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Enhancing Food Security and Physical Activity for Māori, Pacific and Low-income Peoples2.5 Provision of free or subsidised food in schoolsMat WaltonSummaryMeals or fruit provided free at schools could potentially improve food securityoutcomes for children, with possible flow-on effects household food budgets.Compared to several other developed countries, New Zealand has a limited history ofschool food programmes, such as free or subsidised breakfast, lunch, milk, or fruit.There is limited evidence of the impact of school food programmes on child orhousehold food security, and limited infrastructure to support such programmes inNew Zealand schools. Some international research evidence exists but rarelyinvestigates impacts of school food programmes on food security. The limitedliterature suggests that food provided at school has more of an impact on the diets ofchildren from lower socio-economic households than higher socio-economichouseholds. Interviews with New Zealand policy participants indicates limited supportfor development of school food programmes in New Zealand, with exception of thecurrent Fruit in Schools scheme. However, this lack of support may reflect the lack offamiliarity with food provision schemes in New Zealand.Recommendations are that:• Fruit in Schools is maintained, with the possibility of expansion followingcompletion of current scheme evaluations• a robust trial and evaluation of school breakfasts is conducted, as this appearsto have promise for child health, education and food security outcomes.Problem definitionThe ENHANCE workshop on money available in households, identified a possibleintervention of direct provision of food to school students, to offset impacts of foodinsecurity in households. This received support at the workshop with a range ofinterventions identified; from continuing Fruit in Schools, to provision of breakfasts andlunches at school.The 2002 National Children’s Nutrition Survey identified 22 percent of households withchildren as food insecure 1 . Survey results also showed that 92 percent of the leastsocio-economically deprived quintile of households reported being able to afford to eatproperly, compared with 59.5 percent of households in the most socio-economicallydeprived quintile. Variation in food security was also shown by ethnic group with 64.3percent of Māori households reporting being always able to afford to eat properly,compared with 46.6 percent of Pacific households and 86.1 percent of New ZealandEuropean and other ethnic category households. Secondary analysis of this surveyby Parnell et al, 2 indicates that children from food insecure households had lowerlevels of nutrient intake of lactose and calcium (from dairy products); and β-caroteneand vitamin A (from fruits and vegetables). Children’s nutrition has not only beenlinked to short and long term health outcomes 3-5 , but also academic achievement. 6-8There is little information available to consider whether children regularly have enoughfood during the school day. A 1995 survey commissioned by the Public HealthCommission (reported in Gerritsen 9 ), estimated that 3.5 percent of New Zealandstudents were regularly hungry at school.51
Enhancing Food Security and Physical Activity for Māori, Pacific and Low-income PeoplesAn intervention logic exists for provision of food in schools offsetting food insecurity orpoor nutrition practices in the home. 10 If food security is a problem within ahousehold, then direct provision of food to children at school may a) reduce thenegative impacts of food insecurity by providing some essential macro and micronutrients;b) reduce the amount of money required to spend on food within ahousehold, thereby reducing some of the budgetary pressures; and c) ensureinterventions to enhance food security are reaching children, rather than providingadditional resources to a household and leaving distribution of those resources to thehousehold decision-makers. Nelson et al 11 report in the UK that school mealspositively contribute to the nutritional intakes of the students who, due to deprivedsocio-economic circumstances, are eligible for free school meals.To be successful in alleviating food insecurity for children, and improving nutritionaloutcomes, several aspects must be addressed. The food provided must be of astandard that benefits the students. 12 If food in the home is reduced by more than thechild receives at school, then it will likely disadvantage the child, 13 or if foodpurchasing patterns at home change then other members of the household may bedisadvantaged. Several authors also point to the possibility of stigma for childrenreceiving free food if it labels them as poorer than their peers, which in the UK hasbeen associated with low take- up of free school meals. 14MethodsThe information included in this chapter is the result of a literature scan, andinterviews with policymakers as part of an ongoing research project, outside ofENHANCE, looking at policy options to support primary schools to promote healthychildhood nutrition. 15 The literature scan was undertaken between November 2008and January 2009. The Scopus bibliographical database was searched for paperssince 1990 with combinations of the following keywords: school food, schoolsupplementation, food security, school lunches, school breakfast, fruit in schools,breakfast clubs. A Google search was also undertaken. Titles of articles werescanned for relevance and 18 peer reviewed articles and grey literature reports havebeen used for this review.Fifteen interviews were conducted with policymakers as part of the National HeartFoundation funded research project Promoting healthy childhood nutrition throughprimary schools 15 . This study aims to identify policy options for supporting primaryschools in promoting childhood nutrition, and involved both case studies with primaryschools and a series of interviews with policymakers. The interviews were conductedbetween October 2008 and February 2009. Interview participants included politicians,individuals from national non-governmental organisations, district health boards,government departments and agencies. Participants were asked for personalopinions, rather than organisational positions. As part of a semi-structured interview,participants were asked about school food programmes in general, and in relation tofood security. These aspects of the interviews have been analysed for this chapter. Athematic analysis was conducted using a full interview transcript.Literature Scan: International ContextThe use of school food programmes internationallyThe School Food Trust in England, established in 2004 to improve the quality of foodsupplied and consumed in schools, has published a report comparing the provision of52
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