The dragnet of children’s feeding programs in Atlantic Canada

Social Science & Medicine 51 (2000) 1783±1793

www.elsevier.com/locate/socscimed

The dragnet of children's feeding programs in Atlantic Canada Jutta B. Dayle a,*, Lynn McIntyre b, Kim D. Raine-Travers c a Department of Anthropology, Saint Mary's University, Halifax, Nova Scotia B3H 3C3, Canada Faculty of Health Professions, Dalhousie University, 5968 College St, 3rd Floor, Halifax, Nova Scotia B3H 3J5, Canada c Department of Agricultural, Food and Nutritional Science, & Centre for Health Promotion Studies, University of Alberta, Edmonton, AB T6G 2P5, Canada b

Abstract Ivan Illich's 1976 prediction that medical dragnets will continue was correct. Now quasi-health dragnets are being established ostensibly to feed children perceived to be hungry. Our qualitative, multi-site case study found that programs justify their expansion to non-target group children as a means of reducing stigmatization, while reaching only an estimated one-third of targeted children. The dragnet continues as new services are added and franchising is proposed while the purpose of the program Ð feeding healthy foods to children Ð ultimately succumbs to drives for eciency and the desire to maintain the program itself. In this ®eld of social power relations, children become commodi®ed through dialectical interplays among fundamental needs, manipulated needs, benevolence, and domination. 7 2000 Elsevier Science Ltd. All rights reserved. Keywords: Hunger; Children; Nutrition; Lunch programs; Breakfast programs

Introduction

Child poverty rates are a re¯ection of parental poverty rates and tend to rise or fall as economic conditions deteriorate or improve. (National Council of Welfare, 1996). In Canada, domestic ``hunger'' is usually discussed in terms of two key indicators: poverty, and the use of charitable food assistance (Davis & Tarasuk, 1994).

* Corresponding author. Tel.: +1-902-494-1056; fax: +1902-494-1966. E-mail address: [email protected] (J.B. Dayle).

Through the media and advocacy groups, Canadians understand the seriousness of child poverty. While nationally, one in ®ve Canadian children live in poverty (National Council of Welfare, 1997), in Atlantic Canada, child poverty rates range from 21.6% in Nova Scotia to 26% in Newfoundland (National Council of Welfare, 1997). A 1990 estimate of the Canadian Association of Food Banks states that 47% of recipients in Atlantic Canada were children (Statistics Canada, 1994). In a 1990 Gallop Report, 67% of Atlantic, Ontario and Prairie residents considered hunger a serious problem. A 1997 polling ®rm study of 2000 Canadians found that 56% believed that child hunger was more important than quality education and 89% believed it was at least equally important (National Child Hunger Study, 1997). This ``hunger crisis'' has prompted the initiation of breakfast and

0277-9536/00/$ - see front matter 7 2000 Elsevier Science Ltd. All rights reserved. PII: S 0 2 7 7 - 9 5 3 6 ( 0 0 ) 0 0 1 1 0 - 6

1784

J.B. Dayle et al. / Social Science & Medicine 51 (2000) 1783±1793

lunch programs speci®cally targeted at children (CEA, 1989). Unlike the United States, where federally-mandated school feeding programs were established by legislation in the 1950s (Pollitt, Gersovitz & Gargiulo, 1978; Congressional Digest, 1990), Canada does not have a federally administered policy of feeding hungry children in schools or communities (American School Board, 1983; Parker, 1982). In 1989, the Canadian Education Association surveyed 121 school boards and found the widespread existence of school-based nutrition programs across the country. In Canada, the proliferation of food programs speci®cally for children has occurred mainly through localized volunteer e€orts (Cassell, 1990; Lemieux, 1988; McLennan, 1989) rather than through any direct or indirect support of the state. This outpouring of ad hoc, community-based support for poor and presumably hungry children to improve their nutritional status and school performance (McIntyre, Simpson & Ocer, 1991) is a unique Canadian phenomenon. Program operations re¯ect local conditions, often involving community participation of members of church and other non-governmental agencies as well as unaliated community members and school personnel (Cassell, 1989; Lemieux, 1988; McLennan, 1989; McIntyre & Dayle, 1992). The number of programs established across the country likely exceeds 1000, although there is no inventory of such programs. Programs also open and close on the basis of the sustainability of community mobilisation e€orts and availability of funding which is often derived through charitable donations or one-time grants from foundations or governments. While the Provinces of British Columbia and Ontario have provided some core funding to feeding program networks, in the rest of Canada, including the Atlantic Region where this study took place, breakfast and lunch programs targeted at hungry children represent a vast community-driven movement that is unparalleled in other countries, developed or developing. We have studied this sociohealth movement for several years and have found that objective needs assessments for such programs are lacking, and that selfreports of the day-to-day operations of many feeding programs stigmatise recipients and exclude their families from participation in program planning and operations (McIntyre & Dayle, 1992). We questioned whether these programs reduce nutritional inequities, that is inequalities in nutrient intake and nutritional status linked to income as a determinant of health, or reproduce them (McIntyre, Travers & Dayle, 1999). Based on a grounded theory exploration of children's feeding programs in Atlantic Canada, we describe our critical interpretation of the data using Illich's concept of the dragnet. We de®ne a dragnet as a process of increasingly expanding institutional control over those

perceived to be in need of special protection. A dragnet provides new services that steadily increase in numbers and eciency while targeting selected populations (Illich, 1976; Ehrenreich & Ehrenreich, 1978).

The dragnet Ivan Illich and others warned that, in industrial society, increasingly all aspects of people's lives would eventually fall under institutional control. He felt that more and more ``personal functions'' were assigned to ``impersonal institutions'', that the services they provided were neither ``. . .designed for others, not with others nor for the producer'', and that the processes that expand institutional control were: dragnets designed to apprehend those needing special protection: prenatal medical visits; wellchild-care clinics for infants; school and camp check-ups and prepaid medical schemes. Recently genetic and blood pressure `counseling' services were added (Illich, 1976, p. 91). This expansion distinguishes three major dimensions: new types of services in the jurisdictional arena; increases in number and eciency in kinds of services; and availability of services along class lines (Ehrenreich & Ehrenreich, 1978). Furthermore, while ever-increasing resources are controlled by professional providers (Freidson, 1970; Illich, 1976), these developments mystify and expropriate personal autonomy by transforming people into dependent professional clients. Under the guise of science, this transfer of power is then rationalised as ful®lling a need while simultaneously converting ethical and moral problems into technical ones that, in turn, are ``repaired'' by the economic activities of professionals (Illich, 1976). While the technical maintenance and repair of the perceived need is marketed, it does nothing to prevent or eliminate it (Crawford, 1986; Freidson, 1970; Illich, 1976). Instead, it keeps people in a permanent needy and liminal state while depoliticizing their social circumstances (Zola, 1972) and ultimately denying their right to withhold consent to the management of their lives by others (Illich, 1976). Illich called this a radical monopoly because it is a type of social control that forces compulsory consumption of newly created scarcities that only professions and large institutions can provide. People are then judged by their conformity and by their levels of consumption. Personal responses to needs, personal relationships, and political activities are substituted by institutions within an ``aura of crisis'' and justi®ed under myths of ``make-believe functions'' (Illich, 1973).

J.B. Dayle et al. / Social Science & Medicine 51 (2000) 1783±1793

Methodology

1785

operators, service providers, some parents, who were referred by program operators, and focus groups of children. Because parents preferred telephone interviews, extensive note-taking was necessitated. Ethical approval was obtained from a University ethics committee and all individuals gave consent for their participation. Available newspaper reports, funding proposals, budgets and questionnaires were also summarised. The transcribed materials consisted of over 1000 pages of text. Data analysis was conducted using QRS NUD-IST qualitative data analysis software. Coded data were critically analysed using grounded theory methods of Glaser and Strauss (1967) and inductive and logical analyses of others (Achterberg, 1988; Marshall & Rossman, 1989; Miles & Huberman, 1984; Strauss & Corbin, 1990). Our conceptualisation of the dragnet emerged after our grounded theory analysis. A year after data collection, overall results of the study were presented to program operators at site visits during which responses and clari®cations were sought and recorded.

This study is a critical interpretation of nine qualitative case studies of Atlantic Canadian children's feeding programs. Data were collected between November 1994 and June 1995 on six breakfast and three lunch programs in three Atlantic Canadian Provinces. As described elsewhere (McIntyre, et al., 1999), theoretical sampling (Glaser, 1978) using primarily demographic variables was used to identify urban, rural and suburban feeding programs in the provinces of Newfoundland, New Brunswick and Nova Scotia (it was not possible to identify a suitable program from Prince Edward Island). We studied both school and community lunch and breakfast programs established within the past 2 years to within the past 5 years, and beyond. Locations were identi®ed using a previously compiled mailing list (McIntyre & Dayle, 1992) which was augmented by snowball sampling from public health units and provincial community agencies. The selection of the ninth program was determined during data collection because of its unique inception features. Programs operated in a range of settings, from low income neighbourhoods, to economically mixed areas, to one very rural area. While the oldest program had been in existence since the early 1970s, the youngest was in its ®rst year of operation. The majority of programs were either school-based or under the jurisdiction of a school. One program was church-run and another was community-based. A trained, qualitative researcher spent about one month at each site as a participant observer. Only in one site was the researcher a passive observer because program operators preferred that arrangement. Observation methods were based on Jorgensen (1989). The participant observer also audio-taped and verbatim transcribed semi-structured interviews with program

Results and discussion The feeding program context . . . it's atrocious that we even have to have the program. That the kids really need it that badly, that the families need it that badly, that our society has deteriorated to the point that they just don't have the money to feed their kids . . . (Program director) Most programs were initiated by school sta€; two by church or community members; and one by a parent. Reasons for implementation included perceived hunger

Table 1 Rationale Site Rationale

1

No lunch because nobody was home School volunteer noticed an always tired child Inattention in the classroom Appearance of attire Children asking for free food Consultation with children and community Children searching garbage cans for food Needs assessment Children coming to school hungry To improve children's learning Children attacking each other for food

[

2 [

[

3

[ [ [

4

5

6

7

8

9

[ [

[

[

[ [ [

[

[

1786

J.B. Dayle et al. / Social Science & Medicine 51 (2000) 1783±1793

among poverty-stricken children; inattention in classrooms; results of two mini-assessments; and hunger arising from a long school bus ride (Table 1). In most programs, teachers, principals or both identi®ed the need to address hunger based on children's behaviours and appearances, on perceived increased demand once programs were implemented, and on the assumption that parents were unaware of proper nutrition. The operating environment of programs varied: four were under school jurisdiction; two worked under the aegis of large charitable bodies; one was incorporated as a non-pro®t organisation; and two operated informally. A majority of programs received ad hoc funding subsidies from municipal, provincial, or federal sources as well as from charities and a wide variety of other organisations and individuals. Annual operating costs of a majority of sites were between $2000CN and $8000CN. All sites but one operated without monetary contributions from users. Program attendance by children aged 5±12 years ranged from 10 to several hundred daily. Fluctuating attendance depended upon food choices, on weather, and certain months of the year. Overall, children said that they attended because they liked the variety of foods served. Special servings, such as pancakes, French toast, Hawaiian pizza, and pop tarts, also drew new children to the program. During these special food days, children became aware of, and demanded, brand name foods. Without exception, programs involved a great deal of socialising, adults with adults, children with children, and children with adults. The atmosphere was usually noisy, excited and happy. Children loved to socialise with each other: Interviewer: Why do you think other kids come to the program? Child 2: To have fun, to enjoy themselves, like have a good meal or something Child 1: And not sit in the kitchen with nobody around Child 2: It's fun when you can just sit there and enjoy like a meal with people around you and talk (Children's interview). Often attendance depended upon peer pressure and, at one site, children invited each other to have breakfast at the program. Children appeared happy at all programs. On several occasions they became upset when threatened with banishment or if they felt they missed breakfast or lunch when they arrived late. All providers felt that they worked for a good cause, enjoyed their participation, agreed that the programs were wonderful, and believed that they ful®lled their mission to feed hungry children. There was, however, little participation by parents of attending children. They rarely volunteered, did not become involved in

program evaluation, were not asked to sit on committees or boards, were not o€ered paid positions, nor did they participate in fund-raising activities and program initiation. Although no site conducted formal evaluations, teachers' impressions about students' improved performances were used to estimate program e€ects. Teachers themselves, however, found it often dicult to accurately assess these changes. Even though most providers were convinced that, without the program, many children simply would not eat, programs were o€ered during school business ``hours''. For example, breakfast was served before classes began while lunch was o€ered around noon. None of the programs served both breakfast and lunch. The major di€erence between breakfast and lunch was that the latter always consisted of a hot meal. All operated during the school year only, often closed before the end of the year, and service was interrupted if volunteers could not attend. . . . and the only thing that I feel bad is that, when we close these doors in June, is that there is nothing we can do for those children in the Summer . . . (Coordinator). Few programs reported major problems. The consistency of personnel and attending children over time was remarkable. Some perceived challenges included competition with other programs, school cafeterias and commercial eating establishments; declining attendance; stigmatisation of the program; funding instability; logistical problems; and community resistance. Creating clients Without exception, parents who sent their children to programs felt that they were wonderful and that having a feeding program relieved their worries somewhat of not being able to provide food for their children. . . . The program helps me though because I don't have to worry about feeding him before going to work . . . (Parent). Participating parents commented upon other parents who chose not to send their children to programs. The children don't care about the parents' hangups. They just end up healthier with full stomachs and a nice time to interact with friends. It's really too bad that more families don't take advantage of it. It's really a nice social time for kids (Parent).

J.B. Dayle et al. / Social Science & Medicine 51 (2000) 1783±1793

Some parents wished that there were more breakfast as well as lunch services. One parent reported that she phoned the school to see whether her child was selected as a recipient while another parent deliberately moved her children closer to a school with a feeding program. However, despite this expressed interest, very few parents investigated feeding programs and most knew very little about them. Most parents interviewed lived on social assistance and reported that the money provided simply was not enough. . . . I have three growing children, I am on social assistance and they are very big eaters. . . (Parent). Often there was no food in the house because the money ran out after 2 weeks. Even with two incomes, growing children would eat so much that there remained little or no food for other siblings. Parents interviewed felt that even a small user-fee would be too much. Providers deplored that parents were unable to feed and clothe their children and related increased attendance at the end of the month to poverty. In the majority of sites, providers stated that most people living nearby were barely surviving on social assistance and that many were single mothers. Yet all providers had negative views of parents. They believed that parents did not want to get up in the morning, spent money on parties, drugs and drinking, and did not care about, or for, their children. . . . the bulk of the parents are ®ne on staying on the outside and allowing us to do what we do, they just wash their hands of their kids to a great extent, as long as somebody else is looking after them they are ®ne with that. . . (Program director). Providers in only two programs felt that working parents simply did not have the time to provide adequate breakfasts or hot lunches. At six sites (67%), providers expressed prejudices toward recipient children. Although recipients were generally well-behaved, some providers felt that they had ``an attitude'' and commented on their lack of manners and social skills. . . . the lack of social skills and manners when they are eating at the table . . . (Teacher). . . . she's found that they don't have the respect that, she called it attitude, she said a lot of them come with an attitude . . . (Program operator). Punishments for disobedience ranged from verbal reprimands to threats of expulsion and actual banishment

1787

for a limited time. Sometimes misbehaving children were sent away without food. Gathering new clients While none of the parents interviewed had problems with letting their children participate in a feeding program, all believed that a signi®cant number of other parents did prohibit their children from attending. The majority of programs were indeed stigmatised by community members who seemed afraid that, if they used them, they would be labelled as poor, they would lose status within their communities, or that Social Services would cut their food bene®ts. In eight programs, providers knew of needy parents who would not allow their children to attend. . . . we're still missing some of the kids that could take advantage of it. And I think it's sometimes viewed as a `need' thing . . .so we need to keep plugging away at that, that's a real issue . . . (Vice-principal). He reported that there were many `needy' children in the school but they did not come to the program. Often he has seen these children walk past the Home Economics room in the mornings and they frequently stick their heads in the door but they will not come in (Observer's ®eldnotes). . . . actually I am disappointed too because I still think that there's ones out there that really need it that aren't coming . . . (Parent organiser). Access to programs was open to all registered school children ostensibly to minimise stigmatisation of children and their families. In other words, children were not ``selected'' to attend programs, except at one site, located outside of the school, where school principals selected program attendees based on need and where children were placed on waiting lists if no space was available. Yet, a majority of school-based programs served less than 30% of their total student populations and only one site served recipients from severely poverty-stricken homes. Although all providers and parents believed that they fed hungry and povertystricken children, they also realised that of those children who attended, 75% were not in need of feeding while providers estimated that they only reached onethird of the children in need. For example, in two sites, providers believed that only 10 children of 52 and 35 attendees respectively, genuinely needed the program. In another site, only 26% of targeted children attended whereas 85% of the school population was deemed `in need'. Because of the perception that programs were not

1788

J.B. Dayle et al. / Social Science & Medicine 51 (2000) 1783±1793

serving as many children as they could or should, providers at all sites actively recruited children (Table 2). Only two sites, however, asked parents to ®ll out a permission slip. In cases where recruitment failed, some providers encouraged children to come without parental consent and sometimes children themselves attended without parental knowledge. Other providers sent children directly to the program. Still others exercised e€orts of persuasion by calling or speaking directly to parents. Some providers believed that parents should overcome their pride and admit that they are needy. Providers also lamented that not more parents were involved. Providers worked hard to overcome the considerable resistance of those perceived as needy and to improve the image of their programs. Program maintenance and its stated purpose were continually marketed through newsletters to parents; press releases; speeches at service clubs; word of mouth; correspondence and personal phone calls; deliberate image-making by relabelling programs as ``clubs'', and legitimising them as school functions; and by employing more business and consumer language. Thus, despite a presumed crisis of food shortage it seemed that a considerable number of parents forbade their children to attend. We infer this because of what providers told us.

kids when I mention the breakfast program I said I told so and so you know I don't want you to go. . . (Principal).

. . . I have had parents phone and say ``I don't want my Sally or Billy in that program, if he goes in there please ask him to leave'' . . . (Program operator).

We do not know whether this is true or why it might be true because our study could not reach the resisting parents. One might speculate, however, that past negative experiences with institutional control under the banner of ``helping'' might have led to distrust and people who perceive just ``more of the same'' will avoid such services (Ehrenreich, 1978). For example, providers in community health centres in the United States also complained about community resistance (Ehrenreich & Ehrenreich, 1978). Judgements about parents of poverty-stricken children were based on labels, on levels of conformity, and on perceived de®cits in food consumption. Some parents were partially ``normalised'' when they allowed their children to attend feeding programs. While sending their children would not change their social circumstances, it might have some therapeutic value in that at least a part of these circumstances (i.e. not being able to provide breakfast or lunch) would be professionally managed (Ehrenreich & Ehrenreich, 1978). Those who resisted the power of normalisation were subject to indirect coercion (Foucault, 1975; Rabinow, 1984). As providers in US community health centres ``dragnetted'' patients (Ehrenreich & Ehrenreich, 1978), so did providers of Canadian feeding programs by constant recruitment measures. In the United States, the eventual result was overutilisation (Ehrenreich & Ehrenreich, 1978).

. . . I also know that some of the kids are not allowed to come in . . . (Volunteer).

Creating dependent clients

. . . parents have told me that they have told their

Interviewer: What do you think is the worst thing

Table 2 Program recruitment method Sites Recruitment methods

1

Phone calls to other organisations Discreet phone calls to parents Phone lists Ads sent to schools Notices, hand-outs, brochures, pamphlets to parents or community Information at school functions, fund-raising and community events School newsletters Verbally to parents and local businesses Parent consent forms School referral to program Monthly calendar with menu choices to homes Media coverage

[ [

[

2

3

4

5

6

7

8

[

[ [ [ [

9

[ [ [

[ [ [ [

[

[ [

[ [

[

[ [ [ [

[

[

J.B. Dayle et al. / Social Science & Medicine 51 (2000) 1783±1793

about the program? Child 1: Nothing. Child 2: You don't get to eat every day, not on Saturdays or Sundays (Children's interview). Some programs expanded their services beyond food. For example, clothing was handed out on a regular basis at one site Ð it also distributed Christmas gifts. Another site had provided clothing in the past while still another prepared bags of Christmas treats. Despite some bene®ts and the ¯edgling nature of feeding programs, the results of these processes are that children learn at an early age that unlimited goods and services are available freely and free in institutional settings requiring neither money nor labour. . . . I like coming here because they give you things . . . (Child). Children are thus transformed into dependent professional clients by training them to rely regularly on institutions as a substitution for family relationships that ordinarily would provide such basic needs as food and clothing. This also ``depoliticises'' social circumstances while preventing other kinds of poverty-reducing interventions (Zola, 1972). A technical solution . . . ultimately parents have responsibility. Breakfast programs supplement this and by sending children to the program, parents make sure of proper nutrition for their children (Extract from Principal's Letter). Feeding programs expropriated personal and parental autonomy of participating parents by perpetuating myths of programs' ``make-believe functions'', such as alleviating hunger caused by poverty in a non-stigmatising way; preventing further nutritional abuse by parents of their children; providing needed healthy family atmospheres; teaching life-skills; and ful®lling legitimate community needs. These stated functions were then further used to expand the institution, to legitimise this expansion, and to ultimately promise more food and support services (Illich, 1976). Yet providers articulated the contradiction that programs served perhaps a more social value for children than hunger alleviation. You know and to them it's a social thing. I mean you know all the kids won't go to the [program] because the fact that it's not because they are hungry. I think a lot of them want to go because their friends are going you know (Provider). Providers diagnosed who was hungry and the ``politi-

1789

cally convenient myth'' (Illich, 1976) of feeding all starving children materialised. This diagnosis, buttressed by perceived improved behaviours, attitudes and learning capabilities, represented a ``hygienic mask'' that further justi®ed the production and consumption of institutionally provided breakfasts or lunches under the guise of nutritional science (Illich, 1976). It also warranted sending children to programs against their parents' wishes and expected that parents should blindly trust the institutional response to their social circumstances. Providers did not ask why a signi®cant number of members of society could not adequately feed nor clothe themselves or their children or why their full participation in society was denied (Kenway et al., 1994). As in North-eastern Brazil, where Church, state and the medical profession all cooperated to control unacknowledged chronic hunger through re-labeling and medicalisation (Scheper-Hughes, 1992, 1993), so feeding program providers and members of collaborating institutions transformed the moral and ethical problems of society into technical ones believed to be ``repairable'' by simply feeding breakfasts or lunches during school days. This masking of poverty is troublesome, because it hides the root causes of child poverty and gives those who have the power to change it a reason for doing nothing. We observed that as programs grew, a concern with eciency also grew and talk was about adding still new health services. Yet, non poverty-stricken children were the majority of attendees. This is similar to past developments in the United States where, during the expansion of the medical system, the middle class became the major recipient because they were more inclined to accept expert opinions (Ehrenreich & Ehrenreich, 1978). In our study, feeding programs extended institutional control and indirect supervision of parents into other than poverty-stricken strata of society. Professionalisation of food and nutrition The social construction of need is always ideological, involving labelling, storytelling, and image-building which in turn justify ``time, expense and e€orts'' (Van Dyck, 1996). Claims of need are expressed ``in terms of social, psychological or physical necessity'' that are based on ``collective myths and communal assumptions'' (Van Dyck, 1996). Almost all providers told stories about the origins of their programs. For providers, perceived inadequate parenting was routinely assumed. Children's social conditions, their emotional needs, and their perceived poor nutritional status, expressed in terms of observations of child behaviours, increasing demand for programs, and perceived positive outcomes, became the necessary foundations for

1790

J.B. Dayle et al. / Social Science & Medicine 51 (2000) 1783±1793

program implementation and development. Previous research supports these ®ndings of well-meaning motives (McIntyre et al., 1991). Institutional self-interest was thus e€ectively hidden (Van Dyck, 1996). To legitimate the nutritional role of the programs, food and nutrition were professionalised. At three sites, professional nutritionists helped plan menus while some providers refused donations of food of questionable nutritional quality. All providers were concerned with proper nutrition. However, perhaps like parents of the children the programs were designed to serve, many providers also felt that they had to reduce food quality and choices because of limited funds and increasing overall costs. Nevertheless, in addition to ``®lling the hunger gap'', all providers and parents believed that programs supplied nutritious meals and thus o€ered programs as nutritional opportunities.

In schools, feeding programs simultaneously restored and maintained order in classrooms not only because improved behaviour in children was perceived, but also because programs served as transition places between what McLaren (1986) called the ``streetcorner state'', where boisterous peer interactions are expressed before school begins, and the ``student state'', where interactions in classrooms are characterised by controlled and dominated interactions. Feeding programs, therefore, ease children into the behavioural conformity of the student state. The issue of lack of proper nutrition was thus a means of enforcing behavioural uniformity while providers simultaneously acted as agents of social control (McKinlay, 1986).

. . . as long as it is nutrition, nutritious, then she feeds them accordingly but she always makes sure that they get a nutritious meal . . . (Chair of the Board).

Despite having few or no paid sta€, providers did work within, or aspired to, a more professional management framework.

Providers expected children to eat the foods o€ered and the majority allowed second helpings. Yet, how much food children ate depended on gender, peer pressure, and eating time allowed which, on average, was 15 minutes. The shortest eating time was related to school bus schedules and children often left their food because they had to go to class. By citing cases of children who had never seen fruits such as bananas, peaches or cantaloupe, providers implied that parents were unaware of how to meet their children's nutritional needs, or were unable to do so. Some providers hoped that children would educate their parents nutritionally, thus indirectly trying to educate parents and change parental life-styles by assuming that ``good'' experiences would ultimately change behaviours. This may be possible through health instruction (McKeown, 1981), but the path of instruction in feeding programs was reversed since nutritional instruction was mainly to children by adult non-family members who hoped that children would educate their parents. In child-to-child programs in developing countries, older children are deliberately trained to become agents of change. In India and Mexico, for example, children have taken their knowledge beyond their families into their communities (Owen, 1992±1993). In our study, child-to-child training was indirect, simply through participation and peer interactions. We do not know what e€ects feeding programs have either in the community or in the home. Even if parents were reeducated through their children, those living in poverty have few means to apply this new knowledge because, in contrast to child-to-child programs, their ``social'' problems are not alleviated by additional means.

. . . getting the Board and a little more formal structure set up. . . (Volunteer organiser).

Professional management

Some of those that did not have oversight Boards were planning to develop them, and many wanted additional professional expertise on their Boards. Some sites did engage paid operators, some of whom were social assistance recipients. Others relied on volunteers, a few of whom were parents. Some training institutions sent their trainees to programs for work experience. Both paid and unpaid operators knew their exact costs per meals and discussed strategic meal costing options. These structures provided some support for some disadvantaged members of the community. Fund-raising was a signi®cant management activity of all providers. Although all received in-kind donations from a variety of sources, a majority conducted community fund-raising activities but only the largest had a full-time fund-raiser. . . . I mean people seem to have been pretty supportive whenever we say that it is kids . . . (Volunteer operator). Parents were rarely the major fund-raisers. Some providers strove for self-suciency and wished to create partnerships with corporations that might require renaming the program with a sponsor's name or allowing uniformed company sta€ to serve meals to children. Business sponsor's logos were also printed on information sent to parents. Not all companies, however, saw advantages in sponsorship. In this process of cooptative control (Ehrenreich & Ehrenreich, 1978), we noted that providers sprang into action by generating economic activities such as grant

J.B. Dayle et al. / Social Science & Medicine 51 (2000) 1783±1793

applications, fund-raising events, job creation and the like. In return for funding, providers had to produce certain numbers of children. Children were thus commodi®ed by becoming items of exchange between professionals, granting agencies, businesses, corporations, well-to-do individuals, and providers. . . . I know, the thing of it is, the bottom line is that the kids really, it's easy to appeal to people for money and things when it is kids, you know it is the easiest thing I have ever gone looking for money for, and I have been involved in some things over the years for donations and what not. Seems like with this it is hard for people to refuse! (Program provider). And yet, children are not just commodities, they are also embedded in social relationships within feeding programs that at the same time both express and reinforce the relationships and ideologies of the wider society (Ehrenreich, 1978).

Cooperative planning and franchising It seemed that sites co-operated with each other to establish new programs and franchising (i.e. the reproduction of a program in other sites) was supported by many other organisations, ranging from the Salvation Army to government agencies. . . . there will probably be needs in other places and that maybe it can be the, say, the prototype but it could be the one that sort of helps get some others set up in the city . . . (Volunteer operator). For example, at one site, a lunch program was not instituted because it would have con¯icted with another school lunch program. All providers felt that there should be wide networks of feeding programs. Most providers believed that a majority of their community members were supportive and some felt that, without the co-operation of principals, teachers and school boards, these programs could not function. While providers voiced concerns regarding sustainability related to continued funding and volunteer help, a majority also wanted to expand their programs and some viewed their programs as models for others. Indeed, some Junior High Schools were considering establishing feeding programs and one school in an a‚uent area had already implemented one. . . . and certainly the indication was that there are more children who need that kind of a program in that school, so if we could expand it a bit ah. . . (Volunteer operator).

1791

Although schools and some community enterprises operate food services, it is new in Canada to see schools expand their jurisdiction by speci®cally addressing child hunger through free breakfast and lunch programs. Why do feeding programs mushroom even in middle-class areas? It may be that governmental cut-backs force individuals to buy their social needs privately (Dominelli, 1988; National Council of Welfare, 1996). This enables other institutions to step in, thus side-stepping governmental plans of private provision. It may also be that trends of demedicalisation and decentralisation lead to ad hoc forms of administration (Mullard, Dale & Warren, 1987), in this case not in government per se, but in other institutions, such as schools, churches and communities. Conclusions It is our assessment that while children's feeding program are perceived positively by attendees and their parents, and while these programs do meet some children's social and nutritional needs, they are in danger of becoming quasi-sociohealth dragnets. Dragnets are being realised in the establishment of networks of institutional programs designed to apprehend children that are perceived to be in need of special protection from the inability of their parents to feed them properly. This perceived inability is considered a need, created by a lack of food consumption, that is deemed compulsory for certain meals. The stated result is a crisis of hunger among children. Initiating institutional action is then justi®ed as a reaction to this crisis. We have demonstrated that ad hoc charitable programs, no matter how well-intentioned, are inadequate to address the problem of perceived child hunger. Leaving these programs to continue to evolve as they have been will reproduce, rather than reduce, the inequities they are intended to alleviate because they fail to address the root cause of the problem of family food insecurity. Child hunger, however de®ned, is a social problem. Children's feeding programs provide individual services, thus the need to gather more individuals to justify their existence. By treating individuals, programs create dependency Ð that is how the dragnet works. As during the eighteenth century, when the politics of health could be located in many di€erent organisations that aided the poor and sick (Rabinow, 1984), so today feeding programs and food banks can be located in schools, churches and other places. While during the late eighteenth century these various organisations were dismantled because of the criticisms voiced by economists and administrators (Rabinow, 1984), today economists and administrators often advocate the dismantling of governmental programs

1792

J.B. Dayle et al. / Social Science & Medicine 51 (2000) 1783±1793

and the relocation of social programs back into di€erent social strata. As in earlier times, the poor of today are also expected to ®nance themselves while today's feeding programs become a kind of economic management that is based on the biological traits (malnutrition) and the food insecurity of their children. Feeding programs are thus dialectical interplays between the fundamental needs of certain members of society and manipulated needs of others, and between issues of benevolence and domination (Ehrenreich, 1978). They act on individual bodies through nutritional input; they symbolically convey a dysfunctional model of the social body, that is, unhealthy poverty conditions in an a‚uent society and a lack of general family support structures; they maintain the body politic by ignoring structural changes that are necessary to heal the a€ected areas of the social body (Rabinow, 1984; Scheper-Hughes, 1992). The dragnet, however, as represented by feeding programs, assures the utility and thereby pro®tability of the next generation while simultaneously training them for subjugation and order (Rabinow, 1984). The implementation of dragnets, therefore, is only possible from relative positions of power and professionalism. By providing these services, programs do feed a minority of poverty-stricken children, thereby reducing inequities somewhat. They give children places for socialising and o€er caring atmospheres. The dangers are increasing networks of institutional control that expropriate personal and parental autonomy, that sti¯e potential political activity, that maintain and expand dependence on professionalism, that develop radical monopolies, and that deny other alternatives, thereby maintaining inequities. Children's feeding programs do serve a function in western societies. For a majority of families, they serve a child care and convenience function. For some families, where nutritional adequacy is compromised, programs also serve a feeding function. The dragnet creates the illusion of feeding hungry children. It creates dependency and is disempowering to its neediest recipients. The answer may lie in a reframing of the children's feeding program agenda to one that addresses the child care and supervisory needs of all families, and which provides stable funding to accountable persons under a standards-based rubric.

Acknowledgements This study was funded by NHRDP No. 6603-1461201.

References Achterberg, C. (1988). Qualitative methods in nutrition education evaluation research. Journal of Nutrition Education, 20, 244±250. American School Board (1983). The low-cost lunch rule will keep you busy. American School Board Journal, 170, 16. Cassell, L. (1990). Bishop ®eld lunch program. Evaluation. Report to Hungry Children's Committee. St John's, Newfoundland. CEA: Canadian Education Association. (1989). Food for thought: School board nutrition policies and programs for hungry children. CEA Information Note. Congressional Digest (1990). Existing federal programs. Congressional Digest, February, 36±37. Crawford, R. (1986). Individual responsibility and health politics. In P. Conrad, & R. Kern, The sociology of health and illness. Critical perspectives (2nd ed.) (pp. 369±377). New York: St Martin's Press. Davis, B., & Tarasuk, V. (1994). Hunger in Canada. Agriculture and Human Values, 11, 50±57. Dominelli, L. (1988). Thatcher's attack on social security: Restructuring social control. Critical Social Policy, 8, 46± 61. Ehrenreich, J. (1978). Introduction: The cultural crisis of modern medicine. In J. Ehrenreich, The cultural crisis of modern medicine (pp. 1±35). New York: Monthly Review Press. Ehrenreich, B., & Ehrenreich, J. (1978). Medicine and social control. In J. Ehrenreich, The cultural crisis of modern medicine (pp. 39±79). New York: Monthly Review Press. Foucault, M. (1975). Discipline and punish. The birth of the prison. New York: Vintage. Freidson, E. (1970). Professional dominance: The social structure of medical care. New York: Aldine. Glaser, B. G. (1978). Theoretical sensitivity. Advances in the methodology of grounded theory. Mill Valley, CA: The Sociology Press. Glaser, B. G., & Strauss, A. L. (1967). The discovery of grounded theory. Strategies for qualitative research. Chicago: Aldine. Illich, I. (1973). Tools for conviviality. New York: Harper & Row. Illich, I. (1976). Limits to medicine. Medical nemesis: The expropriation of health. London: McLelland & Stewart. Jorgensen, D. L. (1989). Participant observation: A methodology for human studies. Newbury Park, CA: Sage. Kenway, J. et al. (1994). New education in new times. Journal of Education Policy, 9, 317±333. Lemieux, C. (1988). Poor children in schools Ð Focus-onfuture school project update. Ottawa: Ottawa Board of Education. Marshall, C., & Rossman, G. B. (1989). Designing qualitative research. London: Sage. McIntyre, L., & Dayle, J. (1992). Exploratory analysis of children's nutrition programs in Canada. Social Science & Medicine, 35, 1123±1129. McIntyre, L., Simpson, A.C., Ocer, S. (1991). Strategies for feeding low income children. Final Report to Health and Welfare Canada. NHRDP No. 6603-1361-CH(L). Unpublished Monograph, June 30.

J.B. Dayle et al. / Social Science & Medicine 51 (2000) 1783±1793 McIntyre, L., Travers, K., & Dayle, J. B. (1999). Children's feeding programs in Atlantic Canada: Reducing or reproducing inequities? Canadian Journal of Public Health, 90, 196±200. McKeown, T. (1981). Medical technology and health care. In M. S. Staum, & D. E. Larssen, Doctors, patients, and society. Power and authority in medical care (pp. 259±271). The Calgary Institute for the Humanities, Waterloo, ON: Wilfrid Laurier University Press. McKinlay, J. B. (1986). A case for refocusing upstream: The political economy of illness. In P. Conrad, & R. Kern, The sociology of health and illness. Critical perspectives (2nd ed.) (pp. 484±498). New York: St Martin's Press. McLaren, P. (1986). Schooling as a ritual performance. London: Routledge & Kegan Paul. McLennan, G. (1989). Evaluation of the food and nutrition at school (FANS) pilot project: Year two. Calgary Board of Education Program Evaluation. Instructional Support Services Department, Calgary, Alberta. Miles, M. B., & Huberman, A. M. (1984). Qualitative data analysis: A sourcebook of new methods. Beverly Hills: Sage. Mullard, M., Dale, J., & Warren, D. M. (1987). Feedback on decentralization and local control. Community Development Journal, 22, 148±163. National Child Hunger Survey. (1997). Thompson Lightstone & Company, Toronto and Breakfast for Learning: Canadian Living Foundation, Toronto. National Council of Welfare. (1996). Poverty pro®le 1994. A Report by the National Council of Welfare. Spring. Minister of Supply and Services Canada, Ottawa. National Council of Welfare. (1997). Welfare incomes 1996. A report of the National Council of Welfare. Ottawa:

1793

Minister of Public Works and Government Services Canada. Owen, J. (1992±1993). School children as health educators: Lessons from the child-to-child program. Sante Culture/ Culture Health IX, pp. 331±342. Parker, L. (1982). The impact of child nutrition budget cuts: A look at the states and selected school districts. Washington, DC: Food Research and Action Center. Pollitt, E., Gersovitz, M., & Gargiulo, M. (1978). Educational bene®ts of the United States School Feeding Program: A critical review of the literature. American Journal of Public Health, 68, 477±481. Rabinow, P. (1984). The Foucault reader. New York: Pantheon. Scheper-Hughes, N. (1992). Hungry bodies, medicine, and the state: Toward a critical psychological anthropology. In T. Schwartz, G. M. White, & C. A. Lutz, New directions in psychological anthropology. New York: Cambridge University Press. Scheper-Hughes, N. (1993). Lifeboat ethics: Mother love and child death in Northeast Brazil. In C. B. Brettell, & C. F. Sargent, Gender in cross-cultural perspective. Englewood Cli€s, NJ: Prentice±Hall. Statistics Canada (1994). In Canadian social trends, vol. 2. Toronto: Thompson Educational. Strauss, A., & Corbin, J. (1990). Basics of qualitative research: Grounded theory procedures and techniques. Newbury Park, CA: Sage. Van Dyck, J. (1996). Manufacturing babies and public consent. Debating the new reproductive technologies. Washington Square: New York University Press. Zola, I. K. (1972). Medicine as an institution of social control. Sociological Review, 20, 487±504.