The Impact of School Food Policy on Childhood Obesity

描述(申请人提供)：儿童肥胖是美国最紧迫的公共卫生问题之一。我们目前几乎没有在人口层面有效减少肥胖的政策工具。然而，学校是影响这种流行病的主要场所。学校食品计划，包括学校午餐和早餐计划，每天为3000多万名儿童提供服务，可以说是政策制定者可以用来改善美国年轻人饮食的最重要的杠杆之一。虽然联邦政府为这些项目提供资金援助和严格的饮食指导，但学校和学区在价格、菜单、质量、品种、时间、背景、交付方式、支付手段和可用替代方案方面采取的政策对这些项目的成功起着至关重要的作用。这些因素共同影响了学生对学校膳食计划的参与、健康食品的消费，并最终导致儿童肥胖。纽约市(NYC)公立学校提供了一个独特的实验室，用于研究学校食品政策对项目参与度、肥胖和学业成就的影响。纽约市有110万学生和1600多所学校，在不同学校的食物政策和项目上差异很大，社区环境和背景也有相当大的多样性，学生群体也非常多样化。长期以来，纽约市也一直处于与青少年肥胖作斗争的前沿。例如，2005年，城市学校开始收集超过20万名学生的身高、体重、身体质量指数(BMI)和与健康相关的健康指标的年度体质图数据。2008年，该项目扩大到远远超过75万名学生。在这个项目中，我们将把在纽约市收集的体质图数据与学生个人和学校特点联系起来，以更好地了解学校通过其食物政策对学生健康的影响。具体地说，我们试图使用计量经济学方法来调查学校和地区的食品政策对(A)体重指数、(B)膳食计划参与度和(C)学业成绩的作用。第一个结果是我们通过Fitnessgram向我们提供的个人学生，而膳食计划的参与情况是按收入群体和学校报告的。个别学生的学习成绩--可与体质图相联系--可供我们从1年级到12年级的所有学生使用。有关地区政策、学校做法和社区环境的数据将通过对全市学校的调查、对地区人员的采访和几个学校案例研究来收集。该项目将通过对BMI的直接观察，提供关于广泛的学校食物政策对儿童肥胖症的影响的大量数据。随着其他学区以及州和联邦政策制定者为影响儿童肥胖的政策方法而苦苦挣扎，这些结果将表明哪些政策是成功的，值得继续推行。 公共卫生相关性：儿童肥胖是我们面临的最紧迫的公共卫生问题之一，但目前几乎没有以政策为导向的解决方案来解决这一问题。该项目将确定学校层面的政策对身体质量指数(BMI)和其他一些关键结果衡量标准的影响。学校政策是影响肥胖的最有前途的方法之一。

DESCRIPTION (provided by applicant): Obesity among children is one of the most pressing public health problems in the United States. We currently have few policy tools to effectively reduce obesity at the population level. However, schools are a prime place to influence this epidemic. The School Food program, including both the school lunch and breakfast programs, serves more than 30 million children every day, making it arguably one of the most important levers available to policymakers for improving the diet of America9s youth. Although the federal government provides funding assistance and strict dietary guidelines to these programs, their success is shaped critically by policies adopted by schools and school districts regarding price, menu, quality, variety, timing, context, method of delivery, means of payment, and available alternatives. Together these affect student participation in school meal programs, consumption of healthy foods, and, ultimately, childhood obesity. The New York City (NYC) public schools offer a unique laboratory for studying the effects of school food policies on program participation, obesity, and academic achievement. With its 1.1 million students and more than 1,600 schools, NYC exhibits wide variation in food policies and programs across schools, considerable diversity in neighborhood settings and contexts, and a remarkably diverse student body. NYC has also long been at the cutting edge in its efforts to combat youth obesity. For example, in 2005, the city schools began collecting annual FITNESSGRAM data on height, weight, body mass index (BMI), and indicators of health-related fitness for more than 200,000 students. In 2008, the program expanded to well over 750,000 students. In this project, we will link FITNESSGRAM data collected in NYC to individual student and school characteristics to better understand the influence schools have on student health through their food policies. Specifically, we seek to use econometric methods to investigate the role school and district food policies have on (a) BMI, (b) meal program participation, and (c) academic outcomes. The first outcome is available to us for individual students through the FITNESSGRAM, while meal program participation is reported by income group and school. Academic outcomes for individual students--linkable to the FITNESSGRAM--are available to us for the universe of students grades 1-12. Data on district policies, school practices, and neighborhood context will be collected via a city-wide survey of schools, interviews with district personnel, and several school case studies. This project will provide considerable data on the impact of a wide range of school food policies on childhood obesity, through direct observation of BMI. As other school districts and state and federal policymakers struggle with policy approaches to influence childhood obesity, these results will indicate which policies are successful and worth pursuing. PUBLIC HEALTH RELEVANCE: Childhood obesity is one of the most pressing public health problems we face, yet few policy-oriented solutions to address the problem currently exist. This project will determine the influence of school-level policies, one of the most promising approaches to influence obesity, on Body Mass Index (BMI) and a number of other critical outcomes measures.