Universal Access to Free School Meals through the Community Eligibility Provision Is Associated with Better Attendance for Low-Income Elementary School Students in Wisconsin.

BACKGROUND: Beginning in 2014-2015, schools nationwide have had the option of offering free meals to all students in qualifying schools through the Community Eligibility Provision (CEP). The CEP has been linked to greater likelihood of eating school meals, but little is known about its impact on broader outcomes. OBJECTIVE: The purpose of this study was to estimate the association between the CEP and school attendance among elementary school students (grades 1 to 5). DESIGN: This was a quasi-experimental study in which students' attendance records were observed over 1 baseline and 2 follow-up years in a sample of CEP and eligible non-CEP schools. PARTICIPANTS/SETTING: The participants were elementary school students in Wisconsin during three consecutive school years beginning 2013-2014. The main sample included 92,126 observation-years for students in 37 CEP and 108 eligible non-CEP elementary schools. INTERVENTION: CEP-participating schools offered breakfast and lunch free to all students through the School Breakfast Program and the National School Lunch Program beginning in 2014-2015. MAIN OUTCOME MEASURES: The outcome measures were the attendance rate (defined as the percentage of school days attended) and low attendance (defined as attending fewer than 95% of available days) during the first and second implementation years. STATISTICAL ANALYSES PERFORMED: Difference-in-difference regression models with student fixed effects were estimated, with separate impacts for the first and second CEP years. Models adjusted for time-varying school and student characteristics. RESULTS: Implementing the CEP had no association with attendance in the initial year. The second year of CEP was associated with a 3.5 percentage point reduction in the percentage of students with low attendance (P=0.045). An association between CEP and attendance was only found for economically disadvantaged students. CONCLUSIONS: Offering meals free to all students through the CEP may modestly reduce the risk of low attendance among economically disadvantaged students in participating schools.

Access to the School Breakfast Program Is Associated with Higher Attendance and Test Scores among Elementary School Students.

BACKGROUND: The School Breakfast Program (SBP) has grown and evolved substantially since its inception, yet relatively little is known about its impact on school engagement and academic outcomes. OBJECTIVES: The purpose of this study is to estimate the impact of the SBP on school attendance and standardized test scores, as well as how impacts differ among student subpopulations and between traditional and nontraditional program models. METHODS: The study uses administrative data from ∼1000 Wisconsin elementary schools during 2009-2014, including almost all public elementary schools in the state except those in Milwaukee Public School District. Over the 5-y period, 168 schools in our sample introduced a new SBP and/or changed the location of breakfast (classroom or cafeteria) or the payment structure. The impact of breakfast availability and type was evaluated using multivariable regression models with school fixed effects and extensive demographic controls, leveraging within-school changes in SBP availability and type. RESULTS: Implementing the SBP was associated with a 3.5-percentage-point reduction in the percentage of students with low attendance and an increase of 0.08 SD in normalized reading scores among likely-participant boys (P = 0.015), with no impact among girls. When breakfast was offered free to all students, the probability of low attendance was 3.5 percentage points lower than with traditional SBP for a broad cross-section of students (P < 0.001), and math and reading scores were 0.07 and 0.04 SD higher among the higher-income sample, respectively (P = 0.001 and P = 0.035, respectively). When breakfast was offered in the classroom, neither attendance nor reading scores differed relative to cafeteria-based SBP, whereas math scores among likely-participant boys were 0.05 SD lower (P = 0.045). CONCLUSIONS: Offering breakfast at school can modestly improve educational engagement and performance, but benefits differ across children and by program structure. Universally free breakfast appears particularly beneficial to both attendance and test scores.

Household food insecurity during childhood and subsequent health status: the early childhood longitudinal study--kindergarten cohort.

OBJECTIVES: We examined long-term patterns of household food insecurity in children from kindergarten through eighth grade and the association between those patterns and children's proxy-reported health status in eighth grade. METHODS: We obtained data from the Early Childhood Longitudinal Study-Kindergarten Cohort, a study that followed a nationally representative sample of students from kindergarten entry in 1998-1999 through eighth grade. We classified food insecurity according to the number of years of reported household food insecurity over 4 observation years. We estimated logistic regression models to estimate the association between cumulative food insecurity exposure and health outcomes. RESULTS: Food insecurity was generally a transient rather than a persistent condition. Persistent food insecurity over the 9-year period was associated with lower health status in eighth grade, whereas more transient food insecurity was not significantly associated with health outcomes in most models. CONCLUSIONS: Single-year estimates substantially underestimate the share of children whose households experienced food insecurity at some point during their childhood years. Persistent food insecurity is an important public health issue for children. Policy interventions to alleviate children's persistent food insecurity may promote child health.

The School Breakfast Program strengthens household food security among low-income households with elementary school children.

The School Breakfast Program is an important component of the nutritional safety net and has been linked to positive changes in meal patterns and nutritional outcomes. By offering a breakfast, which for low-income children is available either at no cost or reduced price, the program also has the potential to increase household food security. This study examined the relationship between availability of the School Breakfast Program and household food security among low-income third-grade students by using data from the Early Childhood Longitudinal Survey-Kindergarten Cohort. The primary sample included 3010 students. Availability of school breakfast was assessed by surveys of school administrators. Food security was assessed by parents' reports by using the standard 18-item food security scale and considering 2 different food security thresholds. A probit model was estimated to measure the relationship between school breakfast availability and household food security while controlling for a range of other characteristics. Access to school breakfast reduced the risk of marginal food insecurity but not the risk of food insecurity at the standard threshold. That is, the program appeared beneficial in offsetting food-related concerns among at-risk families, although not necessarily in alleviating food insecurity once hardships had crossed the food insecurity threshold. Increasing the availability of school breakfast may be an effective strategy to maintain food security among low-income households with elementary school children.