Abstract
Background:
Violence against women (VAW) poses a serious threat to the psychological and physical health of women. Food insecurity is both a cause and outcome of VAW, with further consequences for women’s health. The COVID-19 pandemic exacerbated economic insecurity and, as a result, the cycle of VAW and food insecurity, demonstrating that VAW survivors have multifaceted needs when healing from situations of violence.
Objectives:
To explore meanings of food and experiences of food insecurity among VAW survivors accessing supportive services during the COVID-19 pandemic, with the goal of informing holistic and trauma-informed service delivery.
Design:
This analysis is based on qualitative data collected as part of the mixed-methods community-based Marginalization and COVID-19 (MARCO)-VAW study.
Methods:
We applied reflexive thematic analysis to qualitative interview data from 10 survivor participants who accessed VAW services in the Greater Toronto Area, Canada during the COVID-19 pandemic and supplemented it with interview data from 18 staff participants working on those services.
Results:
We generated three themes relevant to meanings of food and experiences of food insecurity among VAW survivors: (1) power dynamics as barriers to food and achieving independence for survivors of VAW, (2) intersection between food insecurity and motherhood, and (3) reclaiming food independence and power after abusive situations.
Conclusions:
Food security and autonomy promoted healing and provided a sense of independence for VAW survivors living in or transitioning out of both violent situations and shelters during the COVID-19 pandemic. To better support VAW survivors, organizations that support survivors need to be appropriately resourced to provide food-related programming, supports, and diverse food options, including during public health emergencies, when economic precarity and social isolation increase. Gender-transformative policy is necessary to prevent gender-based and intersectional inequities in violence and food insecurity.
Introduction
Violence against women (VAW) poses a severe immediate and long-term threat to women’s physical and psychological health.1,2 Intimate partner violence (IPV) is the most common form of VAW. 1 In Canada, 44% of women over 15 years old have experienced sexual, physical, or psychological IPV at some time in their lives. 3 A global increase in VAW was reported during the COVID-19 pandemic, in part due to lockdown orders which forced many women to remain in the home with their abusers and prevented them from accessing formal and informal sources of help. 1 Simultaneously, the pandemic also resulted in economic strain for many individuals, exacerbating situations of financial precarity and job instability, which are risk factors for both violence and food insecurity, or inadequate access to nutritious food sources.2,4
Due to the inequitable distribution of power and resources within society, women are more likely to experience poverty and, as a result, food insecurity.5 –7 Food insecurity further intersects with IPV in many ways. First, food can be part of the dynamics of IPV, as it can be controlled or restricted by the abuser either directly or through the restriction of money. 8 Economic abuse is a type of IPV in which the abuser controls economic resources, reducing a victim’s ability to independently provide for themselves, which includes accessing nutritious foods, resulting in an increased dependence on the abuser.8 –10 Second, food insecurity can be a risk factor for IPV, with women who experience IPV being more likely to experience food insecurity. 7 Third, food insecurity can act as a barrier to gaining independence when leaving situations of violence.11 –13 Indeed, after leaving situations of violence, women are placed at a higher risk for food insecurity as lone, female-headed households are more likely to be lower income.7,14 Food can play a critical role in the cycle of VAW, with traditional gender roles, patriarchal control over money, and normalization of violence all strengthening the relationship between food insecurity and IPV. 14
The current study aimed to explore experiences of food insecurity among VAW survivors who accessed supportive services during the height of the COVID-19 pandemic in Canada’s largest city, Toronto. While the COVID-19 pandemic increased both IPV and food insecurity for survivors, we are not aware of research to date that has qualitatively explored this relationship and meanings of food in the context of VAW service provision during the COVID-19 pandemic in Canada. Our goal was to inform the provision of more holistic and trauma-informed services that meet the multifaceted needs of VAW survivors, during and beyond public health emergencies.
Methods
This article uses qualitative data from the People Experiencing Marginalization and the Effects of the COVID-19 Pandemic Response on Violence Against Women Services, or the MARCO-VAW study. The MARCO-VAW Study was a community-based mixed methods study that aimed to understand the response to VAW during the COVID-19 pandemic in the Greater Toronto Area (GTA) in Canada.15,16 The study operated from a transformative worldview which aims to center the voices of people experiencing marginalization and advance social and structural change. 17 In line with this worldview, the study used an integrated knowledge translation approach, which included collaboration with knowledge users (including women with lived experience of violence on the research team and an advisory group of VAW organizational representatives) on all stages of the research. Further information on our full methodological approach has been described in previous publications.15,16 In this article, the term VAW shelter refers to shelters that specialize in anti-violence approaches and provide tailored services to women experiencing violence. The alternative shelter systems referenced are often provided by the municipality, are often not gender specific, and generally provide basic room and board services to clients. 15 The reporting of this study is in accordance with the COREQ guidelines. 18
Data collection
Qualitative data were collected from April to September 2021 using semi-structured interviews. Eligible participants included in this study were adult women who had accessed at least one VAW service in the GTA since March 11, 2020, or direct support or leadership staff employed at a VAW organization in the GTA since March 11, 2020. Survivor participants were recruited through staff contacts at collaborating VAW networks throughout the GTA. Purposive sampling strategies included recruiting individuals with maximum variation on sociodemographic characteristics (e.g., race, age) and services accessed (for survivors) or worked on (for staff) to acquire different perspectives. VAW staff participants were purposively recruited from those who participated in a survey in the first round of data collection for the MARCO-VAW Study and consented to follow up, with an additional four participants recruited through community networks. Interviews were conducted, typically in pairs by the study’s co-leads (ARY (PhD), an academic VAW researcher, and PS (MSc), a community-based VAW researcher) and three peer researchers (women with lived experience of violence) over Zoom. All interviewers were trained in VAW research methods and took field notes following each interview. Survivor interview guides focused on their living situations, their experiences of violence, the personal impacts of the pandemic, service access and outcomes, and external contextual factors. Survivor interviews ranged from 95 to 150 min. Staff interview guides consisted of questions surrounding their role at the organization, the nature of and changes to their VAW work during the pandemic, and the ways in which their clients were affected by the pandemic. Staff interviews ranged from 65 to 115 min. Interview guides are available online. 15 Participants provided written informed consent prior to participating and received a $40 honorarium for participating in interviews. Repeat interviews were not carried out. With the support of staff and interviewer safety checks, we ensured survivor participants were in a confidential, physically and mentally safe environment prior to beginning the interviews. We also provided a list of mental health resources they could access after the interview with contact information.
Data analysis
We used reflexive thematic analysis, as it embraces the subjectivity of researchers, allows for flexible and collaborative coding practices, and facilitates the blending of data- and theory-informed approaches to analysis. 19 The analysis applied a feminist lens focusing on excerpts related to discourses around food within the interviews to investigate the intersection of gender, VAW, and access to food, considering the ways in which food often defines women’s roles and worthiness within society. 20 In particular, we aimed to develop a thematic framework around experiences of food insecurity and the meanings of food to survivors in relation to their experiences of abuse, service access, and healing journeys during the COVID-19 pandemic. Given this focus, we centered our analysis around survivor interview transcripts and supplemented with staff data as relevant.
The MARCO-VAW dataset was first collaboratively coded by four researchers: one researcher initially coded each transcript, followed by double-coding by a second researcher with the goal of integrating diverse perspectives. Coders met regularly to discuss their codes and observations on salient features of the data. For this article, we then focused on analyzing data excerpts that focused on food and nutrition and created new codes to highlight discourses related to food. We used these codes to identify patterns within the data that related to food and generate themes around meanings of food to participants and experiences of food insecurity as they relate to VAW and service access. In the results summary that follows we provide participant identification numbers to locate where quotes and other data are being drawn from while maintaining participant anonymity.
Results
Table 1 summarizes the characteristics of both VAW survivor (n = 10) and VAW staff (n = 18) participants. Staff and survivors in this sample were racially diverse and most identified as cisgender heterosexual women.
Summary of sample characteristics.
IQR: interquartile range; M: mean; VAW: violence against women.
The survey measured ethno-racial identity using the Government of Ontario Data Standards for the Identification and Monitoring of Systemic Racism.
Includes any participant who reported the following gender identities: (1) fluid, nonbinary, gender queer or agender; (2) Indigenous or other cultural identity (e.g., two-spirit); (3) trans man; or (4) trans woman. We have collapsed these categories to avoid any possible reidentification of VAW staff participants due to potentially low numbers of gender diverse staff in the city’s VAW sector.
Only asked of survivor participants.
Rows for each variable do not add up to 100%, as all survivor participants accessed multiple types of VAW services during the pandemic.
Community-specific organizations included language-based and culturally specific organizations.
Only direct support staff participants were asked to indicate their programmatic specialization, as in most cases leadership were responsible for directing, managing, or supervising an entire VAW service or organization. Specializations do not add up to 100%, as one participant worked on both transitional housing support and counseling.
The mean age of survivor participants was 43 years. Exactly half (50%) of the sample were born outside of Canada. Most survivor participants (90%) had a total household income below CAD 20 000 and were unemployed. The most common VAW programming accessed by survivors was mental health and counseling, followed by residential services and the children’s aid society.
The mean age of staff participants was 47 years. Nearly half (53%) of staff participants were born outside of Canada. Majority of staff worked in direct support, with most of them working in generalist organizations. VAW programming areas varied for staff, with 37% working in mental health counseling, crisis support, and case management and 36% working in second stage housing.
We developed three themes in our analysis, which we summarize below: (1) power dynamics as barriers to food and achieving a sense of independence; (2) intersection between motherhood and food insecurity; and (3) reclaiming food independence and power after abusive situations.
Power dynamics as barriers to food and achieving a sense of independence
Survivors expressed how food was related to different power dynamics in their lives, including during (1) abusive situations, (2) while accessing homeless or VAW shelters, or (3) when trying to transition out of shelters.
Use of food to abuse women
Survivors described instances of abuse that were centered around the restriction and monitoring of food. Most commonly, this abuse came from partners and family members in their household and encompassed physical restriction of food and monitoring of money (including for food). These situations were exacerbated by power imbalances within the relationships they were in, where abusers were in control of these aspects of their lives. For instance, survivor C78, who had recently moved to Canada with her baby and had precarious immigration status, shared:
“But with the baby, you just make a change in [. . .] life. And I thought [my partner] was going to change too [laughs] but he didn’t. So it was, like, we didn’t have, like, proper food to feed the baby. He was like saying, like, ‘If you want food, go to the bank food.’ It’s the name? ‘Yeah, don’t be a lazy fuck.’”
Pregnancy and early childhood are stressful periods—not only physically and psychologically but also financially—and can exacerbate rather than reduce VAW, as was the case for C78. For C78, the onus of providing food for her and her partner’s baby was placed on her, even though money was within her abusive partner’s control, which then became part of her experience of control and coercion.
A notable pattern in the data was the way in which the vulnerability of participants with precarious immigration status, including their access to basic needs like food, was exploited by their abusers. In addition to C78, survivor C77 described experiencing food restriction and monitoring at the hands of her husband and mother-in-law:
“She [my mother-in-law] used to hide food. What [can I] eat this time? Because I couldn’t eat specific things in my pregnancy so. . . daily, I was crying, crying, crying, and nobody was there to listen to me. Even my partner didn’t want to listen to me. He said that you have to ignore my mother and now you have to live because you—I invited you here so you should live on my conditions here.”
These participants provided a unique perspective as immigrant women. Their situations placed them in a vulnerable position, as their abusers exercised control of their precarious immigration status as well as their ability to properly feed themselves and their children. Their abusers exploited their situations to exert control and used food as a tool to worsen the abuse and ultimately disempower these women.
Shelter rules and structures as a barrier to feeling independence over basic needs
Most (80%) survivor participants accessed VAW shelters during the pandemic. In addition, two participants stayed in emergency homeless shelters. In some cases, this involved living in hotel space temporarily acquired by shelters as part of COVID-19 infection prevention and control (IPAC) strategies. Survivors shared how the quality and amounts of food were insufficient when accessing some VAW and homeless shelter supports, and how rules surrounding food were detrimental to their ability to heal from their abuse. When survivor participant C71 accessed an emergency shelter located in a hotel during the pandemic, she had to line up in long lines for food provided by the shelter due to social distancing protocols. She described the barriers to having a meal when food was provided this way, as well as the impractical nature of having to eat a meal in a hotel room with two young children:
“Yeah, the line up was crazy long. I couldn’t do that. Like, [. . .] it didn’t feel comfortable, especially with COVID—everyone was spaced out, but I still didn’t feel safe, especially, I had to always put on these safety backpacks for my kids so they don’t run away while I’m holding some food. So, buying food was the best thing because lining up for each spot and waiting, it took too long and my kids are not a 100 percent will eat it [. . .] and the worst part is even when I buy food and we go back into our room, my kids have a chair and table [where] they ate but I had to eat on the bed all the time. 24/7. I had—I hated it so bad, but I had no other choice.”
Participants described IPAC protocols that were put in place by certain shelters around when and what kinds of food they could access. While these protocols were put in place in response to rising rates of COVID-19 to protect the health and safety of staff and clients, participants felt these rules served as barriers to their food independence and limited their ability to consume adequate nutritious foods. One participant further shared how there was a lack of culturally relevant and diverse food options provided by shelters. Survivor participant C77 noted that she had religious dietary restrictions and was unfamiliar with the food served by the shelters. She described the ways in which she felt the unwillingness of the VAW shelter she was staying at to accommodate her religious dietary restrictions impacted her health and served as a barrier to taking care of herself and her child:
“For the food, they were not helping me because I’m vegan. They are not thinking about my health and that how it will impact my health that for 40 years I’m eating something else in my life and suddenly my eating habits. How can it change and how it will affect my life and my child [. . .] But after that, I made a request, [can] somebody cook some boiled lentils for me [. . .]? [The shelter] don’t do anything. The custom thing like for my country, just boil some lentils and give it to me, make the lentil soup or something. And they said ‘nobody can make specific things for you. Whatever we can make, we can give you.’ So they used to buy the canned beans and all—I never eat the canned food [. . .] And they never allowed us to go in the kitchen [due to COVID-19 restrictions]. So, in shelters, there was no food for me.”
Survivor participant C77 had been hospitalized during her stay at the VAW shelter due to low iron and panic attacks, which she connected back to the lack of food she was able to eat during this time. The experience was so significant for her that the participant likened the treatment she received to another form of abuse: “They were giving me canned food and canned beans. Like, I had gone through, like, from one abuse, I went to, like, another abuse in the shelter, too.”
These barriers were also acknowledged by staff. For instance, staff participant P137 expressed how a lack of culturally specific food was a barrier that prevented some women from seeking out their services during COVID-19 “Yeah, yeah, because some of these women [have religious dietary restrictions] and, you know, getting [abused] is better than eating [prohibited] food.” When participants provided feedback to shelters about food, they described how it was not welcomed or actioned by staff. Furthermore, survivors stated that food quality prevented them from receiving adequate nutrition in shelters, as sometimes they would be served cold meals or get sick after eating them. Regarding her stay in an emergency homeless shelter, survivor participant C75 shared:
“I lost track the amount of times I had food poisoning from eating shelter food. It’s not cooked properly or it’s cold or, you know, like they give you a small plate and you’re still hungry. And it’s kind of like, no, I can’t give you anything else. There’s nothing else [. . .]. So I mean, they weren’t giving enough food or they would give—like it would be for lunch it’s tuna sandwich and I don’t eat tuna, but if you don’t eat tuna it was kind of like tough luck then you can wait until dinnertime like I’m sorry, there’s nothing we can offer you.”
C75 detailed how the inadequacy and poor quality of food was normalized in the emergency shelter she accessed. The structure of the homeless shelter that she had accessed prevented her from feeling independence over her basic needs. VAW staff participant P103 explained that when responding to IPAC protocols (including moving shelter services to hotels to facilitate quarantining) VAW shelters needed to adapt how they provided resources, such as food: “So eventually, you know, like in the beginning, there were so many—few glitches about delivering the food, what kind of food, how are they going to cook it, duh duh duh.” These experiences shared by staff and survivors highlight the gaps in food provision in a variety of residential services during the height of the COVID-19 pandemic. Survivors and staff also describe the precarious experience of transitioning from shelter to independent housing, and how personal economic insecurity and systemic barriers to accessing food impacted their sense of autonomy and independence.
Personal economic security as a barrier to achieving food independence
The transition out of shelters was also a period of personal economic insecurity where survivors faced systemic barriers to accessing food that impacted their sense of independence and autonomy. These barriers included unaffordable housing, lack of adequate employment, and unavailability of childcare supports during the pandemic. One survivor participant, C78, had precarious immigration status. As a result, when she left her abuser, she did not qualify for any government financial aid, worsening concerns she had surrounding economic insecurity. She expressed that without governmental support, she would not be able to afford food and housing on her own once she left the shelter she was accessing:
“So I can see that with my friend. She, she has now her house. But she’s receiving some money from the government for the house, to pay the house, [. . .] for her basic needs and [. . .] for the children. And I am not going to have that help, right? So, so like I’m not going to have food. Because, you know, in the shelter I have food. I’m not going to have food. I’m not going to have a, like, an income, right?”
Survivor C78 left an abusive situation, but now faced having to live on her own. Data from across survivor and staff participants emphasized how leaving abusive situations and transitioning out of shelter often placed survivors in situations of economic precarity that brought about food insecurity, only to be exacerbated by the COVID-19 pandemic. For instance, staff participant P110, whose role in her organization shifted from being involved in residential to non-residential services, described how her new position allowed her to observe a new level of vulnerability in her clients:
“And it’s been [pause] kind of sad because I get to see scarcity and vulnerability in ways that I didn’t see before, all my 20 something years of shelter experience. Because the women at the shelter are eating. They’re sleeping. They have a roof. They have clothing that we can get for them. They have food at any time. They don’t have to pay rent. They don’t have to pay bills, right? But the women were—once they leave the shelter is when the trouble really starts, because now you no longer have that breathing space. Now you have to pay rent. Now you have to pay hydro. Now you have to pay transportation.”
As P110 demonstrates, in many cases after survivors leave the shelter, economic insecurity can serve as a barrier to their ability to continue healing from trauma. Many shelters have set timeframes of when women accessing residential services must find their own housing. However, rising costs of living can be a barrier to many survivors achieving this independence and puts them at risk for experiencing poverty. Staff participant P140 provided further insight on this, sharing that many of her clients had experienced food insecurity and used their organization’s food programming even before the pandemic. Due to the pandemic, some shelters (including but not limited to VAW shelters) had reduced programming or ability to provide food supports, resulting in lack of accessibility to programming that was once readily available, which proved to be a large obstacle for survivors wanting to access food programming:
“[Discussing COVID-19 related disruptions to programming] So [clients] miss that. A lot of them, you know, as I said, live in poverty. So, you know, some would come to really participate in the programs or the group, but some just came for the meals [before the pandemic], and that’s okay, right? So they are not able to do that. So it’s a challenge. It’s a struggle. It presents a barrier for them because that was part of many of their schedules, the daily schedules, you know, they get up [. . .] They know how to shuffle their schedules to get a free meal because of the fact that they’re living in poverty.”
Survivor participants described how they needed to use food supports such as food banks to be able to afford their housing and other basic needs. Placing emphasis on one necessity over the other can result in more setbacks to survivors’ ability to heal from their trauma. Staff participant P110 further elaborated on this, sharing how essential food programming was to the well-being of their clients:
“If these issues are not addressed, confounded, complex trauma, all these kinds of things, and coupled with, oh, well, we’re only going to really address the very superficial things. It’s a lot of vulnerabilities. For the most part, poverty is a huge issue for the clients we serve. [. . .] And trust me, people would not be accessing services if they had financial independence. [. . .] One thing is you’re fleeing violence, you’re dealing with that. But the other thing is that poverty, extreme poverty. Some people have told us that the food that we give them is what they usually count on. It’s tough, it’s tough.”
Staff participants noted the exacerbation of food insecurity and economic precarity more broadly as a result of the COVID-19 pandemic. For instance, participant P137 shared: “So, yeah, I’ve heard and seen more housing insecurities and more food insecurities—like basic needs insecurity this year than I’ve seen historically, for sure.” The inability to meet basic needs, especially for survivors during the pandemic meant that community resources like outreach programming needed to be ready for the influx of clients experiencing economic insecurity. Staff participant P5, for example, shared how there was an increase in demand of food supports by their clients, which is something that had grown in significance for their organization:
“Just kind of looking at the services and stuff that we have [. . .] I’m just referring to, for example, we’ve always had food banks and those different things, but like you said, they weren’t necessarily more VAW-specific, so to speak. But with [the COVID-19 pandemic] just looking at actually how important that really is, right? Because a lot of the people that are calling, are calling about a food bank, right? A lot of the people that are calling, are calling about things that would kind of always be—it was just kind of like a side note to us.”
The seemingly overwhelming need for food supports described by P5 and P137 highlights the increase of food insecurity for VAW survivors during the pandemic and how having readily available programming was important for the health and well-being of their clients. Staff from various services acknowledged how resilient and resourceful survivors had to be given rising food insecurity during the COVID-19 pandemic. Staff member P140 described strategies some survivors used to feed themselves and their children by accessing different programming at different organizations: “So, you know, they’re smart. They know how to shuffle their schedules to get a free meal because of the fact that they’re living in poverty.” However, the reduction in food programming at VAW organizations due to the COVID-19 pandemic proved to be a new barrier to survivors accessing food supports. These changes altered how survivors were able to access food and how VAW organizations were able to provide food support. For instance, staff participant P38 explained the importance of adapting how they provide food to their clients:
“Another change [due to the pandemic] was getting gift cards—because we’re also finding food insecurity. So it’s a big issue. So getting food cards and grocery cards and transportation and then it’s also about getting them to the clients.”
As staff participants P38 and P140 demonstrated, some VAW organizations used new or more flexible funding during the pandemic to create new ways of providing food to survivors, including through gift cards and vouchers or food delivery services, considering the increasing prevalence of food insecurity among their clients.
Intersection between motherhood and food insecurity
Survivor participants who were mothers described how food and food insecurity during the pandemic impacted their ability to take on the role of provider for their children. This provider/caretaker role proved to be difficult when accessing VAW residential services because survivors did not have their own kitchen or ability to go grocery shopping due to financial concerns and IPAC protocols, restricting their movements. For example, survivor participant C73 described how her children, who were living with autism, were picky eaters, and how important it would have been for her to cook for them. However, she had to resort to cheap, unhealthy meals because she could not afford anything else or use what the emergency shelter hotel would give her:
“So, yeah, it was it was bad. It was really, really bad just knowing the fact that I had to buy food every day, we were living off of food every day like. It’s important every single morning for those kids. Lunch I had to figure out what lunch is and then I’m like, oh my God. Like, my kids are picky eaters. Almost every other day we’re eating pizza or pasta. And I’m like [. . .] I can’t even cook a different food for them because I have no stove”
This participant illustrates how the lack of food options and freedom at the VAW hotel shelter affected her ability to fulfill her caregiving responsibilities to her children and give them nutritious foods, causing significant distress. It is important to note these difficulties, as the role of “mother” does not go away while in shelter with dependents (whom women most often have to take sole responsibility for); however, the lack of resources makes it more difficult to fulfill.
21
In contrast, when adequate food supports were available to participants, they felt better able to fulfill that “motherly” role, including providing food for their children and a sense of security and safety. For instance, survivor participant C74 shared:
“My daughter and I took a program where they fed us [. . .] We would take home bags of groceries and we would get a hot meal. And that was such a turning point that I want to share for you, because that helped to normalize the situation that we were in, because we were meeting other families. And it was really helpful because my daughter felt safe, because for her, food and smiles and hugs and no men meant safety. So that was a big step in our healing journey.”
As this survivor participant demonstrates, food programming is not only critical for meeting the basic nutrition needs of some survivors and their children. Rather, it can also be an inherently social experience that provides the social support that is likewise necessary to heal and move on from situations of violence. Notably, this was the case for food programming in the context of a VAW-informed and family-supportive environment, which is important to consider in terms of adopting a gender transformative, as opposed to gender-blind or neutral or approach, to food programming. 22
Reclaiming food independence and power
Feelings of autonomy around food were powerfully tied to positive experiences for survivors, both during their shelter stays and as they transitioned out. This played out in two primary ways, with food autonomy both (1) empowering women and (2) creating a sense of community for them.
Adequate supply of food can empower, comfort, and provide safety to women
Survivor participants who had positive experiences with food in shelters oftentimes explicitly mentioned this in their interviews, identifying it as a turning point in their journeys. The ways in which shelters prioritized nutrition for clients played a central role in survivor experiences. A positive shelter experience can improve feelings about accessing shelter resources among survivors. 21 These positive experiences highlighted freedom surrounding food access (e.g., snacks in the fridge that could be accessed at any time), hot meals, and the independence to cook their own meals. For instance, survivor participant C71 stated that their positive experience was shaped by the VAW shelter providing food support and allowing them to cook their own meals: “[The VAW shelter] actually gave me that support I need. They gave me a little bit more hope ‘cause I didn’t [have] to spend money every single day. I could physically cook food for my kids.” As described above, this experience was directly contrasted with the participant’s negative experience staying in an emergency shelter, which was in part shaped around her inadequate access to food and ability to prepare food herself for her children. Autonomy over food preparation not only met the participant’s nutrition needs, but also the more emotional and social aspects of caregiving for her children.
Freedom around food provision allowed participants to emotionally and physically accomplish independence. This was a sentiment that also carried on post-shelter as participants transitioned to permanent housing. Not only was cooking their own meals more affordable than eating out, but it was freeing for participants to have non-restricted access to food and cook freely. This was illustrated by survivor participant C77, who shared the following around her experience of acquiring her own housing: “Now I can cook my food for me. This stove thing, this personal fridge, like it means a lot. I cry a lot when, you know, these things are important for me right now.” This quote powerfully demonstrates the sense of agency and empowerment that food security and autonomy can provide for survivors. Survivor participant C75 similarly shared in regard to getting her own apartment: “We were just happy to have peace and quiet and our own kitchen and our own cooking.” Relying on takeout and delivery can be unsustainable and result in a limited supply of food. Additionally, not being accustomed to a set menu or sharing communal kitchens, as in many shelters, was a barrier to positive experiences for some survivor participants. Finding opportunities for food independence, even within these existing structures, was an important marker of feelings of empowerment.
Food programming as a connection to community for VAW survivors
Survivor participants often expressed how alone they felt in their situations of abuse and during shelter stays. However, some participants discussed how they were able to find community when they were able to access food programming through VAW and other community-based organizations. Community food supports allowed for women to reach out to different organizations that aligned with their culture, values, and backgrounds in ways that VAW organizations were not always equipped to. For instance, participant C77 described how she found an organization that could provide her with the culturally relevant and diverse foods she wanted while in shelter:
“I was looking [. . .] for my food. And so I saw [a] community organization. I sent them email that I’m living in a shelter and I can’t cook my food [. . .] I heard that you deliver cooked food to some places in Canada, so they contacted me, they heard my story, and when I was in the shelter, they were delivering me cooked food daily.”
This was a major turning point in the participant’s healing journey, who, as described above, struggled with food provision during her initial time at a VAW shelter, which did not meet her religious or dietary requirements. This community support provided not only physical satisfaction for the participant, but cultural connection and peace of mind.
More broadly, food can serve as a connector, and when offering services to survivors, it can be an effective strategy for engagement in other VAW programming. For example, staff participant P110 described how important offering food was for getting clients to attend their nonfood specific programming: “Food is such a glue or a conductor. People come, and whenever there’s programming, there’s food, people come.” Food programming within VAW organizations also facilitated opportunities for survivors to create community with each other. For instance, participant C74 had been a part of a cooking program through a shelter and had begun to foster great relationships with those around her: “I started to meet and stay in touch with other women who were able to just instinctively know what I needed. Here’s an amazing chickpea recipe. You have one can of chickpeas. Here’s what you can do. 23 different ways.” Instances like this recipe sharing are a testament to how important food can be in the lives of survivors from a social perspective. Food can help foster relationships and create a community of peers going through similar situations.
Discussion
This article sought to explore survivor perspectives on food insecurity and meanings of food throughout VAW service access during the COVID-19 pandemic to strengthen holistic, trauma-informed service delivery during and beyond public health emergencies. Participants revealed how food was used to perpetuate situations of abuse and impacted survivors’ ability to achieve food independence. This kind of restriction takes a mental and physical toll on survivors’ health, not only subjecting them to hunger but also creating feelings of powerlessness and isolation—even while accessing supportive services—that can have long-lasting adverse impacts.8,23,24 Gendered expectations around food and food provision, which dictate that women should find worth in their ability to do the “food work” for their families, can exacerbate situations of violence and likewise have intense consequences on survivors’ mental health and well-being if they are experiencing food insecurity or lacking food autonomy, as was the case for many participants in the current study.14,25 Patriarchal rules surrounding food suggest that women must take on the primary food caretaker role, which can have negative impacts on women who cannot conform to these “rules” (e.g., during shelter stays with restrictive food policies in place), and, as a result, women’s relationships and personal identities. 25 In light of the prevalence of food insecurity among VAW survivors accessing supportive services and the demonstrated harms created by a lack of food independence, it is critical that VAW organizations receive appropriate funding to provide clients with more autonomy around food preparation and choice around food options (including foods relevant to different dietary restrictions, cultures, and religions).
Perceptions of stays in both VAW and homelessness shelters were greatly impacted by positive or negative experiences surrounding food supply, access, and quality. Due to the COVID-19 pandemic, shelters, as congregate living settings, had to enhance restrictions on common areas and how they distributed supplies to mitigate the spread of disease. 1 Despite being an important component of IPAC policy, the lack of freedom surrounding food preparation and availability in shelter was detrimental to many women seeking help, contributing to their stress. This was exacerbated for survivors with dietary restrictions (e.g., due to culture or religion). Women who come from culturally diverse backgrounds are oftentimes uncomfortable accessing shelters when leaving situations of violence due to the lack of culturally relevant resources and Eurocentric tendencies. 26 This barrier can be removed by increasing emergency preparedness funding to VAW and cross-sectoral organizations (e.g., homeless shelters) to be able to provide diverse food options to clients during future public health emergencies and develop IPAC plans that allow for client autonomy in food preparation in congregate living spaces (e.g., rotating schedules to allow for personal food preparation in shared spaces). 26
When survivor participants had left their abusive situation, some faced barriers that inhibited their ability to gain independence. VAW survivors are at greater risk for poverty and food insecurity due to fewer economic resources (e.g., as a direct result of economic abuse and limited access to household finances, low income, sole caregiving responsibilities).7,8,27 Gender transformative approaches to policy, including for instance, to education, economic, labor, and childcare policies, are critical both to preventing VAW and food insecurity among women as well as reducing food insecurity among VAW survivors leaving situations of violence. 14 After survivors leave situations of violence, there is an overwhelming need for and importance of social services which are designed to provide physical resources such as food, clothing, and shelter for survivors, as well as the need for autonomy in food provision in congregate living spaces.12,21,28,29 Appropriate supports targeted toward survivors can have positive effects on their well-being.29,30 Critically, social protection should be available to survivors, regardless of residential status, which is a significant risk factor both VAW and food insecurity, as highlighted by our study and others. 31 In addition, sustainable funding should be provided to VAW organizations (both residential and non-residential) to deliver ongoing food programming (e.g., food banks, learn-to-cook programs, drop-in meals, grocery gift cards), even during public health emergencies, to meet both the physical and social needs of survivors.
Strengths and limitations
While there is a significant body of literature on the quantitative relationship between VAW and food insecurity,7,14,23,24,27 there has been comparatively less qualitative attention paid to the importance of food to survivors and their healing journeys while accessing supportive services. This article provides important insight on the overlooked food-related needs of VAW survivors accessing supportive services at the height of the COVID-19 pandemic in one of Canada’s most impacted cities. 15 With a diverse sample, we were able to incorporate different perspectives on the meanings of food and experiences of food insecurity among survivors and generate recommendations relevant to future public health emergencies and “post-pandemic” service delivery. Additionally, much of the research on food insecurity and IPV has been conducted in low-middle income countries, even though this issue is prevalent in high-income countries as well; therefore, this article adds nuance to how needs of survivors are overlooked globally.
The interview guides included questions around economic insecurity (for survivors) and adaptations to programming during the pandemic (for staff); however, there were not pre-specified questions related to food, which likely led to limited data relevant to our research questions. Instead, our research focus and the data analyzed in this study were generated through the reflexive nature of data collection and analysis, which led to us recognizing their importance to VAW service delivery, during and beyond public health emergencies. Our findings demonstrate the value of further qualitative research with VAW survivors and staff that intentionally asks about food-related experiences and programming. Our study only focuses on the GTA in Canada, where services provided and accessed may differ from other parts of the country and the world, with a relatively small number of participants. As such, the transferability of our results is limited, highlighting the need for future research in other jurisdictions. While considerations of data saturation were not relevant given our chosen methodology (reflexive thematic analysis), our interview data were rich in informational power, with most interviews spanning 90–120 min of detailed and relevant conversation and storytelling.32,33
Conclusion
This article illustrates the importance of food security and autonomy for VAW survivors to promote their healing from situations of violence. There is a need for more investment in residential and non-residential VAW and other community organizations that support survivors to provide food-related programming and supports for clients and, as relevant, a diversity of food options (including foods relevant to different dietary restrictions, cultures, and religions). Funding should include provisions for emergency preparedness planning to ensure that organizations can continue food programming and develop and implement IPAC protocols that promote client autonomy around food, even in congregate living settings, during public health emergencies. Gender transformative approaches to policymaking, including across economic, education, labor, and childcare policies, are necessary to both prevent gender-based and intersectional inequities in violence and food insecurity as well as support VAW survivors in exiting violent situations and establishing economic empowerment post-relationship or shelter stay.
Footnotes
Acknowledgements
We are extremely grateful to the MARCO-VAW study participants, who made this work possible, and members of the MARCO-VAW team who supported the original study, including Catherine Moses, Elizabeth Tremblay, Monique Arcenal, Patricia O’Campo, Robin Mason, Janice Du Mont, Maria Huijbregts, Lauren Hough, and Amanda Sim. We thank the Toronto Region Violence Against Women Coordinating Committee, who served as the MARCO-VAW study’s advisory group, and the Woman Abuse Council of Toronto, who supported our peer researchers. We would also like to acknowledge the support of the broader MARCO study team, including principal investigators Ahmed Bayoumi and Michelle Firestone.
