School Participation in the Community Eligibility Provision and Blood Pressure Outcomes

• In Event: Universal Free School Meals Policies: Impact on Child Health and Well-being

Abstract

Introduction: The Community Eligibility Provision is a federal universal free school meals policy available to public and charter schools with a large proportion of low-income students. This policy increases participation in school meals which are children’s most nutritious food source. The purpose of this study was to assess whether school participation in the Community Eligibility Provision is associated with child blood pressure outcomes.

Methods: Medical records from patients ages 4-18 who received care from community health organizations in the OCHIN healthcare network between 2013-2019 were matched to schools based on address. We used a doubly robust difference-in-differences approach for staggered policy adoption to assess the association between school participation in the Community Eligibility Provision and proportion of patients with a high blood pressure measurement, a hypertensive measurement, and mean systolic and diastolic blood pressure.

Results: A total of 1,052 policy-eligible schools were matched to 155,778 unique patients. Patients were 48% Hispanic, 22% White, and 16% Black. Schools were located in 12 US states, with 64% in California or Oregon. School participation in the Community Eligibility Provision was associated with a 2.73 percentage point net reduction in proportion of patients with a high blood pressure measurement (95% CI: -4.76, -0.70, p=0.01), corresponding to an 11.10% net decrease from baseline. Participation was also negatively associated with proportion with a hypertensive measurement and mean diastolic blood pressure.

Conclusion: In schools matched to pediatric patients attending community health organizations, participation in the Community Eligibility Provision was associated with improved blood pressure outcomes. These findings add to mounting evidence that universal free school meals policies may benefit child health.

Author

• Anna Localio, University of Washington
  Presenting Author