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Kinsey Et Al. School Closures During Covid.Pdf AJPH COVID-19 School Closures During COVID-19: Opportunities for Innovation in Meal Service In 2019, the National School Lunch Eliza W. Kinsey, PhD, Amelie A. Hecht, PhD, Caroline Glagola Dunn, PhD, Ronli Levi, MPH, Margaret A. Program and School Breakfast Read, MA, Courtney Smith, MPP, Pamela Niesen, Hilary K. Seligman, MD, MAS, and Erin R. Hager, PhD Program served approximately 15 million breakfasts and 30 million lunches daily at low or no cost to s COVID-19 disrupts reg- social condition wherein, at of marginal food insecurity and students. Aular access to food assistance times, 1 or more household the likelihood of skipping Access to these meals has resources and creates growing members are unable to acquire breakfast, especially among been disrupted as a result of economic uncertainty, low- adequate food because of in- low-income children.8 A rise in long-term school closures re- income families are being sufficient money or other re- food insecurity during the sum- lated to the COVID-19 pan- disproportionally burdened. sources.3 In 2018, nearly 1 in 7 mer months, particularly among demic, potentially decreasing Long-term school closures mean children (about 11 million) lived NSLP participants, further sug- both student nutrient intake that millions of students no in a food-insecure household, gests that school meals reduce and household food security. longer have access to the free or with higher rates in Black and food insecurity.9 In addition, By the week of March 23, reduced-price meals they rely on Hispanic households.4 Food in- school meals provide critical 2020, all states had mandated to meet their nutritional needs. security rates are rising as millions economic support to low- statewideschoolclosuresas As social distancing recommen- of people in the United States income families. The NSLP a result of the pandemic, and dations continue, with no clear experience job losses related to lifts 1.3 million people out of 10 thenumberofweeklymissed end date in many places, children COVID-19. Recent estimates poverty. fi breakfasts and lunches served and their families must be pro- show that as many as 33% of School meals signi cantly households with children, in- contribute to students’ daily di- at school reached a peak of tected from the unintended nu- cluding 40% of Black and His- etary intake and are generally approximately 169.6 million; tritional consequences of school closures. panic households, were food more nutritious than meals this weekly estimate remained 5 School meals are a vital insecure in April 2020. from other sources, including steady through the final week 11 component of the US social Federal school meal programs home-packed meals. This is of April. safety net. The US Department reduce household food insecu- especially true for children in We highlight strategies that 6 of Agriculture (USDA) National rity. Among households with at low-income households who rely states and school districts are School Lunch Program (NSLP) is least 1 child receiving free or on school meals as a substantial usingtoreplacethesemissed the largest antihunger program reduced-price meals, NSLP par- source of nutrition. The Healthy, meals, including a case study in the nation other than the Sup- ticipation is associated with a 14% Hunger-Free Kids Act, passed by fi from Maryland and the US plemental Nutrition Assistance reduction in food insuf ciency Congress in 2010, increased ac- Department of Agriculture Program.1 In 2019, the NSLP (an alternate measure of food cess to nutritious meals and had waivers that, in many cases, and the School Breakfast Pro- hardship closest to the most se- a positive impact on diet quality 7 have introduced flexibility to gram (SBP) served approximately vere form of food insecurity). by updating school meal nutri- 12 allow for innovation. Also, we 15 million breakfasts and 30 Access to the SBP reduces the risk tion standards. Its effects are explore lessons learned from million lunches daily at low or no 1 the pandemic with the goal of cost to students. More than three ABOUT THE AUTHORS quarters of all students partici- Eliza W. Kinsey is with the Department of Epidemiology, Mailman School of Public Health, informing and strengthening Columbia University, New York, NY. Amelie A. Hecht is with the Department of Health future school nutrition policies pating in school meal programs Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. for out-of-school time, such as qualify for free or reduced-price Caroline Glagola Dunn is with the Department of Health Policy and Management, Harvard meals because they live in a T. H. Chan School of Public Health, Boston, MA. Ronli Levi and Hilary K. Seligman are over the summer. (Am J Public with the Department of Medicine and the Center for Vulnerable Populations, University of household with an income below Health. 2020;110:1635–1643. California, San Francisco. Margaret A. Read, Courtney Smith, and Pamela Niesen are with 185% of the federal poverty Share Our Strength, No Kid Hungry Campaign, Washington, DC. Erin R. Hager is with the https://doi.org/10.2105/AJPH. Department of Pediatrics and the Department of Epidemiology and Public Health, University of level.2 2020.305875) Maryland School of Medicine, Baltimore. Loss of access to school meals Correspondence should be sent to Eliza W. Kinsey, PhD, 722 W 168th St, New York, NY puts millions of households at 10032 (e-mail: [email protected]). Reprints can be ordered at http://www.ajph.org by clicking the “Reprints” link. increased risk of food insecurity, a This article was accepted July 9, 2020. household-level economic and https://doi.org/10.2105/AJPH.2020.305875 November 2020, Vol 110, No. 11 AJPH Kinsey et al. Peer Reviewed Analytic Essay 1635 AJPH COVID-19 especially pronounced among innovative meal replacement ef- price meals but rather paid full of school closures, and by the low-income students who re- forts being implemented by states price for school meals.2 These following week that number had ceive free and reduced-price and school districts, including a children may, however, come ballooned to nearly 125 million lunches.13 specific case study from Mary- from households with incomes meals. By the week of March 23, Prior to COVID-19, concern land. In addition, we explore that are just above the eligibility with all states having mandated about school meal access during lessons learned from this crisis cutoff or that fluctuate seasonally. statewide school closures, the school closures (e.g., hurricanes, with the goal of informing and Previous estimates suggest that number of weekly missed meals snowstorms, civil unrest, summer strengthening future nutrition as many as 15% of marginally reached its peak. Cumulatively, – break) was mounting.14 16 In a policies with respect to out-of- food-secure students and 10% of we estimate that among students previous policy brief, we pro- school time, including summer food-insecure students do not who receive free and reduced- jected the impact of school clo- meals and unexpected school qualify for free or reduced-price price meals, more than 1.15 bil- sures resulting from short-term closures. meals on the basis of household lion meals were not served in emergencies on the number of income, and thus they may rely school as a result of school clo- “missed meals” (meals that would on full-priced school meals for sures during the 9-week period have been served if schools were nutritious, low-cost meals.21 between March 9 and May 1. open) among children in Phila- Furthermore, with widespread Figure 1 maps total missed 14 delphia, Pennsylvania. These NATIONAL MISSED unemployment resulting from meals per state and the percentage estimates showed that even 3 days MEAL ESTIMATES COVID-19, it is likely that many (in gray) of enrolled students per of school closures could result in In an effort to slow the spread more children qualify for free and state participating in free and more than 400 000 missed meals of COVID-19, school districts reduced-price school meals now reduced-price meals. These esti- among school-aged children. across the United States started to than before the start of the pan- mates account only for break- Missed meals may have a sig- close in March 2020, with the demic. With the weekly value of fast and lunch; an estimated 1.5 nificant impact on children’s earliest closures in the Seattle area meals children receive at school million after-school snacks and health, nutrition, and food se- the week of March 2. By March conservatively estimated at $30 1.3 million after-school suppers curity. Such consequences are 16, at least 907 US school districts (not accounting for time spent are also served to children daily likely to be magnified among had closed and 8 states (in addi- purchasing and preparing foods), through federal child nutrition low-income, Black, and Hispanic tion to Washington, DC) had lost access to school meals could programs (Food Research and children who are already at closed statewide. Other states pose a significant added financial Action Center October 2018 greater risk for poor physical and followed rapidly, with Texas and burden for families.22 estimates). mental health and worse aca- Idaho being among the last states In the early weeks of March, demic performance than their to close schools (on March 23 and when closures were occurring at 20 higher-income and White 24, respectively). the district (rather than the state) 17 counterparts. Black and His- Here we estimate the number level, the number
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