Dignified Food Access in Place: Flexible Payment and Placemaking in a Community Health Centre Food Market

Abstract

Food insecurity remains a persistent public health and planning issue in Canada, shaped by household income in addition to spatial, social and organizational conditions through which people obtain food. Flexible payment food models that operate with a pay-what-you-can approach, have emerged as an alternative between full payment grocery retail and no-payment charitable food provision. Although these models are classified according to payment structure, this study evaluates them as broader systems of food access, considering payment and affordability alongside food adequacy, dignity and placemaking. However, limited research has examined how these models work in practice, particularly when embedded within community health and social service settings. Through a qualitative applied evaluation using a comparative questioning strategy, this thesis explores the Community Market at Community Healthcaring Kitchener-Waterloo, a flexible payment food procurement model located within a Community Health Centre in Kitchener, Ontario. This study asks: How does the Community Market shape user experiences of food procurement including dignity and placemaking in ways that may help address food insecurity? To answer this question, semi-structured interviews were conducted with ten Community Market users who had also used full payment and no-payment food procurement models. Flexible payment food procurement models were also explored in the context of affordability interventions and place-based systems of food access. The findings show that payment structure shaped affordability and access, however, it did not determine user experience on its own. Model efficacy depended on how payment operated alongside food adequacy and place conditions that supported dignity, comfort and belonging. Several planning and program recommendations are provided, grounded in the experiences of Community Market users. These recommendations can help planners, community health centres and community organizations evaluate flexible payment food models in ways that address food insecurity, dignity, community wellbeing and equitable food access.