Reproducing or Reducing Inequity? Considerations for School Food Programs

Publication: Canadian Journal of Dietetic Practice and Research
3 October 2017

Abstract

It is important to consider health inequities when exploring the extent to which school food programs may contribute to the stigmatization and social exclusion of families experiencing food insecurity. As part of a broader school-based project, this paper considers evidence derived from a secondary analysis of research in Nova Scotia (NS). In the original research, interviews were conducted with key stakeholders involved in supporting health promotion activities across NS elementary schools. For this article, data were re-examined using tenets of critical discourse analysis to evaluate if school practices were addressing the root social issues by identifying patterns in language and institutional norms. Our findings suggested that further illumination of programs may be needed to ensure that they do not contribute to the stigmatization and social exclusion of families experiencing food insecurity. Nutrition professionals are in a position to engage families experiencing food insecurity in policy action that will shift from a focus on individual determinants towards the social–structural conditions that underlie the complex issue of food insecurity.

Résumé

Il est important de prendre en considération les inégalités sur le plan de la santé lorsqu’on étudie à quel point les programmes d’alimentation dans les écoles pourraient contribuer à la stigmatisation et à l’exclusion sociale de familles victimes d’insécurité alimentaire. Dans le cadre d’un plus vaste projet en milieu scolaire, cet article examine les données probantes issues de l’analyse secondaire d’une recherche effectuée en Nouvelle-Écosse. Dans la recherche d’origine, des entrevues ont été effectuées avec des intervenants clés jouant un rôle dans le soutien d’activités de promotion de la santé dans les écoles primaires de la Nouvelle-Écosse. Pour cet article, les données ont été réexaminées en utilisant les principes de l’analyse du discours critique pour évaluer, en détectant des tendances propres au langage et aux normes institutionnelles, si les pratiques en milieu scolaire s’attaquaient aux problèmes sociaux qui sont à l’origine du problème. Nos résultats suggèrent qu’il pourrait être nécessaire de mieux expliquer les programmes pour assurer qu’ils ne contribuent pas à la stigmatisation et à l’exclusion sociale de familles victimes d’insécurité alimentaire. Les professionnels de la nutrition peuvent engager les familles victimes d’insécurité alimentaire dans une action politique qui mettra l’accent sur les facteurs sociaux et structurels qui sous-tendent le problème complexe de l’insécurité alimentaire plutôt que sur les déterminants individuels.

Get full access to this article

View all available purchase options and get full access to this article.

Financial support: This work was supported by an operating grant from the Canadian Institutes of Health Research (CIHR) [FRN: 93680]. JLM acknowledges funding from a Vanier Canada Graduate Scholarship (CIHR), Knowledge Translation Canada and CIHR (TGF 97068), a Bright Red Graduate Research Award from the Heart and Stroke Foundation of Canada, and the Canadian Cancer Society (Grant #703878).
Conflict of interest: The authors declare that they have no competing interests.

References

1
Mikkonen J, Raphael D. Social determinants of health: the Canadian facts. Toronto, ON: York University School of Health Policy and Management; 2010 [cited 2017 Jul 16]. Available from: http://www.thecanadianfacts.org/.
2
Canada’s action plan for food security: a response to the World Food Summit. Ottawa, ON: Agriculture and Agri-Food Canada; 1998 [cited 2017 Jul 17]. Available from: www.agr.gc.ca/misb/fsec-seca/pdf/action_e.pdf.
3
Ke J and Ford-Jones EL. Food insecurity and hunger: a review of the effects on children’s health and behaviour. Paediatr Child Health. 2015 Mar;20(2):89–91.
5
Centre for Science in the Public Interest. A national nutritious school meal program for Canadian children. Ottawa, ON: Centre for Science in the Public Interest; 2009 Jan [cited 2017 Jul 17]. Available from: https://foodsecurecanada.org/resources-news/resources-research/national-nutritious-school-meal-program-canadian-children.
6
McKenna ML. Policy options to support healthy eating in schools. Can J Public Health. 2010 Jul–Aug;101(Suppl. 2):S14–7.
7
Bartfeld JS and Ahn H-M. The school breakfast program strengthens household food security among low-income households with elementary school children. J Nutr. 2011 Mar 1;141(3):470–5.
8
Williams PL, McIntyre L, Dayle JB, and Raine K. The “wonderfulness” of children’s feeding programs. Health Promot Int. 2003 Jun 1;18(2):163–70.
9
McIntyre L, Travers K, and Dayle JB. Children’s feeding programs in Atlantic Canada: reducing or reproducing inequities? Can J Public Health. 1999 Jun;90(3):196–200.
10
Mâsse LC, Naiman D, and Naylor P-J. From policy to practice: implementation of physical activity and food policies in schools. Int J Behav Nutr Phys Act. 2013 Jun 3;10(1):71.
11
Mullally ML, Taylor JP, Kuhle S, Bryanton J, Hernandez KJ, MacLellan DL, et al. A province-wide school nutrition policy and food consumption in elementary school children in Prince Edward Island. Can J Public Health. 2010 Feb;101(1):40–3.
12
Vine MM, Elliott SJ, and Raine KD. Exploring implementation of the Ontario school food and beverage policy at the secondary-school level: a qualitative study. Can J Diet Pract Res. 2014 Aug 15;75(3):118–24.
13
Vine MM and Elliott SJ. Examining local-level factors shaping school nutrition policy implementation in Ontario, Canada. Public Health Nutr. 2014;17(6):1290–8.
14
Fung C, McIsaac J-LD, Kuhle S, Kirk SFL, and Veugelers PJ. The impact of a population-level school food and nutrition policy on dietary intake and body weights of Canadian children. Prev Med. 2013 Dec;57(6):934–40.
15
Florence MD, Asbridge M, and Veugelers PJ. Diet quality and academic performance. J Sch Health. 2008 Apr;78(4):209–15.
16
McIsaac J-L, Sim SM, Penney TL, Kirk SF, Veugelers PJ. School health promotion policy in Nova Scotia: a case study. PHEnex J. 2012 Jul 21;4(2):1–13. [cited 2017 Jul 17]. Available from: ojs.acadiau.ca/index.php/phenex/article/download/1460/1251.
17
Province of Nova Scotia. Food and nutrition policy documents. Food and nutrition in Nova Scotia schools; 2008 [cited 2017 Jul 17]. Available from: http://www.ednet.ns.ca/healthy_eating/.
18
Province of Nova Scotia. Food and nutrition policy for Nova Scotia public schools: provincial breakfast program standards; 2007 [cited 2017 Jul 17]. Available from: https://www.ednet.ns.ca/docs/foodnutritionbreakfaststandards.pdf.
19
Province of Nova Scotia. Nova Scotia health promoting schools; 2009 [cited 2017 Jul 17]. Available from: http://nshps.ca/.
20
Mcisaac J-LD, Read K, Veugelers PJ, and Kirk SFL. Culture matters: a case of school health promotion in Canada. Health Promot Int. 2017 Apr 1;32(2):207–17.
21
McIsaac J-LD, Chu YL, Blanchard C, Rossiter MD, Williams PL, Raine KD, et al. The impact of school policies and practices on students’ diets, physical activity levels and body weights: A province-wide practice-based evaluation. Can J Public Health. 2015;106(2):e43–51.
22
Creswell JW. Qualitative inquiry and research design: choosing among five approaches. 2nd ed. Thousand Oaks, CA: Sage Publications; 2007.
23
Strauss A, Corbin J. Basics of qualitative research: techniques and procedures for developing grounded theory. 2nd ed. Thousand Oaks, CA: Sage Publications; 1998.
24
Janks H. Critical discourse analysis as a research tool. Discourse Stud Cult Polit Educ. 1997;18(3):329–42.
25
Kirk S, Kuhle S, McIsaac J, Williams P, Rossiter M, Ohinmaa A, et al. Food security status among grade 5 students in Nova Scotia, Canada and its association with health outcomes. Public Health Nutr. 2015 Nov;18(16):2943–51.
26
Tarasuk V, Mitchell A, Dachner N. Household food insecurity in Canada, 2014. Toronto, ON: Research to identify policy options to reduce food insecurity (PROOF); 2014 [cited 2017 Jul 17]. Available from: http://proof.utoronto.ca/wp-content/uploads/2016/04/Household-Food-Insecurity-in-Canada-2014.pdf.
27
Buott K, Haiven L, Haiven J. Labour standards reform in Nova Scotia: reversing the war against workers. Halifax, NS: Canadian Centre for Policy Alternatives; 2012 [cited 2017 Jul 17]. Available from: https://www.policyalternatives.ca/sites/default/files/uploads/publications/Nova%20Scotia%20Office/2012/03/LabourStandardsReformNS.pdf.
28
Newell FD, Williams PL, and Watt CG. Is the minimum enough? Affordability of a nutritious diet for minimum wage earners in Nova Scotia (2002–2012). Can J Public Health. 2014 May 9;105(3):158–65.
29
Williams PL, Watt CG, Amero M, Anderson BJ, Blum I, Green-LaPierre R, et al. Affordability of a nutritious diet for income assistance recipients in Nova Scotia (2002–2010). Can J Public Health. 2012 Jun;103(3):183–8.
30
Hamm MW and Bellows AC. Community food security: background and future directions. J Nutr Educ Behav. 2003 Feb;35(1):37–43.
31
Tarasuk V. A critical examination of community-based responses to household food insecurity in Canada. Health Educ Behav. 2001 Aug 1;28(4):487–99.
32
Hamelin A-M, Beaudry M, and Habicht J-P. Characterization of household food insecurity in Québec: food and feelings. Soc Sci Med. 2002 Jan;54(1):119–32.
33
Alvaro C, Jackson LA, Kirk S, McHugh TL, Hughes J, Chircop A, et al. Moving Canadian governmental policies beyond a focus on individual lifestyle: some insights from complexity and critical theories. Health Promot Int. 2011 Mar 1;26(1):91–9.
34
McIntyre L, Glanville NT, Raine KD, Dayle JB, Anderson B, and Battaglia N. Do low-income lone mothers compromise their nutrition to feed their children? CMAJ. 2003 Mar 18;168(6):686–91.
35
McIntyre L, Raine K, and Dayle JB. The institutionalization of children’s feeding programs in Atlantic Canada. Can J Diet Pract Res. 2001;62(2):53–7.
36
Ashe LM and Sonnino R. At the crossroads: new paradigms of food security, public health nutrition and school food. Public Health Nutr. 2013;16(6):1020–7.
37
Williams PW. “I would have never…”: a critical examination of women’s agency for food security through participatory action research. In: Page-Reeves J, editor. Women redefining the experience of food insecurity: life off the edge of the table. Washington, DC: Lexington Books; 2014. p. 275–313.

Supplementary Material

File (cjdpr-2017-029suppl.docx)

Information & Authors

Information

Published In

cover image Canadian Journal of Dietetic Practice and Research
Canadian Journal of Dietetic Practice and Research
Volume 79Number 1March 2018
Pages: 18 - 22
Editor: Newton Lupwayi

History

Version of record online: 3 October 2017

Authors

Affiliations

Jessie-Lee D. Mcisaac PhD
Healthy Populations Institute, Dalhousie University, Halifax, NS
Kendra Read MSc, PDt
Northern Zone, Nova Scotia Health Authority, Halifax, NS
Patricia L. Williams PhD, PDt
Department of Applied Human Nutrition, Mount Saint Vincent University, Halifax, NS
Kim D. Raine PhD, RD
School of Public Health, University of Alberta, Edmonton, AB
Paul J. Veugelers PhD
School of Public Health, University of Alberta, Edmonton, AB
Sara F.l. Kirk PhD
Healthy Populations Institute, Dalhousie University, Halifax, NS

Metrics & Citations

Metrics

Other Metrics

Citations

Cite As

Export Citations

If you have the appropriate software installed, you can download article citation data to the citation manager of your choice. Simply select your manager software from the list below and click Download.

Cited by

1. Children’s Perceptions of the Ontario Student Nutrition Program (OSNP) in Southwestern Ontario, Canada
2. Moving from Policy to Practice: A Report of School Nutrition Policy Adherence in Nova Scotia

View Options

Get Access

Login options

Check if you access through your login credentials or your institution to get full access on this article.

Subscribe

Click on the button below to subscribe to Canadian Journal of Dietetic Practice and Research

Purchase options

Purchase this article to get full access to it.

Restore your content access

Enter your email address to restore your content access:

Note: This functionality works only for purchases done as a guest. If you already have an account, log in to access the content to which you are entitled.

View options

PDF

View PDF

Full Text

View Full Text

Media

Media

Other

Tables

Share Options

Share

Share the article link

Share on social media