| Literature DB >> 35634217 |
Kaela Plank1, Sridharshi Hewawitharana1, Evan Talmage1, Suzanne Rauzon1, Gail Woodward-Lopez1.
Abstract
The National School Lunch and School Breakfast programs are a nutrition safety net for millions of children in the United States, particularly children in households with lower incomes. During Spring 2020 COVID-19 school closures, schools served school meals through the Summer Meal Programs. Despite efforts to increase access, meal participation declined and food insecurity increased. We aimed to (1) describe meal program features as communicated in low-income California school districts' on-line resources (2) examine associations between meal program features and change in meal participation between May 2019 and May 2020 and (3) evaluate equity by describing meal site coverage and placement relative to the size of priority populations. Data from district online resources and meal reimbursement claims were collected for a stratified, random sample of 190 CalFresh Healthy Living-eligible districts. Linear regression was used to examine associations between district meal program features and percent change in meal participation. Meal site location and density were examined in relation to the size of priority populations. In May 2020, compared to May 2019, total meals served decreased by a median 46%. There were gaps in the information provided in district online resources and low variation in measured district meal program features. These features explained little of the variation in the percent change in meal participation. A greater proportion of meal sites were placed in areas with larger priority populations, yet the density of sites was not proportionate to the priority populations' sizes. Findings show actionable areas for improving meal access during school closures.Entities:
Keywords: COVID-19; National School Lunch Program; food access; school closures; school meals; school nutrition
Year: 2022 PMID: 35634217 PMCID: PMC9136133 DOI: 10.1016/j.pmedr.2022.101794
Source DB: PubMed Journal: Prev Med Rep ISSN: 2211-3355
Fig. 1Diagram of sampling strategy and composition of final sample. Footnotes: 1 List generated from California Department of Education enrollment data. Accessed April 2020. 2 Districts met one of the following CalFresh Healthy Living eligibility criteria: (1) 50% or more of the district’s student population were eligible for Free and Reduced Priced Meals (FRPM) or (2) 50% or more of the schools in the district were eligible for FRPM or (3) the district was eligible for the Community Eligibility Provision (CEP). Caption: Shows a consort diagram of how CalFresh Healthy Living eligible public schools were identified and steps taken to create final sample of 190 school districts.
District characteristics and meal program features (n = 175 districts).
| Rural | 17 (9.71%) |
| Suburban/Town | 105 (60.00%) |
| Urban | 53 (30.29%) |
| Full grade span (PreK/K-12) | 118 (67.43%) |
| Partial grade span starting in elementary school | 41 (23.43%) |
| Partial grade span starting in middle/high school | 16 (9.14%) |
| American Indian/Alaskan Native | 0.35 (0.20, 0.64) |
| Asian | 2.16 (0.94, 5.69) |
| Black | 2.55 (0.97, 7.57) |
| Filipino | 0.92 (0.39, 2.04) |
| Hispanic | 64.88 (46.03, 78.82) |
| Multiracial | 2.15 (0.94, 3.90) |
| Pacific Islander | 0.27 (0.12, 0.61) |
| White | 15.43 (5.97, 29.21) |
| Not reported | 0.26 (0.02, 0.92) |
| 13695.00 | |
| 70.13 (59.49, 81.99) | |
| 0.19 (0.00, 0.71) | |
| 72.24 (30.73, 199.09) | |
| 101164.50 | |
| 0.35 (0.27, 0.42) | |
| 0.11 (0.08, 0.15) | |
| Onsite pickup, not further specified, only | 82 (47.13%) |
| Onsite drive-thru only | 23 (13.22%) |
| Onsite drive-thru and walk up | 33 (18.97%) |
| Onsite pickup and delivery | 31 (17.82%) |
| Other | 5 (2.87%) |
| Only times between 9am and 4 pm | 150 (87.72%) |
| Times between 9am and 4 pm, along with times before 9am or after 4 pm | 17 (9.94%) |
| Other | 4 (2.34%) |
| Children - not required to be students | 129 (74.14%) |
| Students | 31 (17.82%) |
| Other | 9 (5.17%) |
| Information not specified | 5 (2.87%) |
| 1–2 days/week for all offered distribution methods | 52 (29.89%) |
| 3–4 days/week for all offered distribution methods | 24 (13.79%) |
| 5 days/week for all offered distribution methods | 75 (43.10%) |
| Other | 23 (13.22%) |
| Yes | 16 (9.20%) |
| No | 158 (90.80%) |
| Yes | 51 (30.91%) |
| No | 28 (16.97%) |
| Information not provided on website | 86 (52.12%) |
| Breakfast (n = 120) | 5.00 (5.00, 5.00) |
| Lunch (n = 125) | 5.00 (5.00, 5.00) |
| Total meals (n = 127) | 10.00 (10.00, 10.00) |
| −18.25 (−51.33, 17.37) | |
| −58.73 (−71.95, −41.63) | |
| −46.21 (−63.08, −29.86) | |
District urbanicity was defined using the 2019 National Center for Education Statistics (NCES) district boundary data classifications (city, suburban, town and rural). In this study, we refer to ‘city’ as ‘urban’.
22 sampled districts were excluded from this analysis due to either missing meal site location data in district online resources (n = 21) or having all sites outside district catchment areas (n = 1).
Children defined as less than 18 years old.
< 185%FPL defined as households with incomes below 185% Federal Poverty Level.
Districts which only specified total number of meals offered per week (not distinguishing between breakfast and lunch meals) were excluded from breakfast and lunch analyses but included in total meals analysis. Districts that did not specify meal type or number of meals offered per week were also excluded.
Total meals defined as district specified serving breakfast, lunch, dinner, supper, snack, or other meal type.
Associations between district characteristics, meal program features1, or meal site coverage and percent change in meals served when comparing May 2019 to May 2020.
| Percent change in breakfast meals served | Percent change in lunch meals served | Percent change in total meals served | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| n | Beta (95% CI) | p-value | R-squared | n | Beta (95%CI) | p-value | R-squared | n | Beta (95%CI) | P-value | R-squared | |
| 0.05 | 0.07 | 0.05 | ||||||||||
| Rural | 16 | 17.74 | 0.37 | 16 | 19.67 | 0.06 | 16 | 21.19 | 0.09 | |||
| Suburban/Town | 104 | 6.67 | 0.53 | 105 | −0.60 | 0.90 | 105 | 0.64 | 0.91 | |||
| Urban | 51 | Ref. | – | 51 | Ref. | – | 51 | Ref. | – | |||
| Majority White | 21 | −17.22 | 0.28 | 21 | −3.26 | 0.67 | 21 | −4.12 | 0.67 | |||
| Other racial distribution | 28 | 19.53 | 0.18 | 28 | 1.44 | 0.79 | 28 | 7.22 | 0.30 | |||
| Majority Hispanic | 122 | Ref. | – | 123 | Ref. | – | 123 | Ref. | – | |||
| 171 | −0.07 | 0.02 | 172 | −0.01 | 0.64 | 172 | −0.03 | 0.16 | ||||
| 171 | −0.45 | 0.29 | 172 | −0.05 | 0.76 | 172 | −0.05 | 0.80 | ||||
| Partial grade span starting in elementary school | 39 | 7.72 | 0.54 | 40 | −1.18 | 0.81 | 40 | 0.42 | 0.95 | |||
| Partial grade span starting in middle/high school | 14 | −1.77 | 0.85 | 14 | 13.41 | 0.04 | 14 | 11.64 | 0.09 | |||
| Full grade span (PreK/K-12) | 118 | Ref. | – | 118 | Ref. | – | 118 | Ref. | – | |||
| 0.08 | 0.10 | 0.09 | ||||||||||
| Onsite drive thru only | 22 | –23.25 | 0.09 | 22 | −3.76 | 0.59 | 22 | −8.65 | 0.27 | |||
| Onsite drive thru and walk up | 33 | −12.70 | 0.22 | 33 | −4.89 | 0.28 | 33 | −6.40 | 0.28 | |||
| Onsite pickup (drive thru, walk up, and/or not further specified) and delivery | 30 | 7.92 | 0.53 | 30 | 6.95 | 0.19 | 30 | 7.77 | 0.25 | |||
| Other | 5 | −17.63 | 0.59 | 5 | −5.90 | 0.69 | 5 | −9.95 | 0.56 | |||
| Onsite pickup (not further specified) only | 80 | Ref. | – | 81 | Ref. | – | 81 | Ref. | – | |||
| Yes | 67 | −18.33 | 0.04 | 0.07 | 67 | −6.74 | 0.09 | 0.09 | 67 | −9.56 | 0.05 | 0.08 |
| No | 103 | Ref. | – | 104 | Ref. | – | 104 | Ref. | – | |||
| Yes | 49 | −29.32 | 0.06 | 0.08 | 49 | −12.35 | 0.08 | 0.11 | 49 | −16.92 | 0.05 | 0.10 |
| Information not provided on website | 85 | −13.93 | 0.35 | 85 | −5.45 | 0.44 | 85 | −7.55 | 0.39 | |||
| No | 28 | Ref. | – | 28 | Ref. | – | 28 | Ref. | – | |||
| Times between 9am and 4 pm, along with times either before 9am or after 4 pm | 17 | 3.11 | 0.82 | 0.05 | 17 | −1.48 | 0.82 | 0.07 | 17 | −0.40 | 0.96 | 0.05 |
| Other | 3 | 3.58 | 0.92 | 3 | 9.63 | 0.64 | 3 | 26.39 | 0.73 | |||
| Only times between 9am and 4 pm | 147 | Ref. | – | 148 | Ref. | – | 148 | Ref. | – | |||
| Yes | 16 | 6.15 | 0.72 | 0.05 | 16 | 1.17 | 0.87 | 0.07 | 16 | 2.67 | 0.77 | 0.06 |
| No | 154 | Ref. | – | 155 | Ref. | – | 155 | Ref. | – | |||
| Students | 31 | 25.91 | 0.09 | 0.08 | 31 | 10.30 | 0.07 | 0.11 | 31 | 14.06 | 0.05 | 0.09 |
| Other | 8 | 7.90 | 0.74 | 9 | 9.35 | 0.32 | 9 | 5.56 | 0.60 | |||
| Information not specified | 5 | 14.72 | 0.52 | 5 | 16.39 | 0.24 | 5 | 17.84 | 0.28 | |||
| Children – not required to be students | 126 | Ref. | – | 126 | Ref. | – | 126 | Ref. | – | |||
| More restrictive | 34 | 25.19 | 0.07 | 0.08 | 34 | 10.73 | 0.05 | 0.11 | 34 | 14.16 | 0.04 | 0.09 |
| More liberal | 6 | 10.87 | 0.73 | 7 | 7.60 | 0.42 | 7 | 4.42 | 0.71 | |||
| Not further specified | 5 | 14.93 | 0.51 | 5 | 16.40 | 0.24 | 5 | 17.92 | 0.27 | |||
| Meets waiver (any child under 18 is eligible for meals) | 125 | Ref. | – | 125 | Ref. | – | 125 | Ref. | – | |||
| 164 | 1.07 | 0.21 | 0.06 | 165 | 0.30 | 0.36 | 0.08 | 165 | 0.54 | 0.22 | 0.07 | |
| 157 | 0.03 | 0.63 | 0.06 | 157 | 0.07 | 0.20 | 0.07 | 157 | 0.06 | 0.18 | 0.05 | |
| Children in district catchment area | 157 | 9.84 | 0.01 | 0.09 | 157 | 6.02 | 0.01 | 0.14 | 157 | 7.83 | 0.01 | 0.13 |
| People in households with incomes at or below 185% Federal Poverty Limit (FPL) in district catchment area | 157 | 9.77 | 0.47 | 0.07 | 157 | 4.03 | 0.56 | 0.07 | 157 | 5.70 | 0.53 | 0.06 |
| Children belonging to households below 185% FPL | 157 | 0.55 | 0.75 | 0.06 | 157 | 0.30 | 0.75 | 0.06 | 157 | 0.42 | 0.74 | 0.05 |
| Students eligible for Free and Reduced Priced Meals in district in 2019–2020 school year | 164 | 4.83 | 0.40 | 0.06 | 165 | 1.63 | 0.44 | 0.06 | 165 | 2.08 | 0.46 | 0.05 |
| Students enrolled in district in 2019–2020 school year | 164 | 6.52 | 0.42 | 0.06 | 165 | 2.34 | 0.43 | 0.06 | 165 | 2.91 | 0.47 | 0.05 |
| 171 | 27.32 | 0.07 | 0.07 | 172 | 2,26 | 0.75 | 0.07 | 172 | 7.24 | 0.40 | 0.06 | |
Meal program characteristics as reported in district online resources in May 2020.
All models adjusted for district urbanicity, racial/ethnic distribution, student enrollment, percent of students eligible for free or reduced-price meals, and grade span served unless indicated elsewhere.
Children defined as less than 18 years old.
Adjusted for district urbanicity, racial/ethnic distribution, student enrollment, and grade span served.
Adjusted for district urbanicity, racial/ethnic distribution, percent of students eligible for free or reduced-price meals, and grade span.
Community Eligibility Provision (CEP).
Meal site coverage measures among sampled school districts (n = 168)1.
| Number of meal sites within district catchment area (DCA) | Fall 2019 (Prior to school closures) | May 2020 (Post school closures) | ||
|---|---|---|---|---|
| n | ||||
| 159 | 19 | 159 | 6.0 | |
| 159 | 23.2 | 159 | 8.9 | |
| Children | 159 | 1.0 | 159 | 0.3 |
| Children belonging to households below 185% Federal Poverty Limit | 159 | 2.3 | 159 | 0.7 |
| Students eligible for Free and Reduced Priced Meals | 168 | 2.3 | 168 | 0.8 |
22 sampled districts were excluded from this analysis due to missing meal site location data in district online resources (n = 21) or having all sites outside district catchment areas (n = 1).
Districts with meal sites located outside the district catchment area were excluded from analysis (n = 9)
Data derived from the American Community Survey 2014–2018 5 year-estimate data: table B17024.
Children defined as <18 years old.
Data derived from 2019 to 2020 California Department of Education Free or Reduced-Price Meal (Student Poverty) Dataset.(California Department of Education, 2020).
Fig. 2Proportion of total district catchment area meal sites located in priority population areas by quartile (median, 25th, and 75th percentiles)1 All block groups included were at least partially covered by the district catchment area (DCA). All meal sites located in a block group that was fully or partially covered by a DCA were included. All meal sites located within a United States Census Bureau 2013 block group that was not at least partially covered by the district’s DCA boundaries were excluded (n = 11 meal sites), 2 Q1/first quartile, Q2/second quartile, Q3/third quartile, Q4/fourth quartile. Quartiles determined by ranking DCA block groups into quartiles ranging from first to fourth (Q1: smallest priority population to Q4: greatest priority population) and calculating the proportion of district meal sites located within each quartile. Q1 - defined as blocks groups with smallest population < 185%FPL, children<18 years old (children), or proportion Black, Indigenous, People of Color (BIPOC). Q4- defined as greatest priority population < 185%FPL, children, or BIPOC. 3 Block group population < 185%FPL, population of children<18 years old, and percent BIPOC derived using American Community Survey 2014–2018 5 year-estimate data. Caption: Shows the proportion of total meal sites located in District Catchment Area Block Groups that have been ranked into quartiles based on size of priority populations (<185%FPL, children<18 years old, percent BIPOC).
Fig. 3COVID-19 meal sites in a Northern California, suburban school district catchment area block groups characterized by quartiles of percent Black, Indigenous, and People of Color (BIPOC) population (n = 19 meal sites) Footnotes:1 BIPOC defined as percent of non-white population in block group based on ACS 2019 5-year estimates Table B03002 2 Block group percent BIPOC quartile cutoffs are as follows: Q1/first quartile – <40%; Q2/second quartile– between 40% and 52%; Q3/third quartile– between 52% and 72%; Q4/fourth quartile - greater than 72%3 District quartile cutoffs were based on 25th, 50th and 75th percentiles Block group percent BIPOC population was derived using American Community Survey 2014–2018 5 year-estimate data. 4 Total meal site count within each quartile category for percent BIPOC are as follows: Q1 – 4 sites, Q2 = 4 sites, Q3 – 6 sites Q4 – 5 sites. Caption: Provides an example of meal site locations within a district catchment area overlayed onto district catchment area block groups that have been ranked in quartiles by percent BIPOC.
Fig. 4Number of district catchment area meal sites per 1000 people with incomes<185% of Federal Poverty Level (<185%FPL) (median, 25th, and 75th percentiles) in block groups ranked by population < 185%FPL (n = 168)1 All block groups included were at least partially covered by district catchment area (DCA). All meal sites located in a block group that was fully or partially covered by DCA were included. All meal sites located within a US Census 2010 block group that was not at least partially covered by the district’s DCA boundaries were excluded (n = 11 meal sites). 2 Q1/first quartile, Q2/second quartile. Q3/third quartile, Q4/fourth quartile. Q1 defined as blocks groups with smallest population < 185%FPL. Q4 defined as greatest population < 185%FPL. 3 Block group population < 185%FPL derived using American Community Survey 2014–2018 5 year-estimate data. Caption: Shows the number of meal sites per 1000 people < 185%FPL in District Catchment Area Block Groups that have been ranked into quartiles by size of population < 185%FPL.