Pay For Success

“To be well read, children must first be well fed.”


By Megan Carolan

The connection between adequate nutrition and being ready to face the world is an intuitive one for most people. From candy bar commercials asserting that “you’re not you” when you’re hungry, to the coining of the word “hangry” for that bad mood we fall into when we’re hungry, most adults will laughingly admit they are bit a tough to work with when they need a bite to eat. But for millions of children, the nutritional needs that keep them from being ready to learn and grow are no laughing matter.

Photo used under Creative Commons license. Credit: Flickr user North Charleston.

Photo used under Creative Commons license. Credit: Flickr user North Charleston.

According to a recent paper from the Center for American Progress (CAP), 15.8 million American children, or one in six American families, lived in “food insecure households,” which generally means they do not know where their next meal is coming from. Food security and economic stability are inherently linked, and the risk factors for children compound each other – infants and toddlers in food insecure households are two-thirds more likely than their food secure peers to be at risk for developmental delays, which have serious repercussions in terms of their long-term academic and social development. These dire statistics need not be where the story ends, though: the paper asserts that “[c]hildren who receive nutrition assistance before age 5 have better health outcomes as adults and are more likely to graduate high school.”

Hunger and food insecurity are issues from coast-to-coast, in rural, urban, and suburban areas. The organization Feeding America provides a staggering map on food insecurity rates and unmet need nationwide. An interactive version utilizing county-level data is available here

Food Insecurity Rates, from Feeding America

Image from Feeding America’s Map the Meal Gap 2015 report: http://www.feedingamerica.org/hunger-in-america/our-research/map-the-meal-gap/2013/map-the-meal-gap-2013-exec-summ.pdf

 

A new report from FirstFocus on federal spending on children notes that while mandatory spending on food assistance programs has increased in real dollars, discretionary spending has decreased in the last few years. These trends come at a time when food insecurity has become so visible a presence in children’s lives that Sesame Street introduced a Muppet facing food insecurity as well as parents’ toolkit.

Nutrition assistance can take many forms, including government-provided benefits such as the Women, Infants, and Children (WIC) food program and Supplemental Nutrition Assistant Program (SNAP), which helps families purchase certain foods. However, these programs often come with sharp restrictions on eligibility and purchases, time limits, and a social stigma. A new wave of research promotes the integration of nutritional programs in early childhood education programs to reach more children in a positive, proactive way.

A recent paper from the Sackler Institute for Nutrition Science at the New York Academy of Sciences focused on the potential of integrating nutrition and early childhood development programs to best serve children and families.

  1. Integrate nutrition and child development interventions for young children and their families, wherever possible.
  2. Focus on learning and nutrition in early childhood by promoting high-quality family care.
  3. Adapt interventions to address the local capacities and constraints of families and communities.
  4. Identify the best practices and appropriate indicators in an integrated delivery
    of interventions through focused research and program evaluation.
  5. Mobilize the endorsements of leaders across intergovernmental and government agencies, nongovernmental organizations, academia, and others in civil society to bring effective interventions to scale and sustain them.

The Sackler paper highlights broad parameters for thinking about the integration of nutrition and childhood programs. The previously mentioned CAP examines how one specific program, the federal Child and Adult Care Food Program (CACFP), can improve early childhood education programs specifically. CACFP, administered through the U.S. Department of Agriculture, provides states with grants to subsidize the cost of snacks and meals in programs; two-thirds of meals provided through CACFP funds are served in public and private child care centers and Head Start programs. CACFP undoubtedly plays an important role in the nutrition of children in early childhood settings, particularly through its nutritional standards. However, CAP provides several recommendations for the upcoming reauthorization of CACFP to decrease program burdens in using the funding, which could expand the reach of the program dollars and improve child outcomes. This includes, among others:

  • Increasing the reimbursement rate to meet the Institute of Medicine’s nutritional recommendations. The IOM estimates an additional 56 cents per 2-to-4-year old per day would meet these recommendations.
  • Reduce the CACFP area eligibility test. The area test currently provides as easy means of entry into the CACFP and Summer Food Service Program based on the percentage of an area’s residents living at the federal poverty level. CAP recommends lowering this to 40 percent of an area’s residents meeting FPL, which is essential to make sure that high-poverty but low population-density rural areas can access area eligibility.
  • Allow three meals a day. Current regulations only allow emergency shelters to claim reimbursement for three meals per day, but this is not in line with the current child care needs of parents. As parents work longer hours and “double shifts,” children are served in care settings longer. These children may already be receiving three meals per day, but anything beyond two meals and a snack is being paid out of provider pockets, and potentially passed on to parents.
  • Reduce CACFP paperwork. Early care and education providers commonly “blend and braid” funding streams, but with each stream comes different requirements, fine print, and paperwork. Simplifying CACFP paperwork not only encourages increased provider participation, but leaves program administrators with more time to focus on meaningful program improvements rather than just compliance.

Improving nutritional supports for young children has a range of benefits. As the National Institute for Early Education Research noted in a policy brief, focusing on health development now can pay dividends in the future: “Because health habits are formed at an early age, early education programs should be required to provide health, nutrition, and exercise education.” This goal is summed up most succinctly by the motto of the New York City Coalition Against Hunger: “To be well read, children must first be well fed.”