School meal programs in the United States
School meal programs in the United States provide school meals freely, or at a subsidised price, to the children of low income families. These free or reduced meals have the potential to increase household food security, which can improve children's health and expand their educational opportunities.
The most prevalent school meal program in the United States is the National School Lunch Program (NSLP), a federal program signed into law by President Harry S. Truman in 1946. It was historically looked upon to be the foundation for children’s nutritional health in the U.S. Serving over five billion lunches per year to qualified students, the main goal of the NSLP is to provide highly nutritious meals for children who may not otherwise have access to a proper diet. Additionally, these meals can feed children who live in food insecure households or who may for a variety of reasons have inadequate access to the necessary calories and nutrients for proper functioning. The NSLP was originally established as a “measure of national security, to safeguard the health and well-being of the nation’s children and to encourage domestic consumption of nutritious agricultural commodities” (School Nutrition Association, 2012). In the six decades since its origin, the program has made a significant shift from not only preventing malnutrition, but also fighting childhood obesity. The NSLP is currently operating in over 100,000 public and nonprofit private schools and residential care institutions. In 2011 the program served low-cost or free lunches to over 31 million children per day.
The NSLP and other food programs have been used to target children's health, particularly the health of children who are food insecure or at risk of malnutrition. More recently, nutritional guidelines have been developed to address issues of obesity. However, neither underweight children of the past nor the overweight children of the present have been that way solely because of individual choices, lack of nutrition education, or poor food choices. Rather, the nutrition of these children is tied directly to social and economic circumstances, such as family income and access to fresh foods, just as much as it is connected to individual choice factors. Therefore, school meal programs provide an avenue by which these social and economic circumstances can be targeted to improve the nutritional content of children's food. Children's nutrition, moreover, has broader effects on students' educational achievements and behavior.
- 1 Children’s food security
- 2 Food programs
- 3 Funding
- 4 Participation
- 5 Nutritional guidelines
- 6 Outcomes
- 7 References
Children’s food security
In the United States, children’s food security is an important issue to address. Food insecurity includes both inadequate quantity and poor quality of food. Children need not just enough calories, but enough nutrients for proper growth and development. This proper growth has broad health implications that can affect a variety of development outcomes. Children’s food security can impact children’s success in terms of educational outcomes, family life, and overall health. For example, marginal food insecurity has been linked to worse development trajectories for children, such as impaired social skills and reading development. School meal programs have been implemented as a solution to alleviating issues with food insecurity.
Implications of food insecurity
Inadequate quantity and quality of food affects the health and wellbeing of children in several ways. Food insecurity is a huge risk to the “growth, health, cognitive, and behavioral potential” of those who are "in or near poverty”. Most behavioral, emotional, and academic problems are more prevalent among hungry children than non-hungry children. Food insecurity is linked to lower math scores, greater problems getting along with peers, poor health status, and higher prevalence of illness. A study by researchers at the Boston University School of Medicine found that those children aged 6–11 years in food insufficient homes had lower arithmetic scores, were more likely to have repeated a grade, seen a therapist, and had more difficulty getting along with peers than similar children in food secure homes. Additionally, hungry children are much more likely to have clinical levels of psychosocial dysfunction. They also show greater signs of anxious, irritable, aggressive, and oppositional behaviors than low- income, non-hungry peers.
In addition to being at a greater risk for these behaviors, children without access to adequate diets face challenges to physical health that make them more prone to illnesses. Researchers have found that undernutrition leads to an array of health problems that have the potential to become chronic. Undernutrition can lead to issues such as "extreme weight loss, stunted growth, weakened resistance to infection," as well as "in worst cases, early death." Illnesses and such adversities lessen the amount of time students can spend learning and attending school.
The cognitive, behavioral, and physical health problems that undernourished children face are exacerbated in those children who are from more impoverished backgrounds. Scientists now believe that "malnutrition alters intellectual development by interfering with overall health as well as the child's energy level, rate of motor development and rate of growth." Moreover, "low economic status can exacerbate all [of] these factors, placing impoverished children at particular risk for cognitive impairment later in life.". Paying special attention to food security in school children is especially important for securing their livelihood and abilities not just during primary education, but also for later in life.
Rates of food insecurity
The rate of food insecurity in recent years has been on the rise. Between 2007 and 2008 the rate of food insecurity in the U.S. increased from 11.1 percent to 14.6 percent, which was the largest annual increase since research began in the mid-1990s. Among households with children, food insecurity increased from 15.8 percent to 21 percent during this period. A total of “4 million American children experience prolonged periodic food insufficiency and hunger each year,” which amounts to 8 percent of children under the age of 12 in the U.S. An additional 21 percent are at risk of hunger. School meal programs are an opportunity to alleviate the rise in food insecurity in order to support children’s health, wellbeing, and educational and behavioral outcomes. These programs function in three ways: they give meals to kids who may otherwise forego them, free up household resources for other family members, and reduce uncertainty about household food availability. Additionally, they provide nutrients and vitamins necessary for proper development.
Food insecurity and its effects on education have even broader implications on poverty and inequality in U.S. society. Education and food both fall under the umbrella of what are known as the “Central Capabilities,” which were created by Martha Nussbaum, an American philosopher. Her central capabilities, which are integral to raising people above the poverty threshold, include the following: life; bodily health; bodily integrity; sense; imagination and thought; emotions; practical reason; affiliation; other species; play; and control over one’s environment, both political and material. Nutrition plays into a person’s bodily health and bodily integrity, and education has broader connections to sense, imagination and though, practical reason, and control over one’s environment. A lack of these capabilities leads people to fall into poverty traps, leaving them without the proper opportunities to rise out of the traps. Government policies such as meal programs are an avenue by which the government can prevent people from falling into poverty, as well as lift people out of poverty.
Before the official establishment of the large-scale government-funded food programs that are prevalent today in the United States, other small, non-governmental food programs existed. As early as the late 19th century, there were programs in cities such as Boston and Philadelphia that operated independent school lunch programs, with the assistance of volunteers or charities. Prior to the establishment of government programs, before 1930s, most school lunch programs were volunteer efforts on part of teachers and mother’s clubs. These programs drew on the expertise of professional home economics. For the people who began these programs, school lunchrooms were the perfect setting in which to feed poor children, but more importantly to teach immigrant and middle-class children the principles of nutrition and healthy eating. Thus, the original intent of school meal programs was not to help expand the food security of those in poverty in order to alleviate educational issues, but to primarily instill cultural norms upon children.
During the Great Depression, the numbers of hungry children coming for food overwhelmed lunchrooms. Thus, programs began to look at state governments, then the national government, for resources. The national government then began providing aid for lunches as early as 1932, but it began on a small scale. This funding originated from New Deal agencies such as the Federal Emergency Relief Administration, the Reconstruction Finance Corporation, and the Civil Works Administration. The federal government monitored supplies from commercial farmers and purchased surplus commodities (Levine 6). Schools served as an outlet for federal commodity donations. Then, programs expanded in 1935 through the Works Progress Administration and the National Youth Association, both of which provided labor for school cafeterias.
Eventually, the New Deal policies began to dissolve and farm surpluses were not as large. However, there was still a desire to keep school lunch programs in place, so federal cash assistance began to be appropriated on a year-to-year basis. The National School Lunch Program was subsequently developed.
History of the National School Lunch Program
The NSLP was created in 1946 when President Harry Truman signed the National School Lunch Act into law. By the end of first year, the program helped 7.1 million children. However, from the start, the program linked children’s nutrition to the priorities of the agricultural and food interests, tied to the agenda of United States Department of Agriculture (USDA). In these early years, the program provided substantial welfare to commercial farmers as outlet for surplus commodities, but provided few free meals to those children who were poor, and fed a relatively small number of schoolchildren. In the 1960s, a group of mainstream national women’s organizations focused their attentions on shortcomings of NSLP. The evidence they used became crucial to Senate and House debates on race and poverty. At the end of 1960s, the Nixon administration was forced to expand access to free lunches for poor children. After the 1960s, the NSLP was struggling. Then, in 1966, the Child Nutrition Act was passed, which stated that educational progress was an objective of meal programs in the U.S. By the By the end of the 1970s, many school advocates saw privatization as only way to keep lunch programs going. Fast food from private companies began to be supplied in cafeterias. Schools continue to struggle with the nutrition of the meals served through the NSLP. However, by the end of the 20th century, the NSLP ranked as the nation’s second largest domestic food program after Food Stamps.
Although President Harry S. Truman created the NSLP on June 4, 1946, actual food service in schools had begun long before the official act; however, the NSLP was the first formal recognition of a food service program. The NSLP legislation came in response to claims that many American men had been rejected for World War II military service due to diet-related health problems: it was clear that America’s children were malnourished.
In 1962 the National School Lunch Act amended the funding of the NSLP from a state regulated grant aid to a permanently funded meal reimbursement program. The NSLP must update its regulations every five years under the Child Nutrition and Women Infants Children (WIC) Reauthorization Act. In the six decades since its creation, the NSLP has experienced several major changes.
In 1966 President Lyndon B. Johnson signed the Child Nutrition Act. This Act established the School Breakfast Program (SBP) as a federally assisted meal program that provides nutritionally balanced, low-cost or free breakfasts to public and nonprofit private school children. This Act was signed during National School Lunch Week and is an extension of the NSLP.
In 1968 U.S. Congress created the Child Nutrition Act, which initiated a two-year pilot project School Breakfast Program and increased meals served to needy students. The Child Nutrition Act was also amended to create the Summer Food Service Program. Congress additionally established the National School Lunch Week.
In 1969 President Richard Nixon said, “The time has come to end hunger in America.” He then pushed Congress to authorize free and reduced-price lunches for needy children through sufficient funding in addition to the regular replacement program.
In 1994 a number of changes were made to the NSLP primarily emphasizing the need to standardize the nutritional quality of school meals. Dietary guidelines were proposed to take effect in 1996. Also, the U.S. Department of Agriculture (USDA) launched the Healthy School Meals Initiative to improve nutritional education for school age children.
In 2004, as the childhood obesity crisis came into national focus, new USDA regulations urged school districts to set up wellness policies and initiatives that would answer specific issues to their own needs. These USDA regulations aimed at strengthening nationwide nutritional education and to give schools the autonomy to decide what types of foods could be sold in vending machines and as a la carte items during lunch.
In 2007 the USDA hired the Institute of Medicine (IOM) to oversee a recommendation for “bringing school food up-to-date with current science.” (From the report it was concluded that, “Since the school meal programs were last updated, we've gained greater understanding of children's nutritional needs and the dietary factors that contribute to obesity, heart disease, and other chronic health problems.” (Virginia Stallings, MD, Jean A. Cortner Endowed Chair in pediatric gastroenterology at the Children’s Hospital of Philadelphia, head of the IOM team).
In 2010 the Healthy, Hunger-Free Kids Act was the most sweeping change in the history of the NSLP. Championed by Michelle Obama and directed by the USDA, these new guidelines required an increase in fruits, vegetables and whole grains. The new guidelines also limited sodium, fat and caloric intake to age-appropriate levels. For the first time ever, vending machine snacks and a la carte menu items fall under regulation of the NSLP. The hope is that these new guidelines will allow school children to learn how to make healthy eating choices, and how to embrace nutrition as part of their life choices. These changes went into effect for the 2012-2013 school year.
The National School Lunch Program today
Today, the National School Lunch Program operates in over 101,000 public and non-profit private schools and residential care institutions. Regulated and administered at the federal level by the Food and Nutrition Service of the United States Department of Agriculture (USDA), it currently provides nutritionally balanced, low-cost or free lunches to children across the nation. In 2011, the NSLP fed more than 31 million children each day. Most students benefit from the NSLP because it subsidizes even full-price meals in the majority of U.S. schools. In its 60-year history, the National School Lunch Program has expanded to include the School Breakfast Program, Snack Program, Child and Adult Care Feeding Program and the Summer Food Service Program. At the State level, the National School Lunch Program is usually administered by state education agencies, which operate the program through agreements with school food authorities.
The Food and Nutrition Service, an agency of the USDA, administers the NSLP on the federal level. Within individual states, the NSLP is administered by a state agency, in most cases through offices in the State Department of Education. If state law prevents the state from administering the program, the appropriate FNS Regional Office (FNSRO) may administer it. At the local level, the school or school district administers the program. The state agent in charge of the NSLP works with the school district to make sure each lunchroom worker receives the necessary information and supplies to make the program successful. Additionally, the state agent receives direction stemming from the United States Secretary of Agriculture. The NSLP has a wide-reaching relationship with a variety of other organizations. Over the decades, lawmakers have continued to enhance the program based upon changing national views of nutrition.
At the federal level, the NSLP has a significant impact on other federal agencies and programs. For example, the NSLP established a successful relationship with the immense United States Department of Defense (DoD), providing children of DoD employees with fresh food. Also, the NSLP program works closely with other federal programs such as the National School Breakfast Program and the Supplemental Nutrition Assistance Program (formerly known as the Food Stamp Program). Even though the USDA administers the NSLP at the federal level, its greatest influence is at the state and local levels. As a result, school districts choosing to participate in the NSLP follow specific guidelines and receive federal subsidies for each meal they serve.
Aside from its impact on public organizations, the NSLP also has a direct impact on corporate vendors and local businesses. The program is designed to help local farmers by purchasing fresh fruits and vegetables, which make their way to schoolchildren. Also, many food companies, eager to “earn a piece of the pie,” are reformulating their foods to meet federal guidelines and sell their products to the government.
The School Breakfast Program
The School Breakfast Program (SBP), which was developed as part of the National School Lunch Program, began as a pilot program in 1966 and then became permanent in 1975. The “original legislation stipulated that first consideration for program implementation was to be given to schools located in poor areas or in areas where children had to travel a great distance to school.”. Thus, it was developed directly to target children in poverty. In fact, in “1971, Congress directed that priority consideration for the program would include schools in which there was a special need to improve the nutrition and dietary practices of children of working mothers and children from low-income families.”  In 1970, before the program was permanent, the SBP served 0.5 million children. In the fiscal year 2011, over 12.1 million children participated every day, 10.1 of which received free or reduced breakfasts. The SBP works in essentially the same way as National School Lunch Program ). As with the NSLP, participating schools receive cash subsidies from the U.S. Department of Agriculture for every meal that is served. They must meet Federal requirements and must offer free or reduced priced breakfasts to children who are eligible. The USDA provides schools with technical training and assistance to help food service staffs prepare and serve healthy meals; provide nutrition education to help children understand the link between diet and health.
Both the National School Lunch Program and the School Breakfast Program give cash reimbursements for food that is served in participating schools. In the school year 2012-2013, the NSLP will give the following reimbursements for “non-severe need” schools: $2.86 for free lunches, $2.46 for reduced-price lunches, $0.27 for paid lunches, $0.78 for free snacks, $0.39 for reduced-price snacks, and $0.07 for paid snacks. Additionally, students paying the reduced-price pay no more than 40 cents per meal. In the year 2012-2013, the SBP will give the following cash reimbursements for “non-severe need” schools: $1.55 for free breakfasts, $1.25 for reduced-price breakfasts, and $0.27 for paid breakfasts. Schools may qualify for higher “severe need reimbursements” if 40 percent or more of lunches are served free or at reduced price in the second proceeding year. For the fiscal year 2011, the cost of the SBP was $3.0 billion, compared to $10.8 million in 1970. In the fiscal year 2011, the cost of the NSLP was $11.1 billion, as compared to $70 million in 1947.
Budget trend suggests that meal production costs over the last five years have been increasing faster than revenues are coming in. The Economic Research Report from July 2008 suggests: “Cost pressures may be a barrier to improving school menus in some cases. The nationally representative School Lunch and Breakfast Cost Study II found that while the mean reported cost of producing lunch during 2005-06 was below the reimbursement rate, about one in four school districts reported costs above the reimbursement rate (Bartlett et al., 2008).” It continues to say, “Further, the mean full cost of producing a lunch was higher than the reimbursement rate." The study also found that reported costs increased over 1992-2005 while full costs decreased, reﬂecting an increase in the number of school food authorities being charged by school districts for indirect costs in response to their own budget pressures (School Nutrition Association, 2006). Other sources of increasing cost pressure include increases in health care costs for employees (GAO, 2003; Woodward-Lopez et al., 2005) and, more recently, rising food costs (FRAC, 2008).”
In 2012, scientists conducted research that compared previous year’s data with the limited current year data to see if previously identified problems have persisted or if they have been corrected. They found that in fiscal year 2011 the NSLP served 5.18 billion lunches at a cost of $11.1 billion, representing a 181 percent increase over the same program in fiscal year 2000. Although the problems are not insurmountable, they are significant. However, little research has been completed since the most recent changes to the program in 2012.
In terms of cost efficiency, one can compare NSLP-compliant lunch meal costs with lunches produced in schools that are not participating in the program. Constance Newman’s research in “The Food Costs of Healthier School” compared costs during the 2005-2006 school year (2012). Newman found “healthier meals are more costly” than meals that do not meet the new standards. She also found the “mean reported cost for a reimbursement lunch was $2.36 while the reimbursement rate was $2.51,” or 106 percent of the total cost. What Newman found is that revenues for non-reimbursable meals (competitive and adult meals) amounted to only 71 percent of the cost of the meal. To address this particular issue, the 2010 Healthy Hunger-Free Kids legislation requires gradual increases in amounts charged until costs are covered 100 percent.
In addition to the mandated revenue increase, the USDA has also increased Food Service Authority (FSA) reimbursement rates by 6 cents per meal served for 2012-2013. Not all of the increases are due to food costs alone. Nearly half of the costs are associated with overhead costs such as equipment, labor, and training. Newman’s research identified many of the strengths and weaknesses of the program but she also admits that the majority of her data came from 2005 and is thus outdated. She acknowledges that “another important caveat is that the foods served in schools have changed since 2005” (2012). Newman recognizes that proposed standards will lead to higher costs but fail to address how much the overall labor and capital costs will be affected. She does agree that overhead costs would increase as well, at least in the short term.
Recently, there has been a push to privatize the school breakfast and lunch programs because of rising costs. These private foodservice companies have much greater purchasing power than school districts and are also able to save costs by providing fewer benefits and lower salaries to their employees than those of in-house providers.
Generally, public or nonprofit private schools of high school grade or under and public or nonprofit private residential child care institutions may or may not participate in the school lunch program. School districts and independent schools that choose to take part in the lunch program get minimal cash subsidies and donated commodities from the USDA for each meal they serve. In return, they must serve lunches that meet Federal requirements, and they must offer free or reduced-price lunches to eligible children. School food authorities can also be reimbursed for snacks served to children through age 18 in after-school educational or enrichment programs.
In the late 1990s, NSLP officials determined in a “Study of Direct Certification in the National School Lunch Program” that the paper application process for NSLP certification was inefficient and potentially excluded participants from the program (Jackson, Gleason, Hall and Strauss, 2000). This study showed that direct certification provided the most advantageous way to identify eligible participants in the NSLP by allowing schools to use documentation from local or state welfare agencies to verify eligibility for the program. Although a lack of cooperation between the NSLP and some welfare agencies was identified, direct certification was shown to significantly improve the number of eligible participants in the Food & Nutrition Service’s (FNS) study of direct certification. In 2008, Philip Gleason, Senior Researcher for the Mathematica Policy Research, wrote a paper also validating that direct certification clearly expands access for children to the NSLP.
In addition to student access to the NSLP, the integrity of the NSLP has come under fire for excessively validating students who are not eligible for the program. As a result, a recent three-year study by the USDA FNS (Gleason, 2008) found that 77.5 percent of NSLP applicants were correctly certified. However, 15 percent were certified as eligible when they did not qualify, while another 7.5 percent were denied benefits when they actually were eligible to participate. While the amount of erroneous NSLP payments during the 2005-2006 school year was relatively small in terms of overall percentages for the program, these overpayments totaled more than $759 million, a very significant amount considering that rising costs are an issue (Ponza, 2007). However, more current research by Molly Dahl identifies the cost of ineligible participants as a problem that continues to plague the NSLP (2011). With an estimated overpayment of $1.5 billion to FSA in 2011, her research shows that ineligible participants undeniably added to the cost of the program.
David Bass asserts that the problem is not simply an innocent one, but involves a calculated effort by many to commit fraud (2010). He argues that “State governments dole out benefits according to free and reduced-price lunch percentages. Because of financial benefits, local school districts have a clear incentive to register as many students in the NSLP as possible.” While the NSLP has a verification process built into it, only up to 3 percent of applications can be verified for the accuracy of reported income. Bass found that some school districts who wanted to verify higher percentages of applications were threatened with legal action from the federal government. In fact, Bass identified one district alone that found 70 percent of the applications they verified were incorrect and resulted in reduced or eliminated benefits to the participant.
School lunches must meet the applicable recommendations of the Dietary Guidelines for Americans, which states that no more than 30 percent of an individual's calories come from fat, and less than 10 percent from saturated fat. Regulations also establish a standard for school lunches to provide one-third of the Recommended Dietary Allowances of protein, Vitamin A, Vitamin C, iron, calcium, and calories. School lunches must meet Federal nutrition requirements over the course of one week's worth of lunches served, but decisions about what specific foods to serve and how they are prepared are made by local school food authorities. The 2007 School Nutrition and Dietary Assessment III (SNDA III) study based on research by the U.S. Department of Agriculture during the 2004-2005 school year found that students in more than 90 percent of schools surveyed had the opportunity to select lunches that were consistent with dietary standards for fat and saturated fat.
School nutrition programs are increasingly using more whole grains, fruits and vegetables, lean protein and lowfat dairy in school lunches. Efforts such as the Local School Wellness Policies required by the 2004 Child Nutrition and WIC Reauthorization Act have involved parents, students, and the school community in efforts to promote healthy eating environments and increased physical activity throughout school campuses.
In 2009, the Institute of Medicine of the National Academies released School Meals: Building Blocks For Healthy Children which reviewed and provided recommendations to update the nutrition standard and the meal requirements for the National School Lunch Program and School Breakfast Program. School Meals also set standards for menu planning that focus on food groups, calories, saturated fat, and sodium and that incorporate Dietary Guidelines for Americans and the Dietary Reference Intakes.
Unhealthy meals and malnutrition
Unhealthy school lunches are one of the contributors to malnutrition in the form of excessive consumption of unhealthy foods. However, some measures are being taken to change that. Unhealthy adult eating patterns can be traced directly to unhealthy school lunches, as children learn many eating habits from social settings such as school. A 2010 study of 1003 Michigan junior high students found that students who ate school meals for lunch were significantly more likely to be obese than those who did not. Promoting healthy eating in schools may reduce as many as 25 percent of adolescent obesity cases. An example is the Berkeley Food System project which utilizes vegetable gardens to promote education for healthy eating. Janet Brown, who started the project, explained that students are more likely to eat healthy foods such as fruits and vegetables if they are better introduced to them.
In 2008 the Economic Research Service of the USDA issued a report entitled “The National School Lunch Program: Backgrounds, Trends, and Issues.” Authors Ralston, Newman, Clauson, Guthrie, and Buzby reaffirm one of the main goals of the NSLP as identified by Congress is to “Promote the health and well-being of the Nation’s children” (2008). However, according to their research, new challenges for meeting this goal have emerged with the increased scrutiny on USDA donated commodities high in fat such as meat, cheese, and milk as well as the emergence of “competitive foods.” The NSLP provides federal nutritional guidelines and participating schools receive USDA commodities in return. The authors of this research argue that providing USDA food subsidies high in fat contribute to childhood obesity. While NSLP participants have higher intakes of calcium and fiber—nutrients often under consumed by children—they also have higher fat intakes (Ralston, Newman, Clauson, Guthrie, and Buzby, 2008). Notwithstanding the higher fat intakes, study results comparing weight gain of NSLP participants with their nonparticipating counterparts are inconclusive. The authors of this research assert that another factor challenging school administrators is the emergence of “competitive foods.” Competitive foods are not included in the NSLP reimbursement plan and therefore, not required to meet USDA nutrient standards. Competitive foods may include: food purchased off campus; a la carte items purchased on campus; food purchased in vending machines; food purchased for school fundraising; food available at school parties; treats given to students by teachers.Generally speaking, competitive foods are lower in key nutrients and higher in fat than the NSLP reimbursable meals. The availability of competitive foods in schools often undermines the nutritional goals and disrupts the effectiveness of the NSLP.
Applying nutritional standards
The research by Ralston, Newman, Clauson, Guthrie, and Buzby recommends that nutritional standards be applied to all food served or sold in schools. In addition, they note that the Government Accountability Office (GAO) recommended in 2005 that the USDA’s authority to regulate “foods of minimal nutritional value” be extended to a wider class of foods (2008). Along with the assessment of the nutritional value of a NSLP meal, the economic situation of a child should also be considered with respect to nutritional benefits from the program. A recent article published in The Journal of Econometrics tries to do just that. While maintaining the nutritional advantages of the new Healthy-Hunger Free Kids Act, the authors of “The impact of the National School Lunch Program on child health: A nonparametric bounds analysis” (Craig Gundersen, Brent Kreider, John Pepper, 2011) assert that, “Children in households reporting the receipt of free or reduced-price school meals through the National School Lunch Program are more likely to have negative health outcomes than observationally similar nonparticipants”. They assert that specific cohorts are not receiving the nutritional benefits from the NSLP that many had hoped.
The authors hypothesize that the reason for their data, indicating poorer health in reduced-price lunch participation, is: First, children receiving free or reduced-price meals are likely to differ from nonparticipants in ways that are not observed in the data. Second, households of those cohorts most affected by reduced-price lunch may be misreporting participation in the program. The research methods the authors used were a laborious three-year study of over 5,000 participants per year. The article gives a full description of “food insecurity” as it relates to household food consumption.
Nutrition, food security, and obesity
Research data has shown that 36 percent of the children in reduced-price lunch programs are “food insecure” and 19 percent of those children are obese. The article suggests that while much research has been done to analyze the nutritional value of the NSLP program, little attention is paid to those “food insecure” households in regards to the impact of the NSLP. Based on the high correlation of obesity and reduced-price lunch participation, the authors suggest that given the momentum of the new guidelines for nutrition, the NSLP re-evaluate those at-risk students for more effective nutritional services.
Studies comparing NSLP participants and non-participants have thus far been inconclusive in determining if any weight gain occurs if one participates or not. In fact, one of the most rigorous studies actually showed “similar calorie intakes for participants and nonparticipants but higher fat and sodium intakes for participants.” It is ironic that a program, which began with the intention of reducing under-nourished school-aged children, has come full circle to the current objective of helping to reduce childhood obesity. The most obvious problem is that even if more nutritious foods are provided, there is no guarantee that the students will eat them. The NSLP does not take into account the great variance of the student population. Some children are smaller than others, and some are more athletic than others. Some of their metabolisms require more calories than is mandated by the NSLP, while others find an 850 calorie limit is adequate for their lifestyle.
In 2011, a bill was presented to Congress requiring public schools to post calorie and nutritional information on school menu boards. Bill sponsor, Rep. Joseph McNamara called for it to be implemented by January 2013.
There are two simple ways through which the nutrition and obesity problem in schools can be fixed. The first idea is to have children in schools only exposed to Fruits and Veggies as snacks. The Journal of Nutrition’s article “Restricting Snacks in U.S. Elementary Schools is Associated with Higher Frequency of Fruit and Vegetable Consumption,”  states that “Children in schools with restricted snack availability had significantly higher frequency of fruit and vegetable consumption than children in schools without restricted snack availability.” Suggesting that a restrictive snack policy should be part of a multi-faceted approach to improve children's diet quality in schools. The second idea is to Inform and Educate All school attendees about nutrition. The American Journal of Clinical Nutrition’s article “APPLE project: 2-y findings of a community-based obesity prevention program in primary school–age children” states: “A relatively simple approach, providing activity coordinators and basic nutrition education in schools, significantly reduces the rate of excessive weight gain in children.” 
Outcomes on food security and education
Studies have shown a positive correlation between school meal programs and increased food security. Among low-income children, the marginal food insecurity rate of those with access to the School Breakfast Program was lower than that of those children without access to the program. There is a lower probability of marginal household food insecurity among low-income children with access to the SBP. Studies have shown that the increase in food security does not have significant long-term health effects, but has a positive impact on education. These results may suggest that subsidized lunches induce children to attend school, and also free up food at home for other family members to consume. Researchers from the Georgetown University Public Policy Institute have found that “increasing NSLP exposure by ten percentage points results in an average increase in education of .365 years” for women, and for men this same increase in exposure “increases average education by nearly a year”. Participation in grades seven through twelve “has a stronger effect on educational attainment than participating in the earlier grades does, whereas there is some evidence suggesting that participation in earlier grades is more important for the health outcomes”. Today, the NSLP reaches a broad base of children from different socioeconomic backgrounds. To an extent, it is targeted towards children from lower socio-economics backgrounds, and it has a positive effect on their educational outcomes.
Issues surrounding school meal programs
The National School Lunch Program and School Breakfast Program, in light of their benefits to long-term educational outcomes, have been continuously criticized for what their aims are, how they impact student health, and whether or not they reach out to students who are food insecure. Until the 1970s, the NSLP reached a small percentage of American children and served few free lunches. Therefore, it does not reach out to all of those children in need. School meals have also been criticized for the ways in which the nation’s food and agricultural interests for control over school menus have exploited these welfare programs.
Despite criticisms about the nutritional flaws of these programs, others contend that they provide crucial public welfare support for nation’s youth. It is believed that they provide an opportunity for alleviating issues of food insecurity and thus improving the educational outcomes of the most impoverished children, in turn helping to alleviate issues of poverty and inequality that exist as a result of a lack of education. To fix the issues associated with school meal programs, it will require building a “political coalition that is committed to an agenda that links child nutrition to agriculture, food policy, and social welfare.” 
The NSLP faces the continuous challenge of encouraging eligible households to apply for participation while preventing loss of program benefits through errors in certification of eligible recipients. There are major concerns regarding the NSLP in the area of eligibility certification. In 2011 a government website reported that there was over $8.9 billion in payments or outlays to school foodservice providers, $1.5 billion of which were paid in behalf of ineligible recipients. That is a 16.3 percent improper payout rate. New policies that have come into effect are expected to reduce, but not totally eliminate, some of these improper payouts. Government estimates show a targeted improper payout rate of 14.7 percent by 2014 but their targeted rate for 2012 was 15.5 percent, which they failed to reach. Federal cuts in subsidies for full-price meals have gone up much more slowly than the rising costs of foods and labor. School districts vary greatly in many areas including size, income of population served, labor costs, etc. These variances make the generalizations that are associated with a national program like the NSLP have an unfavorable effect on many school districts.
Results of programs
An article in the Wilson Quarterly of Spring 2011 tells of the effectiveness of the NSLP in the Maplewood-Richmond Heights School District located in suburban St. Louis. Linda Henke, superintendent of the school district, said “ . . . I was struck by the positive vibe around the revamped program. A teacher said he’d lost seven pounds by eating in the high school cafeteria every school day for the previous three months. A senior girl who had embraced the changes from the beginning observed that even she was surprised when football players started eating salads. The elementary school’s cook of 14 years told me her job is now harder, but it’s rewarding” (Hinman, 2011). This suggests that a healthy school lunch is now more popular because of Linda Henke’s vision to change to the NSLP. The article continues to say “It takes a tough-minded school leader to assert that nutrient-rich food is the right choice for kids – and that it’s an appropriate use of government dollars. Kids will complain initially but will come around. And a number of collateral benefits follow when students eat well. Anecdotal reports from schools with healthful and flavorful food indicate that teachers have started eating with students, attendance rates are higher, and fewer students fall asleep in class or commit vandalism and violence at school.” Ultimately the NSLP in suburban St. Louis is gaining more and more participation in the school lunch program.
A different article addresses the positive effect of the NSLP within the L.A. Unified School District (Schilling, 2012). Deputy Director David Binkle said the following, "From what I see and what I hear now that students are getting used to [the new menus] and they have tasted it, they like it. Any time you make change, and major change like this, that's an evolution that we have to go through. There's going to be people now saying the meal is too healthy for the kids and it's stuff they don't know. The reality of this is the rest of the country is about to see what we've gone through [when they adopt the new meal pattern regulations]. We did this on purpose so that we could really get out ahead of this and start to work through it and adjust. I think the rest of the country is going to see a lot of the same impact [that we've seen this year].” Additionally, Binkle validates participation in the program by saying, “What I keep hearing from the principals is that as we keep tweaking and teaching and encouraging the kids, more and more kids are participating” (2012). Overall, research literature overwhelmingly shows that there is an upward trend in NSLP participation.
With this upward trend, Hinman describes another challenge: “Since 2004, the USDA has administered the Healthier U.S. School Challenge, awarding distinction but no money, to schools that voluntarily improve the healthfulness of their meals. By last fall, only a paltry 841 of the 101,000 schools in the NSLP (less than one percent) had received awards. That leaves a lot of schools that are still promoting Tater Tot Day and reheating frozen pizzas.” It could take years before meaningful changes take place nationwide for the NSLP. Only one percent of schools have received awards. Although there are challenges moving forward, the research suggests positive participation rates in the NSLP now and in coming years. Ultimately the value of the literature suggests there will be an increase in students, teachers, and others embracing the NSLP in the future.
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- "McNamara bill on nutritional information gets House approval Read more: Warwick Beacon - McNamara bill on nutritional information gets House approval".