“We Make It Work Because We Must”: Narrating the Creation of an Urban Indigenous Food Bank in London, Ontario, Canada

Abstract

This research draws from a community-engaged methodology and qualitative interviews to narrate the creation and daily operations of an Indigenous food bank in London, Ontario, Canada. In-depth interviews (n = 10) with program leaders, volunteers, and recipients detailed the day-to-day operations, including where and how foods were collected and distributed, and a preliminary analysis of the meanings and challenges of the food bank. The key strengths of the food bank are its focus on cultural safety, provision of traditional foods, and its community-led approach. The limitations of the food bank relate to the structure of the workload and sustainability of program funding. Community-led research with Indigenous non-profit organizations, such as that presented here, offer approaches that are critically important for creating culturally relevant and inclusive data that can both explain and address Indigenous health inequities, and provide the evidence needed to advocate for change.

1. Introduction

Globally, Indigenous peoples’ food systems are prevalent and healthy [1]. A “Traditional Food System” refers to all foods within a particular culture that are available from local natural resources and culturally accepted, including the sociopolitical meanings, acquisition and processing techniques, use, biological composition, and nutritional consequences for the people using the food [2]. The knowledge, practice, and ceremonies surrounding traditional food systems support rich nutritional diets, and they also contribute to the strengthening of cultural identities, belonging, and wellness [2,3,4]. However, for many Indigenous peoples, especially those living in urban environments, traditional foods and other components of Indigenous food systems are not accessible in everyday life [4,5,6]. Traditional and country food consumption practices have been severely impacted by the effects of colonial policies, including forced relocations and other displacements [1,7,8], and the restrictions on the movements and practices of Indigenous peoples—including traditional hunting, fishing, gathering, and other forms of Indigenous food production. The impacts of large-scale environmental changes, including contamination events and the effects of climate change, also contribute in large measure to the decline in access to traditional food systems by Indigenous peoples [9].

In the urban context, many Indigenous households suffer from food insecurity [10,11], malnourishment, and a range of long-term chronic diseases that may be attributed to poverty [12,13], as well as lacking access to jobs and employment opportunities. The complex histories of colonial dispossession, including nutritional transition—that is, the shift away from Indigenous food systems and into market food economies [2]—also considerably contribute to the declining health and poor nutritional status of Indigenous peoples and communities [14]. Across the globe, Indigenous peoples experience similar disparities in contrast to their national population averages, for example, increased obesity and noncommunicable disease are present among Indigenous populations in high-income countries, and increased malnutrition and stunting impact Indigenous populations in low- and middle-income countries [15].

These are the realities for many Indigenous peoples living in the city of London, Ontario, Canada, where the Southwest Ontario Aboriginal Health Access Centre (SOAHAC) has been operating since 1998 to offer a blend of clinical and holistic healthcare and healing for urban Indigenous peoples. Over its 25 years of operation, SOAHAC staff have witnessed the distinct health and social inequities endured by Indigenous peoples living in London, chief among them is hunger, homelessness, and poverty. For many years, SOAHAC has supported elements of food security in their wide-ranging health and social programming. The onset of the COVID-19 pandemic demonstrated increasing food insecurity among their patients, propelling action on this chronic and worsening matter. SOAHAC understands addressing Indigenous foodways means being attentive to the social, cultural, and environmental contexts, which have reduced access to healthy eating, and offering culturally appropriate, community-led ways to rebuild and sustain these foodways. With non-renewable funds from three donors, in 2021, SOAHAC created a culturally unique food bank to support urban Indigenous peoples with access to fresh and nutritious market and traditional foods. The research presented in this paper uses a community-engaged methodology, including qualitative interviews with program creators, volunteers, and recipients, to narrate the creation and daily operations of SOAHAC’s food bank, including where and how foods are distributed; the types and sources of foods provided; and a preliminary analysis of the significance of the food bank, including its limitations and ideas for future growth and program sustainability.

1.1. Indigenous Food Systems and Traditional Foods in North America

Prior to the colonization of North America, Indigenous peoples’ food systems were expressed through sophisticated ecological place-based knowledge, which was accumulated, practiced, and adapted across generations [16]. These systems, known both as Indigenous food systems and/or as traditional food systems (TFSs), centre around Indigenous peoples’ temporal, spatial, and relational ontologies with their unique ecologies and socio-cultural systems [17,18,19]. These systems are expressed through a range of land-based knowledge, practices, and ceremonial protocols related to food harvesting and production practices of traditional foods. These foods are nutritious, local, and centrally important for the physical health and wellness of Indigenous people and communities. Importantly, these systems hold importance that extends well beyond individual nutrition needs. TFSs are supported by and embedded within Indigenous knowledge systems, which refer to the social and cultural ways that Indigenous people relate to elements of their local ecologies, and with one another [20]. In this regard, significant attention is given to the relationships within and between humans and the lands and resources that support life, including a respect for the reciprocal nature of these relationships [21].

Many aspects of the human–food relationship hold deep sociocultural significance [1,2,5,8]. For example, Indigenous communities have unique values associated with food acquisition methods, food processing and preparation techniques, food use and composition, and food consumption [2,3,4]. The social relations that underlie the knowledge and skills needed to procure and process traditional food, and the sharing of food within households, extended families, and communities, are a primary means of reinforcing social networks and bonds [22]. These relationships strengthen cultural identity, belonging, and the affirmation of roles, responsibilities, and relational accountabilities to and with the land and with the wider community [11,21,22].

1.2. Indigenous Food Insecurity, the Urban Context, and the Role of the Food Bank

In a broad sense, food and nutrition security is defined as existing “when all people at all times have physical, social and economic access to food, which is safe and consumed in sufficient quantity and quality to meet their dietary needs and food preferences, and is supported by an environment of adequate sanitation, health services and care, allowing for a healthy and active life” [23]. Food security is determined by four components: availability, access, utilization, and stability. Food insecurity arises when any one of these components is stressed or unmet. Within Canada, Indigenous populations experience disproportionate levels of both severe and chronic food insecurity and the negative health impacts include stress, chronic disease, and early mortality. The high prevalence of food insecurity among Indigenous peoples in Canada is a direct result of colonial policies and structures that have had detrimental impacts on Indigenous food systems [3,5,10,24,25] which some suggest are more pronounced among urban Indigenous peoples. There is a growing body of evidence demonstrating the strong links between colonial policy, the urbanization of Indigenous peoples, and distinct health disparities. As noted in the recent work by Tarasuk and McIntyre [26], the most pressing determinant of food insecurity for Indigenous peoples is income. However, there are important geographic, social, and cultural considerations as well. Urban Indigenous peoples are more likely to be disconnected from their home communities and from the TFSs and knowledge that grow from and are shared in these places [27]. Coupled with other social determinants of health, including low income, the high cost of purchasing traditional foods can be prohibitive for urban Indigenous peoples, as is their ability to travel to their home communities to participate in traditional foods activities. Over generations, this means that urban people may be disproportionately disconnected from the knowledge and skills necessary to acquire, process, and prepare Indigenous foods more rapidly than those Indigenous peoples who live in their home communities or who have strong social connections with those places [10,28,29]. This reality can leave important gaps in the access to and knowledge about traditional foods for urban Indigenous peoples, thereby underscoring the important role that urban Indigenous organizations play in supporting the social, cultural, and health needs of urban Indigenous peoples and communities.

For nearly forty years, food banks have played a key supporting role in addressing food insecurity among Canadians [30,31]. Food banks were established in the 1980s as a temporary solution to address rising patterns of food insecurity that were caused by economic recession. While they were conceptualized as a short-term solution, food banks have become a key and persistent support system for those who struggle to meet their food needs. Among Indigenous people and communities in Canada, patterns and experiences of food insecurity are culturally unique and do not parallel non-Indigenous experiences. For example, while income lies at the heart of Indigenous food insecurity, it is a complex and multidimensional matter that must be contextualized within settler colonial policies that disrupted TFSs and their sociocultural significance for the health and wellbeing of Indigenous peoples. The literature detailing the experience and effectiveness of food banks among Indigenous people and communities is sparse [32,33,34]. The existing data suggest that the redistributive model of food banks fall short in meeting the distinct cultural needs of Indigenous diets [32]. For example, while Indigenous peoples are over-represented in populations accessing food banks, many remain food-insecure [33]. One of Canada’s leading research programs on food security is PROOF1; among their key evidence-based policy directives, they echo call for changes in the public policy to direct funding to Indigenous communities and organizations themselves [32,34] so they can utilize their own cultural models and land-based knowledge to support food security. This paper discusses the creation of an urban Indigenous food bank by an Indigenous health centre in London, Ontario.

1.3. The Southwest Ontario Aboriginal Health Access Centre

Located in the city of London, Ontario, Canada, the Southwest Ontario Aboriginal Health Access Centre (SOAHAC) provides healthcare for urban Indigenous people, which include Inuit, Metis, and First Nations peoples. SOAHAC is one of ten Aboriginal health access centers in the province of Ontario; these centres were launched in 1998 to offer a blend of healthcare services that integrated both biomedical and traditional forms of Indigenous health and healing for Indigenous people living in the province’s largest urban centres. Among all the Canadian provinces, Ontario leads in terms of its representation of urban Indigenous people. In Ontario, nearly 86 per cent of First Nations, Métis, and Inuit live outside of their home communities [35]. London is located on the traditional territories of the Anishinaabek, Haudenosaunee, Lūnaapéewak, and Attawandaron, and has a total population of 422, 324 people [36]. According to the 2016 census, 1.5% of the London population identified as Indigenous [36]. London is located in close proximity to three Indigenous Nations: the Chippewas of the Thames First Nation; the Oneida Nation of the Thames; and the Munsee-Delaware Nation.

SOAHAC’s purpose is to improve access to high-quality healthcare services for First Nation, Inuit, and Métis peoples in the spirit of partnership, mutual respect, and sharing [37]. The inclusion of traditional healing and land-based practices are paramount for SOAHAC to achieve its mission of achieving holistic, integrated care and healing. Traditional healing refers to the health practices, approaches, knowledge, and beliefs that support Indigenous healing and wellness [38]. These practices originate from the cultural knowledges and belief systems of Indigenous peoples and they often include ceremonies, foods and medicines, knowledge, and other therapies and physical or hands-on techniques that may occur in a one-on-one manner, in group settings, and often on the land. SOAHAC is led by an ethical principle of transparency regarding all that they do. To support their commitment to openness and shared responsibility, SOAHAC’s programs are developed in consultation with community members and through formal and informal needs assessments. SOAHAC’s Board of Directors is representative of local Indigenous communities. They are tasked with creating and implementing strategic plans that are based on community feedback and needs assessments. These needs assessments often occur on a small scale to evaluate patient needs and desires, but they can also take the form of large-scale studies, as described in Section 2.

2. Materials and Methods

2.1. Collaborating with Indigenous Foodways

SOAHAC is a patient-centered organization that relies on best practices and available health and social data to address the needs of the community it serves and improve upon its programming. Part of its mission is achieved through continual conversation with and direction from clients. After new programs are initiated or changes are performed to existing programs, SOAHAC staff extend opportunities for clients to offer feedback about their level of satisfaction, most often through surveys. Similarly, when new programs are being proposed, SOAHAC enlists the help of clients to support its planning and take into consideration the desires of the community. To do this, the staff ask clients to complete anonymous questionnaires while waiting for, or at the completion of, appointments.

However, when SOAHAC seeks population-level data, for example, in the form of city-, provincial-, or even national-level data, too often the publicly available data are inaccurate, misleading, and under-representative of the Indigenous population. Indigenous data quality challenges, including misclassification errors and non-response bias, systematically contribute to a significant underestimation of inequities in health determinants, health status, and healthcare access between Indigenous and non-Indigenous people in Canada [39]. Additionally, the resulting gaps in the information present a substantive barrier for Indigenous community leaders, health policy makers, and practitioners responsible for the implementation and evaluation of evidence-based health interventions, and at a policy level, this means that many Indigenous needs and challenges remain unmet [39] (p. 67). To address these limitations, SOAHAC seeks community-based research partnerships to collect data about the health and social characteristics of their clientele.

Community-engaged research with Indigenous communities is predicated on the understanding that Indigenous communities themselves are the experts of their own needs and desires and should be the ones to narrate these stories back to research, community, and policy audiences [40,41]. Building such a partnership evolves through relational practices and the alignment of foundational principles, such as respect, responsibility, relevance, reciprocity, and refusal [40,42]. Together, the research partners come to an agreement about their ethical protocols, that is, how they will work together to achieve common goals [43]. However, central to this agreement is a shared understanding of the value system and principles that will be upheld in the work. These values support the research team in their relational work and in meeting the stated goals and objectives.

The existing body of community-based Indigenous health scholarship focuses on exploring, describing, and sharing the unique relationships between the health and wellness of Indigenous people and their connections to their socio-political, cultural, and physical environments [44]. Experiences of colonization and dispossession from the land are central to many of the health and social inequities experienced by Indigenous populations at present. Indigenous health scholars are responding to these inequities by creating academic spaces that welcome, nurture, and celebrate Indigenous knowledge and leadership in the research [40,41]. The research reported here falls within this approach.

One of the significant challenges SOAHAC has repeatedly witnessed among its patient population is food insecurity [27]. Especially in the aftermath of the COVID-19 pandemic, the inflation in food prices has extenuated the consequences of food insecurity for urban Indigenous peoples, and particularly for those who live on a fixed (low) income. From 2019 to 2022, internal surveys on patients identified a 95% increase in the number of SOAHAC clients reporting food insecurity to their primary care provider. This message echoes the findings of two separate community-based studies SOAHAC partnered with to examine the health and social needs of their patient population.

In 2008–2017, SOAHAC was active in the Food Choices Study, a mixed-methods study collaboratively designed to characterize patterns of food security among Indigenous peoples living in London and in a nearby First Nation community, and secondarily to explore the determinants of food choice among women-led families with young children. This study demonstrated high levels of food insecurity—with important social and geographic inequities between on-reserve and urban residents—and a strong desire for traditional foods and improved access to cultural knowledge and supports for preparing, handling, and preserving traditional foods [10,27,45,46].

The second collaborative study SOAHAC engaged in was Our Health Counts [47], a community-based research project that gathered missing health information about urban Indigenous people to improve and expand upon the existing health and social services. The survey was first developed in 2009 as a partnership between Well Living House at St. Michael’s Hospital (Toronto) and De Dwa Da Dehs Nye>s Aboriginal Health Centre (Hamilton). The success of the initial project inspired urban Aboriginal agencies across Ontario to partner with Well Living House to complete similar surveys in Toronto, Ottawa, and Thunder Bay. In London, SOAHAC partnered with Well Living House and surveyed over 750 Indigenous people living, working, or accessing health and/or social services in London, Ontario. The Our Health Counts study design provides an opportunity to address the broad gaps in urban Indigenous health assessments across holistic health domains and lifecycle stages; the results are publicly available and are being used to improve health, healthcare access, and improve health and social programming for urban Indigenous individuals, families, and communities.

Collectively, the two studies outlined above demonstrate an approach to the research that is necessary to achieve Indigenous leadership, community relevance, and scientific excellence. Community-based health research with and for Indigenous peoples responds in direct and active ways to the historic underrepresentation of Indigenous peoples in scientific inquiry, data analysis and dissemination, and the policies and programs that subsequently emerge from them [39,41]. The inclusion of Indigenous perspectives and methodologies in collaborative health research serve critically important purposes: they offer culturally relevant and inclusive data to explain the inequities that Indigenous people and communities have witnessed for so long, and they provide the hard evidence needed to lobby for change.

2.2. Data and Analysis

This research draws from a community-engaged methodology that builds on a long collaboration between the Southwest Ontario Aboriginal Heath Access Centre and an Anishinaabe scholar and their research team [10,27,45,46] to describe and narrate the creation and daily operations of SOAHAC’s Indigenous Food Bank, in part to create a cultural evaluation for their funder, and secondarily to document the project for future grant applications. The relational work on this study began in spring 2022, with many informal conversations about what a cultural evaluation might look like, including its wider objectives. Over the course of several months, the team came to an agreement that this research would build from qualitative interviews with program leaders, volunteers, and recipients, and would include the development of a short film that could subsequently be used to broadly share SOAHAC’s learnings with diverse audiences, including their funders, and other Indigenous communities and organizations. The interviews were determined to be the best method for documenting SOAHAC’s food bank as they offered flexibility for opinions, reflections, stories, and experiences to be shared by the participants. The interviews began in summer 2023 and are currently being conducted with food bank leaders, volunteers, and recipients. The analysis shared here presents a preliminary thematic analysis of 10 such interviews regarding the creation, daily operations, and challenges and meanings of the SOAHAC food bank. The interviewees included two program leaders, two volunteers, and six program recipients. Nine of the ten interviewees were Indigenous people.

The interview guide for this research contained a mix of open and flexible questions, which encouraged interviewees to share their experiences and stories about their involvement in and perceptions of the food bank. With permission, all the interviews were audio-recorded and five were filmed. SOAHAC’s Board of Directors approved this study. Ethics approval was sought from Western University’s Non-Medical Research Ethics Board.

2.3. Analysis

The recorded interviews were transcribed and uploaded to NVivo 14 software, an organizational and storage tool that permitted analytical techniques for the textual data. A thematic approach was used to develop an analysis that told the story of the interview data [48]. Thematic analysis focuses on the meaning of what is said and recognizing patterns of themes that are similar or overlap [49]. The NVivo program supported a framework for organizing the transcripts, which were read and reviewed numerous times prior to the developing of codes. The main author created a coding framework to apply across the collected interviews, from which main themes were explored and links were developed. To ensure support consistency across the academic and local interpretations of the data and main concepts, the analysis was shared among the research team members at SOAHAC. At this time, thematic ideas, program details, and the application of concepts were refined and suggestions for illustrative examples were provided. Creating opportunities for community interpretations of the data analysis was paramount to the application of community-engaged approaches; while a good deal of attention was often paid to community offerings in problem definitions and the creation of measures, too often their voices and perspectives were absent from the analysis, interpretation, and discussion of the findings.

3. Results

This section draws from the findings of informal conversations and interviews (n = 10) with program leaders, volunteers, and program recipients to describe how the Indigenous food bank was created, its day-to-day operations, and the challenges and meanings associated with operating an Indigenous food bank. SOAHAC has a long history of food security programs, most of which have operated on a small scale and in a non-continuous manner to distribute fresh fruits and vegetables to their clients. During and after the COVID-19 pandemic, food insecurity among Indigenous people reached crisis levels. During this time, many community food resources, such as drop-in kitchens, soup kitchens, and other community-based meal offerings, were canceled and/or closed [50]. This left many hungry and searching for help:

“A lot of the clients we work with are struggling. Many are living on fixed income supports, where the average person gets about $30 a week for food. The cost of food has gone up significantly since the pandemic, and now we’re seeing the aftermath of that. But the fixed income supports have not gone up accordingly. We’re seeing people really, really struggling. And it’s not just people living on fixed incomes, but lots of people, even middle class who are not able to afford the healthy foods that used to come or used to be easier to access” (Program Leader A).

Witnessing these grave impacts on their patients and other community members, in fall 2020, SOAHAC applied for and was successful in receiving two small grants to offer emergency food supplies, including fresh fruits, vegetables, and proteins, for those who needed them. After running the program for a few months, SOAHAC undertook a small-scale survey to determine the uptake and response among the recipients:

“The feedback was overwhelmingly positive; recipients pleased with the program and they wanted more. We understood these small programs were merely addressing the tip of the iceberg of needs, so in 2021, we applied for and were successful on two large grants” (Program Leader A).

These two grants (one from United Way, another from the London Community Foundation) would provide SOHAC with the resources needed to supply foods through their Indigenous food bank for two years (April 2022–2024): “This was the first time we had money specifically for food items, including traditional foods, so we were thrilled” (Program Leader B).

3.1. Components of the Indigenous Food Bank at SOAHAC (London)

Championed by its lead dietitian, the Indigenous food bank operates in two key spaces to serve London’s Indigenous community: (1) SOAHAC’s clinic site and (2) at its daycare. With grant support for food costs, the daily operations of the food bank were fully supported through donated time by SOAHAC staff (e.g., lunch breaks and at other times outside their client-facing work), and with the help of student volunteers. The Indigenous food bank consists of three separate, but interrelated, food distribution programs that work to offer a range of fresh fruits and vegetables, essential items, non-perishable foods, as well as traditional foods and medicines for the Indigenous community in London, Ontario. These three programs include (1) the Emergency Food Hub; (2) the Food Box; and the Traditional Food Bag. The food bank operates from a lens of cultural humility and has a desire to meet Indigenous food insecurity needs in a respectful and culturally relevant manner. The decision to house the Indigenous food bank within the walls of SOAHAC’s clinic and daycare sites was a deliberate attempt to extend cultural safety and other values of inclusion and belonging:

“We could not imagine hosting our Food Bank anywhere but here. We have created a safe space. It is barrier free. We welcome all Indigenous peoples who need help. This is a judgement free space. We never want our people to feel shame when asking for help” (Program Leader 2).

The first and longest lasting of the three programs is the Emergency Food Hub. The food supplies for the Emergency Food Hub are donated to SOAHAC by the London Food Coalition, whose wider objectives are to reduce food waste and to support members of the London community who are at risk of poverty and food insecurity. The London Food Coalition collects produce from grocery stores and redistributes it to organizations in London. Every Monday, the London Food Coalition makes donations to SOAHAC. The supplies offered through the Emergency Food Hub vary week to week, but, in general, these donations are inclusive of a range of fresh fruits and vegetables:

“We happily accept these items. Sometimes the fruits or vegetables are a bit banged up, but their overall quality is good, and our patients love to receive them” (Program Leader A).

The second arm of the Indigenous Food Bank is the Farm Box. The Farm Box was created by SOAHAC in 2022 with funding from the United Way. The United Way supports programs and services that assist people in accessing and obtaining the nutritious food they need to live healthy, active lives and they invest in programs, such as community kitchens, school meal programs, food distribution initiatives, and community gardens. The Farm Box is supplied with fresh fruits and vegetables from Turner’s Farm, a non-Indigenous farm located near London, Ontario. Deliveries are made to SOAHAC on Thursday afternoons:

“When the farmer arrives at SOAHAC, it’s all hands-on deck. There are tomatoes, lettuce, carrots, crates overflowing with fresh foods—so many boxes to move upstairs and repackage for our clients! Thursdays are very exciting because we know how much the food means for our clients” (Volunteer A)

In summer, the Farm Box has fresh fruits and vegetables that are grown and harvested locally. During summer, these items are priced inexpensively, and they are plentiful, which means that many Farm Boxes can be made for recipients. In the late-fall and winter months, Turner’s Farms must outsource fruits and vegetables from greenhouses and non-local growers, leading to cost increases and reducing the number of farm boxes available. The United Way grant supports the Farm Boxes to be supplemented with healthy market foods and nonperishable items, such as whole grains (cereals), high-quality proteins and snacks (nuts, peanut butter, tuna, and beans), and other proteins and dairy products, such as meats, eggs, yogurt, and milk. Basic household items, such as diapers, toilet paper, formula, and meal replacement supplements, may be requested alongside the Farm Boxes. Market foods and supplies that accompany the Farm Box are purchased and delivered weekly to SOAHAC by a local food service.

The third component of the Indigenous food bank is the Traditional Food Bag. The funds for the Traditional Food Bags are provided by the London Community Foundation, through a two-year pilot project grant (2022–2024), called “Minomode-zewin nunge-gehwin”, which translates to “healthy ways of eating.” Traditional Food Bags offer a range of traditional foods from across Canada, including wild rice, white corn, dried beans (navy), squash, traditional meats (bison, venison, and elk, including jerky), fish (salmon, trout, and pickerel), dried and fresh berries, maple syrup, elderberry syrup, saskatoon berry jam, and honey.

3.2. Place and Time of Indigenous Food Bank Operations

SOAHAC’s Indigenous food bank operates from two distinct sites located in London Ontario: SOAHAC’s main clinic site and its daycare site. The clinic site serves Indigenous patients broadly from across the city, and it also supports homeless Indigenous peoples in the London community who are food-insecure and request help. To manage the demand at the clinic site, two afternoons a week (Monday and Thursday) have been designated for distributions, and all supply requests from the community are made by placing an order on the SOAHAC food bank designated telephone line, which was created to support an efficient process for program recipients when the first part of the program was created in 2021. All potential recipients must call the food bank line and request a pickup date. All food resources are pre-packaged and made available for individuals on their requested pickup days. The phone line is essential for assuring the needs are met at the clinic site, and to distribute the foods as efficiently as possible:

“Knowing how many people are coming tells us how much food to order. The phone line helps us manage that. We need to know how many bags to make, because we never want to make too few bags, and we never want to see food wasted either. Because we do not have a permanent position for the food bank, all needs are managed through the food line” (Volunteer A).

The second site of the Indigenous food bank operates out of the SOAHAC daycare. It offers Food Boxes to approximately 60 Indigenous families who have children attending the daycare. The daycare site enlists the help of a local food service that purchases varying market foods and a range of items that reflect the needs and desires of families with young children—diapers, formula, and household items. The daycare site offers Indigenous families with children attending it with a range of traditional foods and fresh fruits and vegetables. The daycare operates its food bank on Mondays and it has a food pantry located near the family entrance, making it easy to access. Families are invited at any time to help themselves to food and other resources from the food pantry. This is a main differentiation between the food offerings and communities served by the clinic and daycare sites; while both operate on specific days and all foods are pre-prepared, the daycare site offers a self-serve option from the food pantry. It is important to note that while recipients at the clinic site do not have the same freedoms and choices as the daycare site, food resources are always made available to patients when they request them—even outside the planned distribution days—and they may be distributed by any care provider when requested by clients during appointments. Non-clients of SOAHAC may access Food Box items from the clinic site. Indigenous Londoners who request food from SOAHAC are enrolled as food bank participants.

3.3. Meanings of the Indigenous Food Bank

The types of foods offered at the Indigenous food bank are representative of a range of fresh market and traditional foods, as noted above. The diversity of foods reflects both the desires of the program recipients, as well as the seasonal nature of the available foods. All traditional foods are purchased from Indigenous farmers, hunters, fishermen, and harvesters, in Ontario and from across Canada, as available across seasons. Program recipients enjoy the healthy properties of the foods, especially the wild meats and produce:

“My son will say, “I’m doing salmon tonight.” Oh, great! And I know it’s going to be the wild rice too. You look forward to it. My daughter doesn’t like fish, but when he cooks, it’s, it’s different… He didn’t cook the other night. So okay, I made salad and omelets. But it had fresh vegetables in it. My energy gets really low at times, so, but I love it when he cooks. Because it’s so good. And watching him do it makes me happy” (Recipient B).

The traditional food bag is a culturally informed approach to operating a food bank meant to support Indigenous peoples with access to traditional foods that originate from local, regional, and sometimes national settings:

“I think it is the only program that runs of this nature. We do a drop-in every week where clients can access a bag with traditional foods in it. We are sourcing from local and actually really across the province and even the country. We bring the foods into our center, and then we’re able to distribute them to those who want them. Some of the more popular items have been things like wild rice, so we found multiple distributors. We also find white corn very popular. We’re unique because we’re the only people doing that. We don’t like to call our program a Food Bank. It is true we are distributing foods just like a Food Bank does, but what’s different is that we’re feeding people’s bodies, their minds, but also their spirits” (Program Leader A).

SOAHAC is very proud of its offering of traditional foods because they are aware of the distinct cultural importance for their clients:

“Our culture, as Indigenous peoples, is connected to food. Traditional foods bring people together because they remind us of the love, comfort and togetherness of our families, and our earliest beginnings. Many of our families would not have had opportunities to have these foods if it were not for this program. In fact, for some families, their connection with SOAHAC is their only connection with their Indigenous identities. We honour our people and we do all we can for them to come back into knowing this way” (Program Leader B).

In addition to traditional food items, the traditional food bag contains pre-packaged ingredients and recipe cards so that recipients can make culturally important food items, including bannock, Indian cookies, and corn soup. For many clients, the opportunity to access traditional foods is exciting, but can also be worrisome as many do not know how to prepare those foods:

“Our clients want items they know how to cook. For some, the inclusion of these traditional food items can cause anxiety because they may have never cooked them before. They lack the knowledge about how to use them, and the thought of wasting food is devastating for a food insecure family” (Program Leader A).

Shortly after the traditional food bag program became operational, SOAHAC started inserting appropriate recipe cards into the bags, which supported clients with knowing how to work with the items they received:

“They give us recipes. Like I want to make corn soup. Still. I haven’t tackled that one yet. But I know the process if you like do your own. It’s the white corn. And I was looking at the process like we put ash and stuff in it. And it’s to do that by scratch looks hard. And you need to know how. And yeah, I wouldn’t know how to do that by scratch, but they have it prepared and there are recipes. That helps” (Recipient B).

SOAHAC have also begun to operate small cooking classes, which they hope to open up more broadly in the future:

“In my experience, people who live with food insecurity are less inclined to try new recipes because if they try a new recipe that doesn’t work out, they’ve sacrificed a meal that they could affect their family. So I think that that piece [sharing knowledge] is very important; bringing in those knowledge keepers because there are those knowledge keepers still there that can teach how to prepare these foods as well. Right now what we’re distributing is very, like basic things that that most people can follow a recipe and prepare. We’ve already started some youth cooking classes. So we’ve started with the young people and it’s been really eye opening actually that a lot of these youth are now going home and teaching their families how to prepare things” (Program Leader A).

Early after the launch of the food bank, SOAHAC questioned waiting-room patients about the quality of the program. The survey questioned recipients about what they liked and did not like about the program, and it asked them to identify the foods they would like to see offered. One of the most important features of these results pertained to receiving the food resources from a place and the people that they were familiar with. The community-centered nature of SOAHAC and its familiarity makes the food bank feel like a place of belonging, and not a place of need:

“Our clients move to the city for a lot of reasons, and our job is to help them feel safe. They face racism on many levels, and we want to undo that harm in all the ways we can. This place [SOAHAC] is meant to support belonging and care. To reduce barriers and needs. We know the needs of our people and we do all we can to the put the pieces together for their wellness” (Program Leader B).

Another key response among the recipients related to the quantity of food available was the following: “I am appreciative of SOAHAC, but the amount provided is not enough food for my whole family”.

3.4. Challenges of the Food Bank

As noted above, all foods are received, packaged, and distributed at the two SOAHAC sites. Food is delivered to the clinic and daycare sites where it is received by the staff onsite, then moved to a program room where the foods are unpacked, organized, and then repacked and made available for client pickups. For some clients, transportation is a considerable barrier to food pickups. The food bank offers bus tickets for program recipients and Indigenous patient navigators [51]2 are able to deliver food boxes to Elders. The weather can create additional problems for all involved in the food bank—suppliers, program planners, and recipients—as on snowy or stormy days, there may be road closures or other limitations to movement.

To adequately package foods in advance of the designated pickup days, it is essential that the recipients use the food bank telephone line to schedule their pickups. This automated methodology enables SOAHAC staff to know how much food to order and how many bags to pack. Early on in the program, the telephone line was identified as a challenge for some participants (e.g., those without a phone or who had trouble using a phone). SOAHAC offered to remove the phone line and instead offered prepared bags on a first-come-first-serve basis. The downside to this approach was that it did not guarantee sufficient supplies for all who wanted them. Program recipients overwhelmingly opted to keep the phone line.

Perhaps the most important limitation of the Indigenous food bank refers to the management of its workload and the sustainability of the program. All the food purchasing, planning, budget, volunteer recruitment, and organization occurred by two main champions: one at the clinic site and one at the daycare site. Despite the funds for food and other product distributions, the grants offered no assistance for human resources:

“When we were putting in the grant application, we did anticipate needing a dedicated staff member. But it is a lot of work. More than we bargained for. In the Daycare, we are short-staffed as it is, which makes managing the day-to-day extremely challenging because we need to pull staff from child-facing roles. That’s not a sustainable method of operation, and it will lead to staff burn out” (Program Leader B).

This meant that employees of SOAHAC ran the food bank programming simultaneously to their own professional work, sometimes at the expense of their client-facing time. During work hours, any time spent on food security programming came at the cost of other specialized program deliveries, including dietetic support, mental health counseling, social work support, or child programming. Outside of work hours, food bank programming comes from the employees’ personal time, including lunch breaks, evenings, or weekends. This is not a sustainable method for running a long-term food security program.

4. Discussion

This paper drew on the preliminary thematic analyses of ten interviews with key leaders, volunteers, and recipients of the SOAHAC food bank (London, Ontario) to share early learnings about how the program was created, how it functioned on a day-to-day basis, and what meaning the food bank held for those involved, including its limitations. Repeated throughout these pages is a narrative of addressing unmet needs. It is estimated that Indigenous peoples in London are ten-times more likely to endure food insecurity than non-Indigenous peoples [47]. SOAHAC and other non-profit Indigenous organizations in London have witnessed heightened levels of poverty, food insecurity, and homelessness in the aftermath of COVID-19 [50]. Pre-existing health, social, and economic inequities were extended during and after the pandemic, and the need for food security programming for the Indigenous population has never been greater [28,32].

However, also shared in these pages is a message of hope and the significance of restoring cultural connections through food-sharing, particularly with respect to traditional foods. Especially among the program leaders, a persistent message is clear: “when we define Indigenous food security, we are not talking only about filling bellies” (Program Leader A). The program leaders were persistent that the goal of the Indigenous food bank was to empower and uplift Indigenous people by offering foods in a culturally safe and dignified way that met the health and nutrition needs of families, but also opened a doorway into understanding the cultural knowledge of and connections with the wider Indigenous community. Just a year into their program, SOAHAC developed visions for its future, including land-based learning and the growth of traditional foods and medicines, cooking classes, and movements toward their own independent Indigenous food markets. In August 2023, SOAHAC’s main clinic site moved to a new location. The new site contains significantly more space, including a large, accessible kitchen where staff hope to continue to develop hands-on programming that will support these missions, including tailored cooking classes (e.g., targeted to demographics) and specialized events where knowledge holders will share their cultural knowledge about different elements of traditional food systems, both at SOAHAC’s clinic site and out on the land.

Among the food bank recipients (n = 6), these preliminary analyses suggest the program is long overdue and vitally important for the provision of healthy market and traditional foods in a dignified and culturally supportive way. For families on a fixed income, the food bank makes it possible for them to have access to fruits, vegetables, or traditional foods, as they desire. This not only makes the program a critical public health intervention, but also a culturally significant one. Indigenous foodways entail a system of relationships, food and inputs, but also knowledge, values, belonging, identity, mental wellness, and social connection [27,28,29]. For many Indigenous peoples living in the city, traditional foods are highly inaccessible. They are expensive, seasonal, and they require specialized knowledge for their preparation. The Indigenous food bank removes these barriers. It makes culturally significant foods available in a safe space and it supports recipients with the associated resources and knowledge needed to prepare them. Thus, while the interviewees expressed concerns about “wasting food”, especially expensive meats, because they lacked the knowledge of how to cook them, SOAHAC offered extra support and empowerment to make traditional foods a part of their diets. Built by Indigenous people for Indigenous people, the strength of this food bank rests in its community-led approach and its continued response and desire to meet the needs of its recipients.

The health benefits of fresh foods, including fruits, vegetables, and traditional foods, are varied and significant. In this analysis, the recipients did not detail the physical health benefits of accessing the Indigenous food bank, but both program leaders shared anecdotal stories about weight loss and improvements in chronic disease among the participants, some of whom were also their clients. Leaders also shared stories about how the uptake of traditional foods had positively impacted the mental wellbeing of the participants by eliciting memories from their childhoods or creating new spaces for families to create these positive associations with their cultural identity as Indigenous people [22,52]. As Program Leader B previously described, Indigenous pathways leading into the city are not predictable or uniform, but they are most certainly entangled with the effects of colonialism and environmental dispossession [23]. Some come to the city looking for economic or educational opportunities, and others leave their communities because of traumatic events or because they are seeking rights to live in a healthier environment, for example, where access to clean drinking water can be secured. As witnessed at the daycare site, many Indigenous families who live on a fixed income live with the constant threat and worry of problems relating to their children [53,54,55]. This echoes the findings from a 2016 paper on Indigenous food security [56] by the Ontario Federation of Indian Friendship Centres who detailed what household food insecurity meant for children’s school attendance and overall academic performance. The resources afforded from the daycare’s food pantry offer a vital intervention for supporting families to access the foods and other household resources they need.

The most pressing limitation of the Indigenous food bank remains the sheer workload of its operations and questions about its future economic sustainability. For SOAHAC staff, managing the ordering, packaging, and distribution of foods presents an ongoing challenge as there is no grant funding for a program coordinator. This means that all the work associated with the food bank at both sites occurs entirely off the side of the desks of program champions—on lunch breaks, evening, weekends, and sometimes during hours that should be spent patient-facing. Not only does this mean that some staff work unpaid hours, but it contributes to a troubling pattern that we observe in far too many non-profit organizations—burn out [57]. While the overall cultural importance of building and housing Indigenous health and social programming within existing infrastructure, such as Indigenous health centres and/or other Indigenous organizations, cannot be over-stated, the depth and intensity of the labour required to sustain these programs over the long term can and has been underestimated.

The second main challenge relates to the overall sustainability of the program. In a short period of time, and with a relatively small amount of grant funding, SOAHAC has created a culturally responsive Indigenous food bank that is making significant progress for all who are able to participate in its day-to-day functioning, most notably the Indigenous residents of London. While the visions for the Indigenous food bank are vast and developing, the financial resources necessary to fulfill those visions are not secure and require on-going investments—financial and cultural—to address the complex matters of Indigenous food insecurity. Careful attention to the planning, resource needs, and long-term goals must be balanced with appropriate cultural and social resources [58].

5. Conclusions

SOAHAC has a long history of food security programs, most of which have operated on a small scale, and in a non-continuous manner, to distribute fresh fruits and vegetables to their clients. During and after the COVID-19 pandemic, food insecurity among Indigenous people reached crisis levels. The intention of this paper was to showcase the positive impacts of the SOAHAC food bank among its recipients and to provide evidence demonstrating the need for continued sustainable funding to stabilize and advance this novel Indigenous-led food security initiative. Indigenous patterns and experiences of food insecurity are culturally unique and do not parallel non-Indigenous experiences. While income lies at the heart of Indigenous food insecurity, it is a complex and multidimensional matter that warrants consideration of the role that settler–colonial policies have played, and continue to play, in the disruption of Indigenous foodways. This research adds to the sparse literature on Indigenous food bank use in Canada by narrating a hopeful and promising account of the program delivery that was created by and for Indigenous people and their distinct cultural diets and food preferences. The importance of highlighting Indigenous leadership, perspectives, and methodologies in collaborative health research, such as that presented in this research, cannot be overstated. Especially in the context of Indigenous non-profit organizations, community-led research approaches are critically important for creating culturally relevant and inclusive data that can both explain and address Indigenous health inequities and provide the evidence needed to advocate for change.