(P19-046-23) Evaluating the Health and Economic Impact of the National School Meal Program in the U.S.

Objectives: The national school meal program is one of the healthiest food sources for US children, but its current health and economic benefits have not been quantified, nor the potential incremental impact of extension to healthy school meals for all. We investigated the national health and economic impacts of the current and universal school meal program.

Methods: A comparative risk assessment model was used to estimate the potential health gains and health-related economic costs associated with the current national school meal programs, as compared to the counterfactual scenario of no program. The model incorporated inputs on differences in children’s habitual dietary intake due to school meal consumption; how dietary changes during childhood are sustained to adulthood; long-term health effects on cardiovascular disease (CVD), diabetes, cancer, cause-specific mortality, and disability-adjusted life-years (DALYs); and healthcare costs from established sources. Using the same framework, the model further estimated the potential incremental health and economic gains associated with a national program of healthy school meals for all, as compared to the current program.

Results: US children's consumption from non-school meal sources, school meals contained higher amounts of fruits, whole grains, and dairy, and lower processed meats, sugar-sweetened beverages, and sodium. Assuming 35% of childhood dietary habits being sustained to adulthood, the current national school meal program would be associated with 10,000 (95%UI 4,430-15,800) fewer annual deaths in CVD, diabetes, and cancer in adulthood. Each year, these health gains would be associated with 223,000 (79,800-358,000) DALYs saved $19.7 (9.58-29.4) billion in direct medical costs and productivity. Expanding the current program to healthy school meals for all would be associated with an additional 3,080 (-5,500 to 9,170) annual deaths averted, 117,000 (-122,000 to 324,000) DALYS saved, and $6.15 (-8.63 to 17.3) billion cost savings.

Conclusions: The current national school meal program is associated with meaningfully lower deaths, disability, and health-related economic costs later in life. A universal free school meal program would gain additional health and economic benefits.

Funding Sources: The National Institutes of Health and the National Heart, Lung, and Blood Institute