Abstract

BackgroundFood insecurity is strongly associated with poor mental and physical health, especially with chronic diseases. Food banks have become the primary long-term solution to addressing food insecurity. Traditionally, food banks provide assistance in the form of pre-packed hampers based on the food supplies on hand, such that the food items often do not meet the recipients’ cultural, religious or medical requirements. Recently, new approaches have been implemented by food banks, including choice models of food selection, additional onsite programming, and integrating food banks within Community Resource Centres.MethodsThis study examined changes in food security and physical and mental health, at four time points over 18 months at eleven food banks in Ottawa, Ontario, Canada. The participants – people who accessed these food banks – were surveyed using the Household Food Security Survey Module (HFSSM) and the Short-Form Health Survey Version 2 (SF-12). Statistical analyses included: pairwise paired t-tests between the mean perceived physical and mental health scores across the four waves of data collection, and longitudinal mixed effects regression models to understand how food security changed over time.ResultsThe majority of people who were food insecure at baseline remained food insecure at the 18-month follow-up, although there was a small downward trend in the proportion of people in the severely food insecure category. Conversely, there was a small but significant increase in the mean perceived mental health score at the 18-month follow-up compared to baseline. We found significant reductions in food insecurity for people who accessed food banks that offered a Choice model of food distribution and food banks that were integrated within Community Resource Centres.ConclusionsFood banks offer some relief of food insecurity but they don’t eliminate the problem. In this study, reductions in food insecurity were associated with food banks that offered a Choice model and those that were integrated within a Community Resource Centre. There was a slight improvement in perceived mental health at the 18-month time point; however, moderately and severely food insecure participants still had much lower perceived mental health than the general population.

Highlights

  • Household food insecurity, defined as the inadequate or insecure access to food due to financial constraints, is a growing health problem in Canada that adversely affects mental, physical, and social health, and strains our healthcare system [1, 2]

  • We found five quantitative studies that examined the health of people who relied on food banks in Europe and North America [24, 40,41,42,43]; none of these studies were of a longitudinal nature with participants who accessed food banks on a long-term basis

  • Study aims The main aim of this study is to model changes in food insecurity over time and identify their associations with different types of food bank approaches offered in Ottawa

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Summary

Introduction

Household food insecurity, defined as the inadequate or insecure access to food due to financial constraints, is a growing health problem in Canada that adversely affects mental, physical, and social health, and strains our healthcare system [1, 2]. The magnitude of the problem is alarming considering that in 2017–2018, one in eight households in Canada faced food insecurity, which translates into nearly 4.4 million people, including more than 1.2 million children. Past research has highlighted the many negative health consequences associated with food insecurity [3,4,5], including a multitude of chronic conditions, such as arthritis, back problems, hypertension, diabetes, and cardiovascular disease [6,7,8,9]. New approaches have been implemented by food banks, including choice models of food selection, additional onsite programming, and integrating food banks within Community Resource Centres

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