every-one, and particularly local, regionaland provincial government staff,would like more program financ-ing.46 In some respects, however,this has always been the case.Professionals and bureaucrats havelong argued that problems, social or

otherwise, can best be addressed byspending money on them, but thereis not always a positive relationshipbetween program spending andsuccessful program outcomes.47

HUNGER

Hunger has been defined narrowly asphysiological discomfort as a resultof a lack of food,48 and defined morebroadly as “the inability to obtainsufficient, nutritious, personallyacceptable food through normalfood channels or the uncertaintythat one will be able to do so.”49

If “the availability of nutritionallyadequate and safe foods or theability to acquire acceptable foodsin socially acceptable ways is lim-ited or uncertain,” then a conditioncalled food insecurity exists.50

Hunger and food insecurity inCanada are primarily the result offamily income insecurity. Family

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income insecurity puts children andadults at risk of a large number ofnegative outcomes including illhealth, stress, family violence, andilliteracy.51

From this review of school foodprograms, it would seem that pro-grams are either an inappropriateresponse to hunger in children, orthe programs are inadequate in theirscope and design. There are anumber of indications of this, in-cluding the following:52

! Programs can only address asymptom—hunger—of one or moreunderlying problems.

! Hungry children and their familiesoften use other means to alleviatehunger—such as food banks,relatives, neighbours—beforeusing school food programs.

! Lack of data makes it very difficultto know, other than throughspecific anecdotes, what percent-age of children at risk of hunger inany given school area participatein programs.53

! The nutritional value of programsand of the food that is served maybe inadequate. A lack of documen-tation means that there is insuffi-cient evidence to measure thenutritional value.

! From a developmental perspective,hunger and undernourishment canhave the most severe effects onpreschool-aged children, ratherthan school-aged children. Fromthis point of view, children not yetin school should probably bepriority recipients of the deliveryof food programs.

! Most programs are elementaryschool-based, thus disregardingyouth.

! Most programs are based in schoolsrather than in other communityfacilities, so the food is availablefor only about half the year.

All informants stated that theybelieved the government’s numberone priority should be to strengthenthe ability of families to provide fortheir own children. This capacitybuilding for families requires manyelements, including job and income

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supports, work and time-stresssupports (most importantly, ad-equate child care), nutrition educa-tion, affordable and accessiblenutritious food, and neighbourhoodand community services (such aspregnancy support and outreach,home visiting, early childhoodeducation, and the like). Within thisresponse, school food programscould be one element in an overallstrategy to alleviate hunger. Theycould be particularly useful asinterventions with high-risk, poorchildren and communities.54

Many informants for this review feltstrongly that hunger—and to someextent, nutritional adequacy—canbe addressed only with additionalmonies for low-income families withchildren. One source estimated thiscan be achieved at a cost of ap-proximately $5,000 per hungryfamily.55 Increased employmentopportunities and higher minimumwages could contribute to families’

increased incomes, but in somecases, for example when parents orchildren are ill or the family is ledby one parent,56 increases in incomesupport programs would also berequired.57

NUTRITION

Some informants believe that thereis a current or emerging “crisis” innutrition (and therefore, a crisis inhealth) for a variety of reasons,including poverty, low education,lack of appropriate food choices,food insecurity, a lack of time, andgender issues (such as body im-age).58 Although research is lackingon the prevalence of hunger andinadequate nutrition, some inform-ants see school food programs aspart of an appropriate response tothese conditions. They note that thefast food industry can create prob-lems for families who have littletime to shop and cook, and thechoices available do not usually

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offer a balanced and nutritionaldiet. School food programs canallow families to bypass the fastfood market.59

For these observers, after the family,schools are considered the locationof choice for delivering a foodprogram because many of the socialconditions that children face else-where are minimized or equalized inschools. Schools can provide apositive environment in whichchildren can learn about appropriatenutrition and eat a nutritious meal.For these informants, in addition toalleviating hunger, school foodprograms can introduce children tofoods that they might otherwisenever have eaten, and the programscan provide the children with ageneral education about food secu-rity and their place in the foodsystem. Again, we do not haveadequate information from evalua-tions or from other research in orderto determine how, or even if, theseoutcomes are achieved.

OTHER ISSUES

Dependency/Institutionalization/Professionalization

The literature indicates that someschool food programs appear to havecreated various forms of depend-ency.60 In some cases, programshave become an institutionalizedresponse to a lack of money, timeand, to a lesser extent, knowledgeamong families about how to pre-pare and deliver nutritious meals.

This institutionalization of fooddelivery can also serve todepoliticize responses to communityfood issues, for example by encour-aging people to concentrate oncontinuing a food program ratherthan tackling the underlying issuesof food and income production anddistribution.61

Some of the research on school foodprograms has argued that the pro-fessionalization of school foodprograms—evident in the hiring

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of staff, increased management andadministrative activity, andfundraising—may indicate that aprogram is focussing more on itscontinued existence and less onprogram objectives like hungerreduction or nutrition enhance-ment.62 These researchers haveconcluded that, over time, programdelivery objectives gain prominenceover hunger reduction and nutrition-enhancement objectives. As men-tioned earlier in this paper, it maybe erroneous to equate the contin-ued existence of a program withsuccess, without an examination ofthe program outcomes.

Sustainability

Most school food programs dependon voluntary support for their exist-ence. Because of this, programs varywidely, particularly in regard to foodquality and safety. To ensuresustainability, program operatorsrequest more money or theyconcentrate some of their time on

fundraising. An adequate and as-sured funding base, along with plansfor the maintenance and successionof staff or volunteers, are central toa program’s sustainability.

Charity

Charitable groups believe that theyare contributing to communitycapacity by delivering programs tomeet community needs.63 Manygovernments, community groups andthe private sector also hold thisview of charities. For a number ofreasons, however, many informantssaid they are uncomfortable withcharitable responses to social prob-lems. Primarily, they view charitableresponses as a sign that governmentpriorities have shifted away fromserving the broad public interestthrough the delivery of a basicnecessity of life. Thus while fillingan apparent void in public services,charitable programs tend to viewvulnerable populations as beingunable to help themselves. As a

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result, some informants suggest thatcharities contribute to the promo-tion of values that are the antithesisof equity, perpetuating a socialsystem that fails to make moresystemic, structural changes thatwould equalize opportunities forall citizens.

Other informants feel that the time,energy, and resources generated byprivate charities should not bedismissed. These informants wereconcerned that in an era of de-creased public sector initiatives anda focus by governments on sectoralpartnerships, charities have filled avoid in services by providing vitalsupport. These informants believethat there can be dynamic andcreative roles for charities as long asappropriate criteria were in place toguide their actions. Two criteriamost frequently mentioned weretransparency and accountability.

There is also evidence that charities

are unable to respond adequatelyto the large problem of food insecu-rity in Canada, with the result beingthat many Canadians are still goinghungry.64

Food Security/Food Policy

According to some commentators, adhoc, band-aid attempts to alleviatehunger and enhance nutrition havebeen insufficient because they havebeen based on a food charity systemthat “does not have the capacity toaddress any of the deeper, structuralissues that have created the condi-tions of poverty and hunger.”65

In some jurisdictions, community/government partnerships are ad-dressing broader issues of foodsecurity and food policy. Manyinformants feel that dialogue andaction at this level would greatlybenefit family and communityhealth and that this is the mostappropriate forum in which to assessthe need for school food programs.66

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POTENTIAL ROLESFOR THE FEDERALGOVERNMENT

A few of the informants interviewedfor this study, particularly the pro-vincial government representatives,gave a one-word answer when askedwhat role the federal governmentshould have in the area of schoolfood programs: none. Provincialofficials recommended that thefederal government restore federaltransfer payments delivered throughthe CHST to their pre-1995 or earlierlevels. They did not feel that desig-nating any part of the CHST fundingfor food programs was workable,given the ongoing social uniondiscussions and other federal/provincial/territorial initiatives.

On the other hand, community andlocal or regional government repre-sentatives would like stronger fed-eral involvement in this area. Theybelieve that federal dollars are more

readily available—at least cur-rently—and potentially more sus-tainable than provincial governmentfunding sources. These informantsalso believe that the federal govern-ment should take on the role ofproviding national leadership bysetting standards for healthy childdevelopment, family food security,and school food programs, and bypromoting ongoing collaborationwith the provinces. Some informantswould support the direct delivery ofa broad-based food or nutritionprogram by Health Canada. Thesepotential roles are explored in moredetail in the following section ofthis paper.

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Recommendations

This paper summarizes the findingsfrom interviews with key informantsand from a review of relevant re-search literature to address thefollowing questions:

1. Are school-based nutrition pro-grams a sound social policy re-sponse for children?

While there doesn’t seem to be aclear answer to this question, theshort answer appears to be “No.”Overall, the available evidence doesnot clearly demonstrate that school-based nutrition programs are asound social policy response forchildren. More evidence is requiredto adequately assess the contribu-tion these programs can make toalleviate hunger, enhance nutrition,and contribute to healthy childdevelopment, without creating anyadverse consequences such as de-pendency or stigmatization.

2. What role, if any, should thefederal government assume insupporting these programs?

As a response to social programfunding cuts, communities acrossCanada are examining school foodprograms as a potential solution toissues of hunger and inadequatenutrition. However, without ad-equate evidence, the federalgovernment should not supportfurther development of schoolfood programs.

The federal government should sharewith provincial and communitystakeholders information and re-search conducted into school foodprograms. This could contribute tothe development of additionalresearch, with the following goals:

! Creating outcome targets and keyindicators to better assess levels

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of hunger, nutrition, and foodsecurity among Canadians gener-ally and for children in particular.

! Building appropriate evaluationframeworks—including outcometargets and key indicators—toevaluate and assess currentprograms.

! Identifying, documenting anddisseminating innovative ap-proaches to food security.

More broadly, the federal govern-ment can make a number of contri-butions to reduce hunger and en-hance nutrition for Canadians withinthe five existing elements of itsmandate:

! Population Health

! Healthy Child Development

! Income Security

! Food Security

! Social Policy Leadership

Population health and healthy childdevelopment provide the context

and basis for priority policy direc-tions in income security and foodsecurity. Social policy leadership isimportant to demonstrate federalcommitment to these policydirections.

Population Health

Strategies to reduce hunger andenhance nutrition among childrenand families need to be situatedwithin a guiding framework thatestablishes a common understandingof where we are and where we wantto go.67 The population healthframework is legitimated by sub-stantial national and internationalresearch, it is comprehensive andmulti-sectoral, and it has alreadybeen adopted by governments. Thepopulation health framework recog-nizes the interdependence of thecauses of ill health—individualcharacteristics and endowments, thephysical environment, and socialand economic factors. The popula-tion health framework could help to

19


emphasize the need for school foodprograms as a way to reduce hungerand enhance nutrition.

Healthy Child Development

The policy directions outlined inBuilding a National Strategy forHealthy Child Development should bemore fully developed and should beintegrated with priority incomesecurity and food security initiatives(see below). They can then be usedas an implementation framework atthe community level to ensure thatthey are relevant to particular localneeds.

Two policy and program initiatives,grounded in the population healthframework, would contribute mostto hunger and nutrition strategies.These are income security and foodsecurity.

Income Security

This paper has discussed the impor-tance of adequate income security

as the major contributor to thealleviation of hunger and the im-provement of nutritional outcomes.Recent policy research has outlinedcomprehensive income securityproposals containing a number ofsound proposals, and they should befully assessed.

Notwithstanding these proposals,a commitment is essential to thefollowing elements of an incomesecurity policy:

! adequate and equitable income,to be defined and agreed uponby Canadians.

! a legislated commitment by gov-ernment to ensure the provision ofadequate and equitable income.

! adequate and equitable incomelevels for all families, whatever thesource of family income.

! mutual accountability of govern-ments and citizens to ensuringadequate incomes.

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Food Security

Building on Nutrition for Health: AnAgenda for Action, and using thefood security framework developedin Canada’s Action Plan for FoodSecurity, the federal governmentshould make funds available for thedevelopment of local, regional andprovincial food security policies. Todevelop these policies and strate-gies, all governments must worktogether, taking into account cur-rent mechanisms such as the SocialUnion Framework Agreement andfederal/provincial/territorial divi-sions of responsibilities.68 There areparticular needs for the following:

! comprehensive food securityassessments, including assess-ments of levels of hunger andnutrition.

! development of food securitycouncils to ensure ongoing dia-logue, activity, monitoring andaccountability.69

! community economic developmentinitiatives in the food sector.70

Social Policy Leadership

It is imperative that the federalgovernment do the following:

! provide leadership in all of theseareas (population health, healthychild development, income secu-rity, food security).

! articulate the values underlyingsocial policies.

! demonstrate a commitment toincome security and food security.

! provide support for programs andresearch, particularly adequate andaccessible information that allowsthe public to be informed andparticipate in policy development.

! provide meaningful opportunitiesfor ongoing, broadly based citizenparticipation, discussion anddecision-making.

! promote the democratization ofsocial policy development, imple-mentation, administration, assess-ment and accountability.

While it is imperative that thefederal government provide leader-

21


ship, responses to hunger and inad-equate nutrition in Canadian chil-dren and families will need to en-gage and involve many actors—parents and children, governments,community organizations, schools,private business, charitable organi-zations, and so on—in collaborativeaction to ensure success.

End Notes1. These elements are relevant for assessing

virtually any policy, program, or service. SeeW.R. Shadish, T.D. Cook, and L.C. Leviton,Foundations of Program Evaluation, NewburyPark, CA: Sage, 1991.

2. Specific program criteria, such as nutritionaladequacy, accessibility, affordability,sustainability (especially funding), qualifiedstaff, and the like are also obviously impor-tant in assessing school food programs. Thispaper does not assess school food programsin all of this detail, however.

3. Aurelia T. Shaw, Yvonne Racine, Dan R. Offord.The Effects of Breakfast on Children’s Mood,Behaviour and Ability to Learn. Hamilton:Canadian Centre for Studies of Children atRisk, 1998, p. C-1, unpublished.

4. For example, although the British Columbiagovernment assesses “Statistics Canadaindicators relating to family income and

relevant information about the school andcommunity” as part of the criteria fordeciding on allocations of school mealprogram funding, this is not a formalprocess, nor are data on sites or potentialprogram participants directly measured(also see note 9). See, British Columbia:Ministry of Education, Skills and Training,Investing In All Our Children: A Handbook ofSocial Equity Programs. Victoria: Queen’sPrinter, 1996, pp.1-2.

5. Perceptions is a key word here. School foodprograms have been initiated with little orno formal needs assessments. Informalneeds assessments (usually anecdotal)concentrate on indicators of hunger, ratherthan direct measures. These indicators arecorrelated with, and sometimes also knownto be causal of, hunger. Common indicatorsare incidence of low income/poverty, foodbank use, and the like (also see note 8).

6. Scan of Canadian School Nutrition Programs1998. Ottawa: Health Canada, Childhood andYouth Division, 1998, unbpublished; BritishColumbia: Ministry of Education, Skills andTraining, Investing in All Our Children.

7. BC: Ministry of Education, Skills and Training,Investing in All Our Children, p.7.

8. Ibid.

9. Ibid.

10. Although there are very few formalevaluations of school food programs. SeeShaw, Racine, and Offord, The Effects ofBreakfast on Children’s Mood…; Scan ofCanadian School Nutrition Programs 1998.

11. Lynn McIntyre, Kim Travers, and Jutta Dayle.Children’s Feeding Programs in Atlantic

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Canada: Reducing Inequities? Halifax:Dalhousie University, 1997.

12. Toronto Community Partners for ChildNutrition. Child Nutrition Programs in the NewCity of Toronto. Toronto: TCPCN, 1998.

13. Lynn McIntyre, personal communications,December 19, 1998.

14. See McIntyre, Travers, and Dayle. Children’sFeeding Programs in Atlantic Canada. One keyinformant consulted for this review de-scribed the shifting goals of school foodprograms as a consequence of “a program insearch of a problem.” Also see, NationalInstitute of Nutrition, cited in Shaw, Racine,and Offord, The Effects of Breakfast onChildren’s Mood….

15. The first year in brackets represents the yearof adoption by the UN. The second year isthe year of ratification by Canada. In the caseof the World Food Summit, it is the year ofCanada’s response.

16. Edward Broadbent. The Rise and Fall ofEconomic and Social Rights – Thoughts onCitizenship in the Welfare State in the NorthAtlantic World. Oxford: Oxford University,1997.

17. Cited in Graham Riches, “Canada: Abandon-ing the right to food,” in Graham Riches (ed.),First World Hunger: Food Security and WelfarePolitics. London: Macmillan Press,pp.47-77, 1997.

18. Ibid., p.61. For discussion of the applicationof the Convention in Canada, see David I. Hayand Tom Walker, Children’s Rights and theMunicipal Role: A literature review andannotated bibliography. Vancouver: SocialPlanning and Research Council of BC, 1992.

19. Cited in Joint Steering Committee, NationalNutrition Plan for Canada, Nutrition andHealth: An Agenda for Action. Ottawa: HealthCanada, 1996, p.25.

20. Ibid.

21. Joint Consultative Group, A Response to theWorld Food Summit. Canada’s Action Plan forFood Security. Ottawa: Agriculture and Agri-Food Canada, 1998, p.47.

22. Ibid., p.46.

23. Riches. First World Hunger; Valerie Tarasukand Barbara Davis. “Responses to FoodInsecurity in the Changing Canadian WelfareState,” in the Journal of Nutrition Education,28(2):71-75, 1996.

24. Riches. First World Hunger; Tarasuk and Davis.Responses to Food Insecurity … ; McIntyre,Travers, and Dayle. Children’s FeedingPrograms in Atlantic Canada ; Valerie Tarasukand Randi Reynolds. “A Qualitative Study ofCommunity Kitchens as a Response toIncome-Related Food Insecurity,” in theCanadian Journal of Dietetic Practice andResearch, 60: 11-16, 1999; Lynn McIntyre,Sarah Connor, and James Warren. A Glimpseof Child Hunger in Canada. Ottawa: HumanResources Development Canada, AppliedResearch Branch, No. W-98-26E, 1998.

25. A discussion that is well developed else-where. For a discussion focussed on foodsecurity, see Riches, First World Hunger; andDebbie Field, “Putting Food First: Women’sRole in Creating a Grass-Roots Food SystemOutside the Marketplace,” in DeborahBarndt, Women Working the NAFTA FoodChain: Women, Food and Globalization.Toronto: Second Story Press, 1999. For an

23


excellent discussion of Canada’s interna-tional commitments in the context ofchanges to social programs, see Shelagh Dayand Gwen Brodsky, Women and the EqualityDeficit: The Impact of Restructuring Canada’sSocial Programs. Ottawa: Status of WomenCanada, 1998. For two more generalexamples, see Broadbent, The Rise and Fall ofEconomic and Social Rights and Tom Kent,Social Policy 2000: An Agenda. Ottawa:Caledon Institute of Social Policy, 1999.

26. For a good discussion of Canada’s dismissalof its commitments, see Riches, First WorldHunger, pp.65-69; Day and Brodsky, Womenand the Equality Deficit. For a discussion ofCanada’s human rights commitments incontext of Canada’s social union, see PaulLeduc Browne (ed.), Finding Our CollectiveVoice: Options for a new social union. Ottawa:Canadian Centre for Policy Alternatives, 1998.

27. For example, see National Anti-PovertyOrganization, The 50th Anniversary of the UNDeclaration: Human Rights Meltdown inCanada, Submission to the UN Committeeon Economic, Social and Cultural Rights,Geneva, November 16, 1998. For a discussionof education and advocacy activities andinternational commitments, see Day andBrodsky, Women and the Equality Deficit.

28. Centres of Excellence for Children’s Well-Being were announced in the 1997 FederalGovernment Throne Speech, but they arenot yet operational.

29. The National Children’s Agenda was initiatedin 1997. In the spring of 1999, a frameworkpaper for the Agenda was released.

30. Federal/Provincial/Territorial AdvisoryCommittee on Population Health. Strategies

for Population Health: Investing in the Healthof Canadians. Ottawa: Health Canada, 1994.

31. For an elaboration of the determinants ofhealth and an understanding of thedevelopment and principles of populationhealth, see Canada: Department of Health,Towards a Common Understanding: Clarifyingthe Core Concepts of Population Health,Ottawa: Health Canada, 1997; Canada:Department of Health, Health Canada’sTransition to a Population Health Approach,Ottawa: Health Canada, 1997. For a con-densed version, see David I Hay and AndyWachtel. The Well-Being of British Columbia’sChildren and Youth: A framework for under-standing and action. Vancouver: First CallCoalition, 1998, especially Sections II and III.

32. Joint Steering Committee, National NutritionPlan for Canada. Op. cit.; Federal/Provincial/Territorial Advisory Committee on Popula-tion Health. Building a National Strategy forHealthy Child Development. Ottawa: HealthCanada, 1998.

33. Canada: Department of Health. CanadaAction Plan for Children: Guide to Applicants.Ottawa: Health Canada, 1995; Canada:Department of Health. Canada PrenatalNutrition Program: Guide to Applicants.Ottawa: Health Canada, 1995.

34. Federal/Provincial/Territorial MinistersResponsible for Social Services. The NationalChild Benefit: Building a Better Future forCanadian Children. Ottawa: HumanResources Development Canada, 1997, p.6.

35. Ibid., p.3.

36. See Government of Canada. Backgrounder –National Children’s Agenda. Ottawa: Minister

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of Public Works and Government Services,1997, <http://socialunion.gc.ca/nca/nca1_e.html>; Also see, Task Group Report.National Children’s Agenda Framework,August 22, 1997.

37. Government of Canada. Backgrounder –National Children’s Agenda, p.1.

38. It can also be argued that the CHST is amajor mechanism through which cuts toprograms were made and may continue tobe made. Unlike previous arrangements forfederal-provincial transfers, like CAP and EPF,the CHST is relatively unencumbered withlegislative requirements as to how thetransfer monies have to be spent. See Dayand Brodsky, Women and the Equality Deficit.

39. See Broadbent. The Rise and Fall of Economicand Social Rights ; Canadian Council onSocial Development. Will the 1998 FederalBudget Bring Down Canada’s Social Deficit?Ottawa: CCSD, 1998 <http://www.ccsd.ca/pr/pp_bud98.htm>; Day and Brodsky. Womenand the Equality Deficit; Christa Freiler andJudy Cerny. Benefiting Canada’s Children:Perspectives on Gender and Social Responsibil-ity. Ottawa: Status of Women Canada, 1998;Kent. Social Policy 2000; Judith Maxwell.“Reconnecting Communities: Two Scenariosfor the 21st Century,” in The Philanthropist,14(3), 1998; Tarasuk and Davis. Responses toFood Insecurity … ; Sherri Torjman. Strategiesfor a Caring Society. Ottawa: Caledon Instituteof Social Policy, 1998.

40. Ken Battle. Persistent Poverty. Ottawa:Caledon Institute of Social Policy, 1997;David I. Hay. “Campaign 2000: Child andFamily Poverty in Canada,” in JanePulkingham and Gordon Ternowetsky (eds.),Child and Family Policies: Struggles, Strategies,

and Options. Halifax: Fernwood, pp.116-133,1997; National Council of Welfare. PovertyProfile 1996. Ottawa: NCW, 1998; ArmineYalnizyan. The Growing Gap: A report ongrowing inequality between the rich andpoor in Canada. Toronto: Centre for SocialJustice, 1998.

41. Statistics Canada. Income Distributions by Sizein Canada, 1996. Ottawa: Statistics Canada,1997, catalogue No. 13-207-XPB, cited in (andwhere the quotation is from) NationalCouncil of Welfare. Poverty Profile 1996, p.1.

42. Ken Battle. Government Fights the GrowingGap Between Rich and Poor. Ottawa: CaledonInstitute of Social Policy, 1995.

43. Ibid.; Battle, Persistent Poverty, 1997.

44. Canadian Council on Social Development.“Average Incomes of Families and Unat-tached Individuals, Canada, 1951-1995,” from<http://www.ccsd.ca/fs_avgin.html>.Ottawa: CCSD, 1997.

45. Although some commentators disagree thatgovernments are unable to continue theirsupport of social programs. See LindaMcQuaig. The Cult of Impotence. Toronto:Viking Penguin, 1998.

46. Federal, provincial, and territorial govern-ment representatives are currently negotiat-ing a “new social union,” a major componentbeing the restoration of federal cuts tohealth, education, and social service transferpayments, although the talk is all abouthealth care funding. See Edward Greenspon.“Federal offer plays well at social-uniontalks,” in The Globe and Mail, January 13, 1999,p. A1; Edward Greenspon. “Provinces mustcooperate to get health funds,” in The Globe

25


and Mail, January 13, 1999, p. A7; EdwardGreenspon. “Health care not the onlycasualty of federal cutbacks,” in The Globeand Mail, December 19, 1998, p. A9.

47. On the professionalization of the welfarestate, see J.K. Krane, “Least Disruptive andIntrusive Course of Action … for Whom?, in J.Pulkingham and G. Ternowetsky, Child andFamily Policies: Struggles, Strategies, andOptions, Halifax: Fernwood, 1997. On therelationship between program spendingand program outcomes, see W.R. Shadish, T.D.Cook, and L.C. Leviton, Foundations ofProgram Evaluation

48. Life Sciences Research Office. “Core indica-tors of nutritional status for difficult-to-sample populations,” in the Journal ofNutrition, 120:1559-1600, 1990. Cited inMcIntyre, Connor, and Warren. A Glimpse ofChild Hunger in Canada, p.7.

49. Barbara Davis and Valerie Tarasuk. “Hunger inCanada,” in Agriculture and Human Values,11:50-57, 1994. Cited in McIntyre, Connor,and Warren. Ibid.

50. Life Sciences Research Office. Core indicatorsof nutritional status …. Cited in McIntyre,Connor, and Warren. Ibid. See also ValerieTarasuk, George H. Beaton, Jennifer Geduld,and Shelley Hilditch. Nutritional Vulnerabilityand Food Insecurity among Women in FamiliesUsing Food Banks. Toronto: University ofToronto, 1998.

51. Hay. Campaign 2000: Child and Family Povertyin Canada.

52. For a comprehensive discussion of theseissues, see Shaw, Racine, and Offord. TheEffects of Breakfast on Children’s Mood …;

McIntyre, Travers, and Dayle. Children’sFeeding Programs in Atlantic Canada.

53. Shaw, Racine, and Offord, Ibid.

54. Although some research shows that poorchildren at risk of hunger have actively beenwithheld from programs. See McIntyre,Travers, and Dayle. Children’s FeedingPrograms in Atlantic Canada; Tarasuk, Beaton,Geduld, and Hilditch. Nutritional Vulnerability.

55. McIntyre, Connor, and Warren.A Glimpse ofChild Hunger in Canada.

56. McIntyre, Connor, and Warren. Ibid. See alsoTarasuk, Beaton, Geduld, and Hilditch.Nutritional Vulnerability.

57. Particularly important programs requiringrate increases are provincial social assistanceand federal child benefits. For a discussion ofthis in the context of hunger and foodinsecurity, see McIntyre, Connor, and Warren.Ibid; Shaw, Racine, and Offord. The Effects ofBreakfast on Children’s Mood … ; Tarasuk andDavis. Responses to Food Insecurity. For recentassessments of federal and provincial childand family benefits, see National Council ofWelfare. Child Benefits: Kids Are Still Hungry.Ottawa: NCW, 1998; Ken Battle and MichaelMendelson. Child Benefit Reform in Canada:An Evaluative Framework and Future Direc-tions. Ottawa: Caledon Institute of SocialPolicy, 1997; Freiler and Cerny. BenefittingCanada’s children ; and, Jane Pulkingham,Gordon Ternowetsky, and David I Hay.“Eradicating poverty or victimizing thepoorest? New program will not raise poorchildren’s incomes,” in CCPA Monitor, 4(1):6-7,1997. For a discussion of the adequacy of themix of employment and transfer income, seeHay. Campaign 2000: Child and Family Poverty

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in Canada ; Battle. Government Fights GrowingGap., 1995; Battle. Persistent Poverty , 1997.

58. Again, evidence tends to be anecdotal. For areview of this issue, see British ColumbiaHeart Health Coalition. Feed Our Future:Secure Our Health. A plan to put BC at theforefront of food and nutritional health inCanada. Vancouver: Heart and StrokeFoundation of BC & Yukon, 1997.

59. Field. Putting Food First .

60. McIntyre, Travers, and Dayle. Children’sFeeding Programs in Atlantic Canada ; Tarasukand Reynolds. A qualitative study …

61. Riches. First World Hunger

62. McIntyre, Travers, and Dayle. Children’sFeeding Programs in Atlantic Canada .

63. Martha O’Connor, personal communications,January 29, 1999.

64. Tarasuk, Beaton, Geduld, and Hilditch.Nutritional Vulnerability .

65. Toronto Food Policy Council. Developing aFood System Which is Just and Environmen-tally Sustainable. Toronto: Toronto FoodPolicy Council, 1994, p. 7. Cited in Riches.First World Hunger , p. 69.

66. For a discussion and examples of commu-nity-government partnerships, see:W.Roberts, R. MacRae and L. Stahlbrand, “RealFood for a Change,” Toronto: Random House,1999; M. Koc, R. MacRae, L.J.A. Mougeot, J.Welsh, (editors), For Hunger Proof Cities;Sustainable Urban Food Systems, Ottawa:International Development Research Centre,1999; Toronto Food Policy Council, “If theHealth Care System Believed ‘You Are WhatYou Eat’: Strategies to Integrate Our Food

and Health Systems”, Discussion Paper 3,November 1997; Toronto Food PolicyCouncil, “Reducing Urban Hunger in Ontario:Policy Responses to Support the Transitionfrom Food Charity to Local Food Security, “Discussion Paper 1, December 1994; DebbieField and Anuja Mendiratta, “Food 2002:What Would It Take For Everyone in Ontarioto Have Access to Affordable, NutritiousFood?”, Toronto: FoodShare,1999.

67. For a discussion of the importance ofconceptual frameworks, see David I Hay.Evaluating Measures of Well-Being, a paperpresented to the CSLS Conference on theState of Living Standards and the Quality ofLife in Canada, Victoria: InformationPartnership, October 1998. Available at<www.CSLS.ca> and at<www.InfoPartners.ca>.

68. Information on the social union frameworkagreement (SUFA) is available at thefollowing site: http://socialunion.gc.ca/news/020499_e.html

69. See McRae, Rod. “So Why Is the City ofToronto Concerned about Food andAgriculture Policy? A Short History of theToronto Food Policy Council,” C and ABulletin, Volume 50, Winter, 1994.

70. For examples of community economicdevelopment (CED) initiatives in the foodsector, see Fairholm, Jacinta. “Urban Agricul-ture and Food Security Initiatives in Canada:A Survey of Canadian NongovernmentalOrganizations,” Cities Feeding People (CFP)Report Series, Report 25, InternationalDevelopment Research Centre,March, 1999(see www.idrc.ca/cfp/rep16_e.html); OntarioHealthy Communities Coalition. “HealthyFood, Healthy Communities: How to initiate

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grassroots food projects using the HealthyCommunities Process,” Toronto, Ontario,January, 1997; Garr, Robin. Reinvesting InAmerica:The Grassroots Movements That AreFeeding the Hungry, Housing the Homelessand Putting Americans Back to Work,Addison-Wesley, 1995 (see www.grass-roots.org).

Appendix ABACKGROUND

Health Canada recently completed athree-phase review of school-basednutrition and feeding programs inCanada. In Phase I, interviews wereconducted with provincial govern-ment officials about existing pro-grams within their jurisdictions.1

Tables summarized the state ofprogram development by provinceand territory, including programdescriptions, characteristics, man-agement, and evaluation. In addi-tion, some information on school

food service guidelines, policies andnutrition education initiatives wasincluded.

During Phase II, a literature reviewand analysis were conducted on therole of breakfast programs in con-tributing to children’s mood, behav-iour and ability to learn.2 The paperproduced from this analysis con-tained a concise summary of themajor findings from the scientificliterature, and it outlined policyimplications and recommendations.

This paper represents the work donein Phase III. It contains an analysisof whether school food programs arean appropriate social policy choicefor children. Building on the firsttwo phases of Health Canada’s work,and supported by additional re-search, this paper also suggestspolicy directions for the federalgovernment, community organiza-tions, and other food programstakeholders.

28


RESEARCH QUESTIONSAND METHODS

Health Canada requested that thefollowing two research questions beaddressed:

Research Question 1

Are school-based nutrition programs asound social policy response for children?This discussion may take into con-sideration the following points:

! context of changes to social serv-ices and the public safety net.

! context of commitments underFood Security Action Plan, UNConvention on the Rights of theChild.

! multiple goals of school-basednutrition programs (for example,as a response to hunger, poverty,pressures of working parents,children’s poor eating patterns,and the like).

! issues of local sustainability anddependency.

! consistency with other key federalstrategies in health, social policyand income security.

Research Question 2

What role, if any, should the federalgovernment assume in supportingthese programs? This discussionshould consider the following:

! the present involvement of provin-cial governments and the voluntarysector (such as charitable founda-tions and community groups) inthe funding and delivery of theseprograms.

! the role of families in the provisionof basic needs for children.

! assessing the range of possibleroles with respect to federal in-volvement.

Interviews with key informants anda review of relevant research litera-ture were the two methods used inthis study. A list of people consultedas key informants is attached as

29


Appendix B. All literature cited isreferenced in the paper’s endnotes.

Health Canada provided a selectedbibliography of 14 citations onschool-based nutrition. From thesecitations, and through a consulta-tion with Graham Riches at theUniversity of British Columbia, aninitial list of key informants wascreated. Additional literature wassought, and key informants wereinterviewed based on the recommen-dations of other informants, or as aresult of the particular issues beinginvestigated. Key informants wereprovided with the background andcontext for the research verbally orin writing prior to being inter-viewed. Informants were interviewedby phone or in person in Victoria,Vancouver, Burlington, Hamilton,and Toronto.The research was conducted betweenNovember 1998 and February 1999.A preliminary overview of the paper

was reviewed by Health Canada inmid-December 1998.3 The completedraft paper was later reviewed byHealth Canada and a select group ofkey informants,4 and the paper wasaccepted by Health Canada in Febru-ary 1999. This version of the paperhas been edited for publication.

Notes1. Scan of Canadian School Nutrition Programs

1998. Ottawa: Health Canada, Childhood andYouth Division, 1998, unpublished.

2. Aurelia T. Shaw, Yvonne Racine, Dan R. Offord.The Effects of Breakfast on Children’s Mood,Behaviour and Ability to Learn. Hamilton:Canadian Centre for Studies of Children atRisk, 1998, unpublished.

3. The preliminary overview was also reviewedby Graham Riches and Lynn McIntyre. Allcomments were incorporated into the paperat the author’s discretion.

4. Lise Bertrand, Lydia Dumais, Debbie Field,Phyllis Godfrey, Lynn McIntyre, MarthaO’Connor, Dan R. Offord, Yvonne Racine,Graham Riches, and Valerie Tarasuk.

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Appendix BPeople consulted for this review:

Janice Aull, Ministry for Children andFamilies, Victoria

Carolyn Barber, Department of PublicHealth, City of Toronto

Herb Barbolet, Farm Folk/City Folk,Vancouver

Lise Bertrand, Public Health Directorate,Montreal

Gavin Brown, Ministry for Children andFamilies, Victoria

Barbara Crocker, Vancouver/RichmondHealth Board, Vancouver

Lydia Dumais, Health Canada,Ottawa

Laurie Duncan, Ministry for Children andFamilies, Victoria

Corinne Eisler, Vancouver/RichmondHealth Board, Vancouver

Debbie Field, FoodShare,Toronto

Lisa Forster-Coull, Ministry of Health,Victoria

Phyllis Godfrey, Ministry of the AttorneyGeneral, Victoria

Louise Hanvey, Canadian Council onSocial Development, Ottawa

Anne Hay, St. Christopher’s Church,Burlington

Clyde Hertzman, University of BritishColumbia, Vancouver

Joanne Houghton, Consultant, PrinceGeorge

Colin Hughes, Children’s Aid Society,Toronto

Laura Kalina, Food Policy Council,Kamloops

Fiona Knight, Consultant,Toronto

Rod MacRae, Food Policy Council,Toronto

Lynn McIntyre, Dalhousie University,Halifax

Catherine Moraes, Toronto District SchoolBoard, Toronto

Martha O’Connor, Canadian LivingFoundation, Toronto

Dan R. Offord, McMaster University,Hamilton

Yvonne Racine, McMaster University,Hamilton

Graham Riches, University of BritishColumbia, Vancouver

David Ross, Canadian Council on SocialDevelopment, Ottawa

Valerie Tarasuk, University of Toronto,Toronto

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