Over the past decade, the concept of food security (centred around issues of hunger and lack of sufficient, healthy food) has expanded to community food security (CFS). This broader approach addresses all aspects of our food system and is concerned with its effect on the long term health of the entire population. The food system includes food production and processing and distribution (locally and globally), as well as food access and utilization by individuals, communities, and populations. These components are in turn influenced by public policies.
In this context, CFS can be defined as "a situation in which all community residents obtain a safe, culturally acceptable, nutritionally adequate diet through a sustainable food system that maximizes self-reliance and social justice." (Hamm & Bellows, 2003)
II Community Food Security and Public Health
How can such an all-encompassing, multi-disciplinary set of issues be relevant to, and within the scope of, public health work? There are two main responses to this question.
A. Changes in the food system have given rise to changes in public health.
The rising incidence of chronic diseases (especially obesity and diabetes), food borne illness, and hunger throughout North America since the mid 1980s is not explainable through individual behaviours alone. People are affected by the environment in which they live and the choices that are available to them. Many aspects of the food system have changed during this time.
On an economic level, the pressure to keep food prices low and competitive on a world market has driven countless family farms out of business or into poverty. Federal and provincial policy favours the growth of large-scale agricultural operations and massive food processing facilities. Multi-national corporations, which now own and control most of the food economy, ensure that agricultural production feeds the needs of the lucrative fast food and soft drink industries. The majority of food on our table no longer comes from the nearest source but is transported from all over the globe. The cheap, processed food that is so widely available, however, has not slowed down the need for emergency food. Provincial policy has prevented an increase in minimum wages and social assistance for the past nine years while the cost of housing has gone up. The result? The paradox of co-existing food abundance, obesity, and poverty. As well, we are gradually becoming more food insecure at a community level because we rely on an imported food supply.
On a social level, the time pressure of working families has led to fewer communal meals and more eating on the run. This trend is promoted and catered to by the food industry, so that many people consume mostly processed food and lack food preparation skills. Food advertising equates convenience food with social status, enhanced appearance, and instant gratification. There is a strong disconnect between consumers and producers--most people have no idea where their food comes from or how it is grown. Food justice issues have emerged from the use of cheap labour and poor working conditions (globally) in order to maintain low food prices. Reduced social cohesion and deterioration of our rural communities, due to economic pressures, is something we must counteract in the interest of community food security.
On an environmental level, it is becoming clear that depletion of soil and groundwater and pollution of air and water systems are associated with intensive agriculture for crops, livestock, poultry, and farmed fish. Community food security in the long term depends upon a sustainable food system, one that minimizes environmental degradation and fosters crop diversity (as opposed to the mono-cropping that results from biotechnology). Farm land, which produces food for us all, must be protected from relentless urban development and sprawl. Air quality is compromised when massive amounts of fossil fuels are burned to transport food for thousands of miles. Pesticide use must be minimized because it affects human and environmental health.
B. CFS actions are congruent with public health principles.
CFS is a paradigm that is very much in tune with the principles of population health, health promotion, and healthy communities.
In terms of population health, food intake at the individual level is influenced by household resources (food affordability, skills, etc) and by availability of healthy food in the community, workplaces, and schools, which are in turn influenced by policies that affect transportation, agriculture, food safety, urban planning, and social assistance, to name a few. Public health strategies must address food issues at all these levels to make a difference in the way people eat.
CFS actions are based on those of the Ottawa Charter for Health Promotion -- building personal skills, strengthening community action, building healthy public policy, and creating supportive environments. To create food-secure communities, decisions around food must be made in a more participatory, democratic way.
Building healthy communities, as Dr. Trevor Hancock has pointed out, involves improving health determinants in the economic, social, and environmental spheres. (Hancock, 2000) An essential element of healthy communities is the presence of "healthy public policy," which means that explicit concern for health and equity is embodied in the policies of all sectors. When food is perceived only as a commodity--or only a source of nutrients for the body, or only fuel for alleviating hunger--without taking into account broader health-related issues, it has a detrimental effect on community food security.
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III Community Partnerships and Strategies for CFS
How can public health take on such a range of complex, and often politically sensitive, actions?
An essential feature of CFS work is community partnership. Health promotion professionals can be at the table with various players in a local/regional food system, including growers and producers, citizen groups, community agencies, governmental organizations, businesses, academic researchers, and environmental advocates. Of course, they cannot work with all such partners at once but should choose specific strategies opportunistically depending on key issues that arise, which will be different in every region.
In a multi-disciplinary context, health promoters have unique skills that can contribute to CFS. For example, initiating CFS projects requires experience with community development, proposal-writing, media communication, and evaluation design as well as health knowledge. They can help design regional "food charters" that outline food-related principles and values meant to inform policy. Another key contributor to CFS work is research and data collection--a prerequisite for advocacy campaigns and requests for funding.
Here are some examples of CFS projects that can include health promotion professionals.
A. "Buy-local" Campaigns
Purpose: To support farmers who produce food for local sale; to increase awareness about, and to increased opportunities for consumers to buy, healthy, local food (at stores, restaurants and markets)
* Development of a "buy-local" map featuring farms where consumers can buy direct from farmers
* Information materials that feature the health and economic value of locally-grown foods
* Promotion of the health, social, and economic benefits of farmers' markets and food box programs
* Media stories that feature local farmers and their contribution to community food
* Creation of an organization or network where farmers can interact with health promoters, food distributor's, and local institutions where food is sold
* Work towards regional and provincial policies that support the preservation of small farms that sell locally
B. Healthy School Food Programs
Purpose: To increase the capacity of students to choose healthy foods at school and understand the various dimensions of the food system that affect their health and to increase opportunities for local farmers to expand their markets to local schools and universities
* Inclusion of food systems issues and nutrition information in school curriculums
* Adoption of school policy that prohibits the exclusive sale of soft drinks in school vending machines
* Adoption of school policy that ensures the provision of health food choices at school cafeterias
(e.g., salad bar programs)
* Development of farm-to-school and farm-to-university food marketing programs
* Promotion of provincial policy that adequately funds school meal programs and ensures the provision of healthy, minimally processed foods
C. Other CFS-promoting projects
* "Mapping" of retail food outlets of all types and sizes in a region to determine if there are areas were food access is poor
* Training for, promotion of, and policy to support urban agriculture projects
* Food-related skills training to enhance employment opportunities, such as catering or food preserving enterprises for direct marketing
* Promotion of a breastfeeding-friendly society
* Development of policy to protect local agricultural lands and fish habitat
* Promotion of policy for adequate incomes for consumers and producers.
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The Ontario Public Health Association has had a Food Security Work Group (FSWG) for over a decade, with a core group of members who are especially devoted to these issues. In 1995 they produced a document called Food for Now and the Future. In 2002, their position paper, A Systemic Approach to Community Food Security: A Role for Public Health was released.
A current project of the FSWG is the Foodnet website, documenting the CFS work being carried out at health units across Ontario. This includes regional or city-wide networks, food policy organizations, coalitions, forums, Food Box programs, directories of community programs, food
charters, Buy Local campaigns, urban agriculture, farmers markets, school food programs, multicultural food and community cooking programs, prenatal and infant nutrition programs, collection of Nutritious Food Basket data and anti-hunger advocacy. One goal of this project is to achieve formal recognition of CFS projects as part of mandated public health work. Foodnet is in progress, but will be accessible through http://www.opha.on.ca.
The FSWG also does advocacy work, such as making food insecurity a provincial election issue (fall 2003). A press release for local use and briefing notes for MOHs were prepared. These provided evidence-based information for the poverty-health connection. FSWG members are also advocating for provincially-funded school meal programs.
Work group members presented at the 2003 OPHA conference, showcasing how public health can work with community partners such as business people, farmers, and environmentalists. Such teamwork illustrates the "systemic" approach to community food security: namely, that healthy people result from healthy communities that support a sustainable, just, and healthy food supply.
If you would like to tune in to key CFS information documents, conferences, and events across North America, you can have your e-mail address added to the Foodnet-l list serv. Call Sophie Bart at OPHA, 1-800-267-6817 x237, for more details.
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V References and Further Reading
1. Hamm MW, Bellows AC. Community food security and nutrition educators. J Nutr Educ Behav. 2003;35:37-43.
2. Hancock T. Healthy communities must also be sustainable communities. Public Health Reports. 2000;115:151-156.
While not referred to in this article, the following are key texts for anyone interested in this topic.
Coveney, J. (2003). Why food policy is critical to public health. Editorial, Critical Public Health, Vol. 13, No.2, pp.99-105.
Koc, M, MacRae R, Mougeot LJA, Welsh. For Hunger-Proof Cities: Sustainable Urban Food Systems. International Development Research Centre, Ottawa, Ontario; 1999.
Feenstra G. Local food systems and sustainable communities. American Journal of Alternative Agriculture. 1997;12:26-28.
See OHPE 370.2 for further resources.