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Effects of food insecurity and universal school meals on children’s dietary intake


This dissertation focuses on dietary intake patterns of children from low-income communities, and specifically the relationships of diet to food insecurity and school nutrition programs, respectively. The dissertation is divided into two parts. Part I discusses issues surrounding the measurement of food insecurity among children and provides support for the use of self-reported food insecurity measures, and for investigating effects that may differ by gender. Paper 1 explores the relationship between self-reported food insecurity and diet separately for boys and girls, using a dataset of 3,582 fourth and fifth grade students from San Diego area elementary schools. It concludes that among food-insecure children, gender may interact with food insecurity to influence eating behavior, with girls more prone than boys to alter their eating. Findings support a rationale to reduce child food insecurity and to address eating patterns that may place girls at greater risk for energy imbalances during critical periods of development.

Part II focuses on the role of school nutrition programs in reducing food insecurity and improving dietary intake among participants. It introduces the Community Eligibility Provision (CEP), discusses relevant legislation and political trends, and provides a conceptual framework for hypothesized pathways through which CEP may influence student outcomes. Paper 2 examines associations between CEP and school meal participation among students who are eligible for free or reduced-price meals (FRPM), near the eligibility cutoff but possibly eligible, or above the cutoff and ineligible, using a difference-in-difference framework and a cross-sectional national sample of 2,305 students from grades K-8. It finds that CEP is associated with higher participation in school breakfast and lunch, particularly among those who were above the cutoff and would not have had access to free or reduced-price meals through a 3-tiered application and certification model.

Paper 3 investigates associations among school meal participation, CEP, and dietary intake patterns using a larger sample of 4,124 students from grades K-8. It uses a regression framework to identify whether CEP is an effect modifier of relationships between school meal participation and dietary measures. It concludes that CEP is modestly associated with improved dietary intakes and may help reduce nutritional disparities for students in high-poverty schools. Finally, a special supplemental section explores the extent to which endogeneity in meal participation at CEP schools is a potential threat to these conclusions, using an instrumental variable approach to help control for omitted variables. There was no evidence to support the hypothesis that the dietary effects identified in Paper 3 resulted from shifting the source of student meals from home to school for the subset of students whose participation was induced by CEP. The dissertation concludes with a discussion of alternative explanations for the relationships found.

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