INSTITUTT FOR SAMFUNNSØKONOMI DEPARTMENT OF ECONOMICS SAM 15 2016 ISSN: 0804-6824 October 2016 Discussion paper Childhood Nutrition and Labor Market Outcomes: Evidence from a School Breakfast Program BY Aline Bütikofer, Eirin Mølland AND Kjell G. Salvanes This series consists of papers with limited circulation, intended to stimulate discussion Childhood Nutrition and Labor Market Outcomes: Evidence from a School Breakfast Program∗ Aline B¨utikofer Eirin Mølland Kjell G. Salvanes August 18, 2016 Abstract While a growing literature documents the short-term effects of public programs provid- ing children with nutritious food, there is scarce evidence of the long-term effects of such programs. This paper studies the long-term consequences of access to nutritious food using the rollout of a free school breakfast program in Norwegian cities. This program provided children with nutritious food and replaced a hot school meal at the end of the day with similar caloric value but less micronutrients. Our results indicate that access to a nutritious school breakfast increases education by 0.1 years and earnings by 2{4 percent. 1 Introduction A large body of evidence shows that early-life exposure to disease and malnutrition has long- term consequences for adult health, education, and labor market outcomes (for an overview, see Barker, 1992; Almond and Currie, 2011). A nutritious diet may therefore enhance cognitive development and, ultimately, academic success and post school productivity. While there is support from experimental interventions that highly nutritious food supplements affect edu- cational outcomes (see Maluccio et al., 2009), there is scarce evidence of long-term effects of ∗The authors thank the Norwegian Research Council for financial support (grant number 240321). We grate- fully acknowledge comments from Na'ama Shenhav, Gordon Dahl, David Figlio, and seminar participants at University of California Davis, the Norwegian School of Economics, the Essen Health Conference, the SDU Work- shop on Applied Microeconomics, the Nordic Summer Institute in Labor Economics, and the Annual Conference of the European Society for Population Economics. Arn-Tore Haugsdal provided excellent research assistance. Aline B¨utikofer, Department of Economics, Norwegian School of Economics, Helleveien 30, 5045 Bergen, Norway. Email: [email protected]. This paper was written while Eirin Mølland was employed at the Norwegian School of Economics and she has since moved to Agderforskning: Eirin Mølland, Agderforskning, Gimlemoen 19, 4630 Kristiansand S, Norway. Email: [email protected]. Kjell G. Salvanes, Department of Economics, Norwegian School of Economics, Helleveien 30, 5045 Bergen, Norway. Email: [email protected]. 1 policy-induced improvements in early-life nutrition. An exception is Hoynes, Schanzenbach, and Almond (2016) who present evidence that access to the food stamp program during early childhood improved adult health. In addition, there is a growing literature documenting short- term effects of public programs providing children with nutritious food. Examples include Belot and James (2011) and Figlio and Winicki (2005) who show that providing children with school meals with better nutritional or caloric content improves test scores. This evidence demonstrates that policy-induced changes in the provision of appropriate nutrition, such as free nutritious breakfast, might have the potential to mitigate the negative effects of poverty or other adverse early-life circumstances in the long-run. In this paper, we exploit a staggered implementation of the so-called \Oslo breakfast"|a nutritious breakfast including vitamin-rich foods such as whole grain bread, milk, cod liver oil, and unprocessed fruit and vegetables|in 26 Norwegian cities in the 1920s and 1930s to determine the long-term impacts of improved nutrition on educational attainment and labor market performance. In addition, the rollout of the policy in combination with the abrupt ending because of food rationing during World War II allows us to analyze both at what age breakfast provision in schools was most influential and whether the length of exposure to the policy matters. The Oslo breakfast had a long-lasting impact on Norwegian eating behav- ior. Whereas the traditional breakfast in the 1920s consisted of coffee, plain bread and cold porridge, the Oslo breakfast taught children healthy eating habits and even today Norwegian breakfast preferences reflect the content of the Oslo breakfast (see Schiøtz, 1926; Evang and Galtung Hansen, 1937). For these reasons, Norway provides an ideal laboratory for this type of analysis. Our analysis is based on historical data documenting the rollout of the Oslo breakfast, which are linked to Norwegian register data. This allows us to evaluate the impact of access to school breakfast 30 or more years after the breakfast program was implemented. Our estimation strategy is a differences-in-differences approach, comparing cohorts that finished school before the program was implemented in their city of residence (control group) to cohorts that were in school after the breakfast was offered in their city of residence (treatment group). We find that access to free school breakfasts increased the completed years of schooling by 0.1 years and earnings by 2{4 percent. Moreover, we find that men who had access to free school breakfasts are more likely to have skilled and semi-skilled occupations and less likely to have low-skilled occupations. The estimated effects are not significantly different for men and women or for individuals attending school in cities with high or low poverty levels. In addition, we find empirical evidence that early exposure matters most, however the effects at different ages are not significantly different from each other. Moreover, there is no significant difference between the effect of being exposed for only one or two years or during all seven primary school years. The remainder of the paper is structured as follows. Section 2 provides an overview of 2 the recent literature on school breakfast programs and nutritional interventions. Section 3 reviews the history of the Norwegian school breakfast program. Section 4 outlines the empirical strategy. We discuss the data and provide descriptive statistics in Section 5. We discuss our results and analyze whether there were heterogeneous effects by individual characteristics in Section 6. Section 7 provides different sensitivity tests. Section 8 explores potential channels behind the results and links our results to the previous literature. Section 9 provides a brief conclusion. 2 Literature Review As noted above, the Oslo breakfast program intended to provide children with nutritious food. An increasing number of studies focus on the effects of a nutritious diet on educational outcomes. For example, Glewwe, Jacoby, and King (2001) and Alderman, Behrman, Lavy, and Menon (2001) document the correlations between malnutrition and educational outcomes. Maluccio et al. (2009) examine the causal effect of a randomized early childhood nutritional intervention in rural Guatemala during 1969{1977 on educational outcomes. They find that the intervention increased the number of years of education for women by 1.2 and reading com- prehension and nonverbal cognitive ability test results for both women and men by one-quarter of the standard deviation of the test results. Belot and James (2011) investigate the effect of nutritional changes in school meals in Britain. In particular, they exploit the \Feed Me Better" campaign conducted in 2004{2005 by the British chef Jamie Oliver, which aimed to improve the nutritional standards of school meals in Britain. They find that healthier food improves test scores in English and science significantly. Furthermore, Figlio and Winicki (2005) show that if schools increase the calorie content of school lunches on test days, there is a significant improvement in scores on examinations that take place after lunch. Hence, nutritious food|as provided by the Oslo breakfast program|may have positive impacts on educational outcomes. One can think of several ways by which a nutritious school breakfast may affect educational attainment. First, participation in a school breakfast program may enhance the daily nutri- ent intake and improve students' academic performance and psychosocial functioning directly (Kleinman, Hall, and Green, 2002). Moreover, a free breakfast at school may affect the incen- tives to go to school and thereby increase attendance rates among students (Murphy, Pagano, and Nachmani, 1998). Furthermore, free breakfasts at school may decrease household expendi- ture on food among the poor (Long, 1991). As Dahl and Lochner (2012) find a causal impact of income on poor children's math and reading achievement, breakfast provision at school may affect educational outcomes indirectly through family income. Recent research studying the causal impacts of free school breakfasts focuses primarily on two different school breakfast programs in the United States. The first series of papers analyze 3 the introduction of universal free breakfasts in certain school districts, while the second series of papers focuses on the so-called Breakfast in the Classroom program that provides free school breakfasts to all children during class time in the classroom. The universal free breakfast allows children to participate in the school breakfast program (commonly served in the school's cafeteria) at no charge regardless of parental income. Thus, children that are not eligible for