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<p>Food—where we obtain it, how we obtain it, and so forth—is just one of myriad considerations in everyday life. Considerations about food can be particularly salient for lone mothers, who face a set of challenges in supporting their families, including being the sole caregivers of their children. In examining a case study of Hamilton, Ontario, this research utilizes qualitative methods (interviews and mental maps) and a feminist geography lens to understand the complexity of food insecurity for lone mothers living in two neighbourhoods characterized by a low socio-economic status. Feminist geography offers a unique perspective for understanding food insecurity with its philosophy of improving women’s lives and its story-telling and meaning-making methods. This thesis will explore qualitative themes from face-to-face interviews (<em>n</em>=7) and a focus group (<em>n</em>=1, 5 participants) that include: the distance and time taken to acquire food; loving and caring for one’s child(ren); contextual considerations mothers have to weigh in order to choose food resources, the need for structural change; strategies mothers used to provide for their families; and feelings around being a lone mother. Together, these themes paint a rich and nuanced picture of food insecurity for lone mothers in Hamilton and they illuminate how and where food intersects with household functions and structural forces, such as social assistance. The findings also point to places where social change can take place to improve quality of life.</p> / Master of Arts (MA)

The present study investigates the self-care and health maintenance strategies undertaken by individuals from Halton Region, Ontario living with type 2 diabetes and receiving assistance from food acquisition services such as community food re-distribution centres and food banks. This qualitative research project pulls narrative and thematic interview data from 18 semi-structured one-on-one interviews analyzed with syndemic theory and social determinants of health frameworks to demonstrate how clustering non-communicable diseases and social conditions disproportionately affect those in the lowest income category, and interact with each other to exacerbate the negative health effects of each condition alone. The contributions of this study are theoretical and applied. Theoretical contributions augment existing evidence for the study of non-communicable diseases using a syndemic model. The study participants demonstrated syndemic clustering of five conditions: type 2 diabetes, food insecurity, low income, poor mental health, and activity limitation. Further, this study suggests an applied element to the syndemic model through an approach to health and diabetes care that incorporates the whole person as opposed to a single disease as a unit of care. As suggested through the findings of research participant testimony, a diabetes health care centre, in addition to traditional diabetes care, would ideally screen and offer care for the other common clustered conditions listed in the syndemic elements above. Thus, the centre would provide nutrition, physical activity, mental health, and social supports to patients. As well, it is recommended that future research contributes to prevention and treatment of non-communicable diseases through social, political, and economic in form of increasing government and healthcare supports for people living with low-income and food insecurity. / Thesis / Master of Arts (MA) / This study looks at how individuals from Halton Region, Ontario maintain their health while living with type 2 diabetes and reduced access to healthy, fresh food. The project uses interview data from 18 one-on-one interviews to demonstrate how people with low income suffer from poorer overall health. Specifically, five conditions affected the study participants’ health: type 2 diabetes, reduced access to healthy food, low income, poor mental health, and reduced financial or physical access to exercise or activities of daily living (activity limitation). To combat these conditions, this study suggests an approach to health and diabetes care that looks at the whole person. Evidence and participant suggestions indicate a diabetes health care centre that screens and offers care for other common conditions that occur such as the elements listed above, and also provides nutrition care, physical activity, and social support to patients.

Food apartheid, a term that describes the deliberate nature of food insecurity in the US, is a bioethical issue because people need access to nutritious foods to help sustain a healthy lifestyle, but not all people have this access. The lack of this ability to easily obtain healthy food has contributed to chronic medical issues that span across generations in urban areas such as North Philadelphia. Hospital systems have an ethical obligation to address food apartheid in order to uphold the urban bioethics principles of social justice, non-maleficence, and solidarity. There have been many solutions implemented by local and national organizations and governments to try to combat food apartheid, which healthcare institutions can incorporate in order to benefit their patients. In this thesis, I will discuss some of these solutions and whether they have been shown to be effective in combatting food insecurity. These solutions include fresh food financing initiatives, which aim to open more grocery stores carrying fresh produce in areas affected by food apartheid, and healthy Corner Store Initiatives, which try to increase produce availability in existing corner stores. I will also discuss produce subsidy programs, which discount the price of fresh fruits and vegetables, and urban agriculture, which is usually a community-based initiative to increase access to fresh produce. After a description of the solutions, I will discuss the efficacy of examples of each of these types of programs, and if applicable, will mention if these programs have worked to address food apartheid in Philadelphia. Then I will discuss how well each solution incorporates Urban Bioethics principles. Finally, I will conclude with an analysis on which method may be most sustainable in combatting food apartheid and will explore why healthcare institutions must incorporate these methods in order to improve the effectiveness of the care they provide patients. / Urban Bioethics