260731 Impact of a State Policy Incentivizing Elimination of Unhealthy Competitive Foods on National School Lunch Program Participation

Tuesday, October 30, 2012 : 12:30 PM - 12:50 PM

Michael Long, MPH , Department of Society, Human Development, and Health, Harvard School of Public Health, Boston, MA
Joerg Luedicke, MS , Rudd Center for Food Policy and Obesity, Yale University, New Haven, CT
Marice Dorsey, MS , Rudd Center for Food Policy and Obesity, Yale University, New Haven, CT
Kathryn E. Henderson, PhD , Rudd Center for Food Policy & Obesity, Yale University, New Haven, CT
Introduction: Concern that improving the nutritional quality of competitive foods could lead to reduced school district revenue has been cited as a barrier to improving school food environments. However, strengthening competitive food standards could increase revenue from healthier meal programs by removing unhealthy, yet attractive alternatives. This study analyzed the impact of a Connecticut policy incentivizing district-level elimination of unhealthy competitive foods on participation in the National School Lunch Program. Methods: School lunch participation data from public schools (n=904) in Connecticut school districts (n=154) from 2004-2010 were analyzed using multilevel Poisson regression. The effect of district-level participation in Connecticut's Healthy Food Certification (HFC), which requires monitored implementation of strong nutritional standards for all competitive foods, on school-level lunch counts was assessed by school type (elementary, middle, high school) and meal program (free, reduced-price, paid) controlling for year and sociodemographics. Results: Participation in HFC was associated with decreased free lunch participation (-2.5%, p<0.05) in elementary schools. In middle schools, HFC was associated with significant increases in free (0.3%; p<0.05), reduced-price (3.2%, p<0.01), and paid (9.4%, p<0.001) lunch participation. In high school, HFC was associated with significant increases in free (7.0%; p<0.001), reduced-price (11.6%, p<0.001), and paid (19.9%, p<0.001) lunch participation. Discussion: Overall, a state policy eliminating unhealthy competitive foods was associated with increased free, reduced-price, and paid school lunch participation, which has positive implications for the financial health of school food services. Strengthening nutritional standards for competitive foods would support ongoing USDA efforts to implement rigorous national school meal nutritional standards.

Learning Areas:
Conduct evaluation related to programs, research, and other areas of practice
Public health or related laws, regulations, standards, or guidelines
Public health or related public policy
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
1. Evaluate the impact of state policies improving competitive food nutrition standards on school meal participation; and 2. Discuss implications of recently revised National School Lunch and School Breakfast Program nutrition standards on student meal program participation rates

Keywords: Nutrition, School Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the lead author on previous research evaluating the impact of nutrition standards on school meal participation and have worked with local school districts to improve school meal participation and nutritional standards. I have experience evaluating school and neighborhood food environments and analyzing state and federal nutrition policy changes.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.