Improving U.S. school lunches: An opportunity for public health
===============================================================

* Carmen Nevarez

Over the years, I have gotten to know the man who drives the airport shuttle bus from the long-term parking lot to the terminals. One day, he asked me what kind of work I was in. After I answered public health, he brightened up and immediately asked me “if you work in public health, can you please tell me why the schools feed such terrible food to the children? The food is so bad that my wife goes every day to take my children a healthy lunch.”

That’s it in a nutshell. The problem of school lunches, and in particular, what we feed children as part of our American culture, is a hot issue right now and an important moment for the public health community to have a real impact on preventing disease for generations to come. The National Child Nutrition Program is up for reauthorization this year and therein lies a huge public health opportunity.

![Figure1](http://www.thenationshealth.org/http://www.thenationshealth.org/content/nathealth/40/2/3.1/F1.medium.gif)

[Figure1](http://www.thenationshealth.org/content/40/2/3.1/F1)

The National School Lunch Program — funded by the National Child Nutrition Program — operates in more than 100,000 schools and serves more than 30 million students per day. Considering that a student can eat thousands of school lunches and breakfasts from kindergarten through 12th-grade, there is no question that the school lunch program provides an excellent policy opportunity to improve youth health.

The National School Lunch Program feeds hungry kids. According to the U.S. Department of Agriculture, 17 million households, or 14.6 percent, were food insecure and had difficulty putting enough food on the table at times during 2008. This is an increase from 13 million households, or 11.1 percent, in 2007. For many children in these households, school lunch is their most important meal of the day. Good nutrition is necessary for concentration and achievement.

But federally supported school lunch programs are not without their warts. Many schools have lost their ability to prepare their own food and are purchasing pre-made meals that are simply heated on-site. The federal reimbursement rate per lunch ranges between $2 and $3, and in many markets, does not cover the cost of balanced meals that include fresh fruits and vegetables. Reimbursements need to be higher.

As I was writing this column, First Lady Michelle Obama and Surgeon General Regina Benjamin, MD, joined forces to launch a campaign to prevent childhood obesity. President Barack Obama has announced that his budget contains an additional $1 billion a year for 10 years to be divided between school food programs and the Special Supplemental Nutrition Program for Women, Infants and Children — better known as WIC. This is only a start.

APHA is crystal clear about why prevention is important to health reform and has provided critical leadership in defining specifics that are required for a health reform agenda that really prevents disease and moves to achieve health equity. We need to move with similar vigor to assure that our children can learn in an environment that supports their health, provides the nutrition they need and can enable them to live at least as long as their parents.



*   Copyright The Nation’s Health, American Public Health Association