Universal Free Meals Associated with Lower Meal Costs While Maintaining Nutritional Quality.

Michael W. Long,Tatiana Andreyeva,Keith Marple

doi:10.3390/nu13020670

Michael W. Long, Tatiana Andreyeva + Show 1 more

Open Access

https://doi.org/10.3390/nu13020670

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Abstract

The Community Eligibility Provision (CEP) of the Healthy, Hunger-Free Kids Act of 2010 allows the provision of universal free meals (UFMs) in high-poverty school areas. Participation in UFM programs, including through CEP, could reduce meal costs due to economies of scale and a lower administrative burden. We analyzed the School Nutrition and Meal Cost Study (SNMCS) data from 508 UFM-eligible schools (103 UFMs) to evaluate whether meal costs varied by UFM status. We used school-level data to address the non-random selection to UFMs with inverse probability of treatment weighting (IPTW). We estimated a generalized linear model with a log link and gamma distribution to predict meal costs by UFM status and school size. Full costs among medium and large schools were marginally lower in UFM schools for lunch (−$0.673; 95% CI: −1.395, 0.0499; p = 0.068) and significantly lower for breakfast (−$0.575; 95% CI: −1.077, −0.074; p = 0.025). UFM was not associated with meal costs among smaller schools. Healthy Eating Index scores did not vary significantly by UFMs, suggesting that lower costs could be achieved without an adverse effect on nutritional quality. This analysis is limited by the lack of identified student percentage (ISP) data needed to definitively identify CEP eligibility, although results were robust to sensitivity analyses addressing the lack of ISP data. The potential policy impact of these findings emphasizes the need for future studies that assess ISP and cost with more recent data and longitudinal designs.

Highlights

After schools not eligible for the Community Eligibility Provision (CEP) were excluded (n = 368), we had the final sample of 508 schools, including 103 schools with universal free lunch, 87 that participated in the CEP, and 16 that operated the National School Lunch Program (NSLP) under Provision 2 or 3
The contrast of the predictive margins for full breakfast cost by universal free meals (UFMs) over school size showed no difference between UFM and non-UFM participating schools among small schools (0.171; 95% CI: −0.826, 1.169; F = 0.11 (1df), p = 0.735) and a substantially, statistically significant lower full cost among medium or large schools participating in UFMs compared to medium/large schools not participating in UFMs
We found that almost two thirds of the difference between schools participating and not participating in UFMs came from unreported costs, suggesting that changing how the program is administered can lead to substantial efficiencies, even in the absence of economies of scale in the production of school meals

Summary

Introduction

Breakfast Program (SBP) and the National School Lunch Program (NSLP), eliminated the sale of most sugary drinks and reduced the calorie content of snack foods [1]. Overhauls of the nutritional requirements for meals qualifying for reimbursement through the SBP and NSLP have led to a healthier meal program with strong programmatic adherence, improvements in student diet quality, and no increases in food waste or reductions in participation [2,3,4,5]. While the improvements in the nutritional quality of school meals and rules governing the nutritional quality of competitive foods have gained much of the research and policy attention, changes in the mechanisms of school meal financing have the potential to substantially increase the access and sustainability of the programs.

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