Over the past two decades, household food insecurity has emerged as a significant social problem and serious public health concern in the "First World." In Canada, communities initially responded by establishing ad hoc charitable food assistance programs, but the programs have become institutionalized. In the quest for more appropriate and effective responses, a variety of community development programs have recently been initiated. Some are designed to foster personal empowerment through self-help and mutual support; others promote community-level strategies to strengthen local control over food production. The capacity of current initiatives to improve household food security appears limited by their inability to overcome or alter the poverty that under-pins this problem. This may relate to the continued focus on food-based responses, the ad hoc and community-based nature of the initiatives, and their origins in publicly funded health and social service sectors.