School Meal Programs
Competitive Foods Are Widely Available and Generate Substantial Revenues for Schools Gao ID: GAO-05-563 August 8, 2005Recent increases in child obesity have sparked concerns about competitive foods--foods sold to students at school that are not part of federally reimbursable school meals. The nutritional value of these foods is largely unregulated, and students can often purchase these foods in addition to or instead of school meals. In our April 2004 report on competitive foods (GAO-04-673), we reported that several states had enacted competitive food policies that were more restrictive than federal regulations. However, these policies differed widely in the type and extent of restrictions. In addition, it was unclear how and to what extent states were monitoring compliance with these policies. GAO was also asked to provide a national picture of competitive foods in schools, as well as strategies that districts and schools themselves are taking to limit the availability of less nutritious competitive foods. This report provides information from two nationally representative surveys about the prevalence of competitive foods in schools, competitive foods restrictions and groups involved in their sale, and the amounts and uses of revenue generated from the sale of competitive foods. It also provides information about strategies schools have used to limit the availability of less nutritious competitive foods, based on visits to a total of six school districts in California, Connecticut, Mississippi, Missouri, and South Carolina.
Nearly 9 out of 10 schools sold competitive foods to students in school year 2003-2004, and the availability of competitive foods sold in middle schools and through a la carte lines has increased over the last 5 years. Schools often sold these foods in or near the cafeteria and during lunch, and the competitive foods available ranged from nutritious items such as fruit and milk to less nutritious items such as soda and candy. High and middle schools were more likely to sell competitive foods than elementary schools. Many different people made decisions about competitive food sales, but no one person commonly had responsibility for all sales in a school. In a majority of schools, district officials made competitive food policies, while school food authority directors and principals made decisions about specific sales. Other groups, such as student clubs and booster groups, also made competitive food decisions through their direct involvement in sales. Many schools, particularly high schools and middle schools, generated substantial revenues through competitive food sales in 2003-2004. Specifically, the nearly 30 percent of high schools generating the most revenue from these sales raised more than $125,000 per school. Food services, responsible for providing federal school meals, generally spent the revenue they generated through a la carte sales on food service operations. Other school groups often used revenues for student activities. The six school districts visited all recently took steps to substitute healthy items for less nutritious competitive foods. In each district, committed individuals took actions to initiate and lead change while also involving those affected. However, districts faced several barriers to change, including opposition due to concerns about revenue losses. In the districts visited, the effects of changes on revenues were often unclear because of limited data.
GAO-05-563, School Meal Programs: Competitive Foods Are Widely Available and Generate Substantial Revenues for Schools
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Report to Congressional Requesters:
United States Government Accountability Office:
GAO:
August 2005:
School Meal Programs:
Competitive Foods Are Widely Available and Generate Substantial
Revenues for Schools:
GAO-05-563:
GAO Highlights:
Highlights of GAO-05-563, a report to Congressional Requesters:
Why GAO Did This Study:
Recent increases in child obesity have sparked concerns about
competitive foods”foods sold to students at school that are not part of
federally reimbursable school meals. The nutritional value of these
foods is largely unregulated, and students can often purchase these
foods in addition to or instead of school meals. In our April 2004
report on competitive foods (GAO-04-673), we reported that several
states had enacted competitive food policies that were more restrictive
than federal regulations. However, these policies differed widely in
the type and extent of restrictions. In addition, it was unclear how
and to what extent states were monitoring compliance with these
policies. GAO was also asked to provide a national picture of
competitive foods in schools, as well as strategies that districts and
schools themselves are taking to limit the availability of less
nutritious competitive foods. This report provides information from
two nationally representative surveys about the prevalence of
competitive foods in schools, competitive foods restrictions and groups
involved in their sale, and the amounts and uses of revenue generated
from the sale of competitive foods. It also provides information about
strategies schools have used to limit the availability of less
nutritious competitive foods, based on visits to a total of six school
districts in California, Connecticut, Mississippi, Missouri, and South
Carolina.
What GAO Found:
Nearly 9 out of 10 schools sold competitive foods to students in school
year 2003-2004, and the availability of competitive foods sold in
middle schools and through a la carte lines has increased over the last
5 years. Schools often sold these foods in or near the cafeteria and
during lunch, and the competitive foods available ranged from
nutritious items such as fruit and milk to less nutritious items such
as soda and candy. High and middle schools were more likely to sell
competitive foods than elementary schools.
Many different people made decisions about competitive food sales, but
no one person commonly had responsibility for all sales in a school. In
a majority of schools, district officials made competitive food
policies, while school food authority directors and principals made
decisions about specific sales. Other groups, such as student clubs and
booster groups, also made competitive food decisions through their
direct involvement in sales.
Many schools, particularly high schools and middle schools, generated
substantial revenues through competitive food sales in 2003-2004.
Specifically, the nearly 30 percent of high schools generating the most
revenue from these sales raised more than $125,000 per school. Food
services, responsible for providing federal school meals, generally
spent the revenue they generated through a la carte sales on food
service operations. Other school groups often used revenues for student
activities.
The six school districts visited all recently took steps to substitute
healthy items for less nutritious competitive foods. In each district,
committed individuals took actions to initiate and lead change while
also involving those affected. However, districts faced several
barriers to change, including opposition due to concerns about revenue
losses. In the districts visited, the effects of changes on revenues
were often unclear because of limited data.
A Majority of Schools Sell Competitive Foods to Students through
Vending Machines:
[See PDF for image]
[End of figure]
What GAO Recommends:
www.gao.gov/cgi-bin/getrpt?GAO-05-563.
To view the full product, including the scope and methodology, click on
the link above. For more information, contact David Bellis at (415) 904-
2272 or bellisd@gao.gov.
[End of figure]
Contents:
Letter:
Results in Brief:
Background:
Almost All Schools Sold Competitive Foods in 2003-2004, and Middle
School Availability Has Increased over the Last 5 Years:
Many People Made Decisions about Competitive Food Sales, but No One
Person Commonly Had Responsibility over All Sales in a School:
Many Schools Raised a Substantial Amount of Revenue through Competitive
Food Sales and Used It to Support Food Service Operations and Student
Activities:
School Districts We Visited Substituted Healthy Competitive Foods for
Less Nutritious Items while Overcoming Obstacles to Change, and the
Effects on Revenue Were Unclear:
Concluding Observations:
Agency Comments:
Appendix I: Scope and Methodology:
Appendix II: GAO Contacts and Staff Acknowledgments:
Related GAO Products:
Tables:
Table 1: Select USDA Initiatives That Promote Child Nutrition and
Address the Competitive Food Environment:
Table 2: Estimated Percentage of Schools of Different Levels with Each
Competitive Food Venue in 2003-2004:
Table 3: Types of Competitive Foods Often or Always Available through
Each Venue in Schools, by Nutrition Category:
Table 4: Types of Competitive Foods Often or Always Available through
Any Venue in Schools, by School Level and Nutrition Category:
Table 5: District, School, and Community Groups Involved in the Process
of Changing Competitive Foods, by District Visited:
Table 6: Sampling Error Calculations for Questions in Which the Error
Exceeded 15 Percent:
Table 7: SFA Director Survey: Population and Sample by School Level:
Table 8: Principal Survey: Population and Sample by School Level:
Figures:
Figure 1: Categories and Sources of Competitive Foods in Schools:
Figure 2: States That Have Made Efforts to Restrict Competitive Foods
in Schools beyond USDA Regulations, as of April 2005:
Figure 3: Estimated Percentage of Schools Selling Competitive Foods
through Each Type of Venue in 2003-2004:
Figure 4: Estimated Percentage of Schools with a Written Competitive
Food Policy in 2003-2004 Enacted by Districts and Schools:
Figure 5: Number of Groups Directly Involved in Competitive Food Sales
in 2003-2004, Reported as an Estimated Percentage of Schools with Sales:
Figure 6: Groups Most Frequently Involved in Various Competitive Food
Venues Commonly Available in High Schools:
Figure 7: Estimated Percentage of Schools Generating Different Minimum
Amounts of Total Competitive Food Revenue in 2003-2004, by School Level:
Figure 8: Estimated Percentage of High Schools in Which Food Services
Generated Different Amounts of Revenue through a la Carte Sales in 2003-
2004:
Figure 9: Estimated Percentage of High Schools in Which Other School
Groups Generated Different Amounts of Revenue through Exclusive
Beverage Contracts in 2003-2004:
Figure 10: Estimated Percentage of Schools Using Competitive Food
Revenue, Excluding Food Service Revenue, for Various Purposes in 2003-
2004:
Abbreviations:
CCD: Common Core of Data:
CDC: Centers for Disease Control and Prevention:
FMNV: foods of minimal nutritional value:
FNS: Food and Nutrition Service:
HHS: Department of Health and Human Services:
NSLP: National School Lunch Program:
SFA: school food authority:
USDA: U.S. Department of Agriculture:
WIC: Special Supplemental Nutrition Program for Women, Infants, and
Children:
United States Government Accountability Office:
Washington, DC 20548:
August 8, 2005:
The Honorable Tom Harkin:
Ranking Member:
Committee on Agriculture, Nutrition, and Forestry:
United States Senate:
The Honorable Patrick J. Leahy:
Ranking Member:
Subcommittee on Research, Nutrition, and General Legislation:
Committee on Agriculture, Nutrition, and Forestry:
United States Senate:
The Honorable George Miller:
Ranking Member:
Committee on Education and the Workforce:
House of Representatives:
The Honorable Lynn Woolsey:
Ranking Member:
Subcommittee on Education Reform:
Committee on Education and the Workforce:
House of Representatives:
Increasing child obesity rates have recently focused attention on
children's health and nutrition and have raised concerns about foods
available in schools that compete nutritionally and financially with
federally regulated school meal programs. The number of children who
are overweight has more than doubled, and the number of adolescents who
are overweight has more than tripled since 1980, according to the U.S.
Centers for Disease Control and Prevention (CDC). These changes are
related, in part, to poor nutrition. According to U.S. Department of
Agriculture (USDA) data, more than 60 percent of young people eat too
much fat and less than 20 percent of the recommended daily servings of
fruits and vegetables. In addition to having negative health outcomes,
children with poor nutrition may have a harder time concentrating and
succeeding in school than other children. The Surgeon General's 2001
call to action identified schools as one of the key settings for public
health strategies to address child nutrition. Since children spend a
large portion of their day in school, providing them with healthful
food options throughout the school day can be an important step toward
good child nutrition.
The key school meal programs, the National School Lunch Program and the
School Breakfast Program, provide millions of children with nutritious
meals each school day. USDA's Food and Nutrition Service administers
these programs through local school food authorities (SFA) and
subsidizes the meals served in local schools as long as meals meet
certain nutritional guidelines. However, other foods not provided
through these programs, typically referred to as competitive foods, are
often available to children at school. Competitive food sales can take
place at a variety of venues in schools, including vending machines,
school stores, and a la carte lines in the cafeteria, through which the
SFA sells individually priced food and beverage items. Federal
restrictions concerned with the nutritional value of competitive foods
are limited. Specifically, federal regulations require that one segment
of competitive foods, defined as foods of minimal nutritional value,
not be sold to students during the breakfast and lunch periods in food
service areas.
In recent years, federal, state, and local governments have
increasingly focused on the role that competitive foods play in
children's diets. In our April 2004 report on competitive
foods,[Footnote 1] we reported that increasing numbers of state
legislatures have enacted and proposed legislation to restrict the
availability of competitive foods in schools. In addition, school
districts and schools themselves are taking steps to limit the
availability of competitive foods.
Because of your interest in further understanding issues related to
competitive foods in schools, you asked us to answer the following
questions: (1) How prevalent is the sale of competitive foods in
schools across the country, and has this prevalence changed over time?
(2) Who makes decisions about competitive food sales in schools? (3)
What amount of revenue is generated from the sale of competitive foods,
and for what purposes is the revenue used? (4) What strategies have
schools used to limit the availability of less nutritious competitive
foods, what obstacles did they face, and how have these strategies
affected sales revenue?
To answer your first three questions, we obtained information through
two Web surveys, one of school principals and the other of district-
level SFA directors. To conduct our surveys, we selected a stratified
random sample from the 80,000 public schools nationwide that
participate in the National School Lunch Program, which allowed us to
provide national estimates based on school level. The surveys were
administered between October 19, 2004, and February 11, 2005, with 65
percent of principals and 70 percent of SFA directors
responding.[Footnote 2] The surveys asked respondents about conditions
in their schools during specific school years, primarily 2003-2004, and
therefore, all years cited refer to school years. In addition, all
estimates presented from the surveys have margins of error of plus or
minus 15 percent or less, unless otherwise noted. To answer the fourth
question, we conducted site visits to 6 school districts in California
(Oakland), Connecticut (New Haven), Mississippi (McComb), Missouri
(Independence and Fort Osage), and South Carolina (Richland One),
including visits to a total of 10 schools. Our site visit localities
were selected from a group of approximately 100 districts and schools
recognized as making efforts to limit access to less nutritious
competitive foods. The 6 districts visited were also selected because
it appeared that they used different strategies to restrict competitive
foods, and when viewed as a group, they provided variation across
characteristics such as geographic location, district size, and
socioeconomic status. See appendix I for detailed information on our
surveys, sampling strategy, and site visits.
We conducted our work from May 2004 through July 2005 in accordance
with generally accepted government auditing standards.
Results in Brief:
Almost all schools sold competitive foods to students in school year
2003-2004, and over the last 5 years, the availability of competitive
foods has increased both in middle schools and in a la carte lines in
many schools. We estimate that nearly 9 out of 10 schools offered
competitive foods through one or more of the following venues in 2003-
2004: a la carte cafeteria lines, vending machines, and school stores.
While competitive foods were commonly sold in schools of all levels,
high schools and middle schools were more likely to sell these foods
than elementary schools. For example, vending machines were available
to students in almost all high schools and middle schools but in less
than half of elementary schools. Schools often sold competitive foods
in or near the cafeteria and during lunchtime, allowing students to
purchase these foods as their lunch or to supplement their lunch. The
competitive foods available ranged from nutritious items such as fruit
and milk to less nutritious items such as soda and candy, with
nutritious foods more frequently available through a la carte lines
than through vending machines or school stores. Between 1998-1999 and
2003-2004, the availability of competitive foods increased in middle
schools, and the volume and variety of a la carte foods sold increased
in many schools.
Many people, including district and school officials as well as members
of groups involved in sales at schools, made decisions about
competitive foods, but no one person commonly had responsibility for
all competitive food sales at the school level. The decisions ranged
from broad policies about the school nutrition environment to decisions
about which foods to sell at a specific venue or event. According to
school principals, an estimated 60 percent of schools had written
policies in place in school year 2003-2004 that restricted competitive
food sales to students, and in a majority of those schools the policies
were set at the district level, often by superintendents and school
boards. Regarding competitive food sales in schools, district SFA
directors were commonly involved in policy decisions related to a la
carte sales, while school principals often had final approval over
other competitive food sales, such as items sold through vending
machines. In addition to SFA directors and school principals, many
other groups such as teachers, student clubs, parent-teacher
associations, and booster groups were involved in selling competitive
foods in schools. These groups therefore often made decisions
concerning the types of food to sell to students and when to make such
food available. The number and variety of groups involved in these
sales typically increased as the school level increased.
Many schools raised a substantial amount of revenue through competitive
food sales in school year 2003-2004 and used this revenue to support
food service operations and student activities. High schools and middle
schools generally raised more revenue from competitive food sales than
elementary schools, reflecting the greater availability of competitive
foods in high and middle schools. According to our survey, the nearly
30 percent of high schools generating the most revenue from competitive
food sales raised more than $125,000 per school in 2003-2004. Across
all competitive food sales, food services generated more revenue than
other school groups, largely through a la carte sales, and they
generally used this revenue to support overall food service operations.
Other school groups commonly used their revenues to support student
activities, and the most frequent uses were student field trips, school
assemblies and programs, and athletic equipment and facilities.
The six school districts we visited all recently took steps to
substitute healthy competitive foods for less nutritious fare while
overcoming obstacles to these changes, and the effects of these changes
on sales revenues were often unclear because of limited data.
Specifically, many of the schools we visited increased the availability
of healthy items, including low-fat and low-sugar foods and beverages,
while they decreased the availability of less nutritious foods, such as
deep-fried French fries, candy, and soda. Further, although different
districts used different approaches and achieved different outcomes,
district and school officials identified several factors that
consistently facilitated change and several that hindered it. For
example, in all of the districts we visited, motivated individuals took
action to initiate and lead the process of change while obtaining
support from those affected in the district, schools, and community.
However, districts noted that they also faced many barriers to
implementing changes, such as opposition due to concerns about
potential revenue losses. Regarding the effect of changes on sales
revenues, none of the districts we visited had clear and reliable data
concerning the impact of competitive food changes on sales revenues.
From the limited data that were available, it appeared that changes had
varied effects on revenues across districts. Related to this, while a
few districts anticipated and planned for the effects of changes on
sales revenues, most had not. Consequently, many officials expressed
strong concerns about potential revenue losses because competitive food
revenues have provided them with a valued source of funding.
Background:
Competitive foods in schools are those foods sold to students during
the school day that are not part of the federal meal programs. These
federal programs, the National School Lunch Program (NSLP) and the
School Breakfast Program, subsidize public school meals and regulate
their nutritional content. Competitive foods, however, are only
minimally regulated at the federal level. They are typically sold a la
carte in the cafeteria, and through vending machines and school stores.
NSLP and School Breakfast Program:
The two largest federal school meal programs, the NSLP and the School
Breakfast Program, aim to address problems of hunger, food insecurity,
and poor nutrition by providing nutritious meals to children in
schools. The NSLP, established in 1946, provides nutritionally balanced
low-cost or free lunches in participating schools to more than 28
million children each school day, as well as reimbursement for snacks
served to those through age 18 in after-school educational and
enrichment programs. Similarly, the School Breakfast Program,
permanently established in 1975, provides free or reduced price
breakfasts to more than 8 million schoolchildren daily.[Footnote 3] At
the federal level, these programs are administered by USDA's Food and
Nutrition Service (FNS). As part of its strategic goal to improve the
nation's nutrition and health, the department has laid out plans to
increase access to, and utilization of, these school meal programs.
In fiscal year 2004, the federal government spent over $8 billion on
the NSLP and the School Breakfast Program. FNS provides reimbursement
in the form of cash subsidies and donated commodities based on the
number of lunches and breakfasts served that meet certain federal
requirements. The meals must adhere to the Dietary Guidelines for
Americans, which include limits on total fat and saturated fat and call
for diets moderate in sodium.[Footnote 4] The meals must also meet
standards for the recommended daily allowances of calories, as well as
nutrients such as protein, calcium, iron, and vitamins A and C.
Compliance with the standards is determined by averaging the
nutritional content of the meals offered over a school week. USDA
reimburses states, usually through the state departments of education,
which in turn reimburse local SFAs that operate the programs in one or
more schools.
SFAs function as the governing entities responsible for the local
administration of the federal meals programs. They are often, but not
always, responsible for school meals in an entire school district. SFAs
have some flexibility in operating their school meal programs. For
example, they may operate the programs themselves or contract with food
service management companies to perform functions such as planning and
preparing menus and selecting and buying food. All or some food
preparation may occur at on-site school kitchens or at central
kitchens, which then distribute food to satellite schools. In addition,
SFAs may select among different menu-planning approaches to comply with
the federal nutritional requirements.
SFAs receive a significant portion of their funding from federal
reimbursements that are based on the number of meals served to students
in their schools. In addition, SFAs also receive some funding from
states for program operations, and they may generate revenues by
selling competitive foods or by offering fee-based catering services.
Further, SFAs are permitted to combine costs and revenues for
reimbursable meals and nonreimbursable offerings, such as competitive
foods, as long as they maintain their nonprofit status. Therefore, if
revenues from reimbursable meals are less than the costs of producing
these meals, SFAs may use competitive food revenues to support the cost
of reimbursable meals. Likewise, if revenues from reimbursable meals
are more than the costs of producing these meals, SFAs may use these
funds to support competitive food sales.
Minimal Federal Restriction of Competitive Foods:
Competitive foods are those foods sold in schools, during the school
day, that are not part of the federal school meal programs--that is,
they compete with the nutritionally regulated school meal programs.
These foods can range from candy and soda to pizza and popcorn to
apples and milk and are typically available in cafeteria a la carte
lines, vending machines, and school stores.
Unlike federally subsidized school meals, the sale and nutritional
content of competitive foods are largely unregulated by the federal
government. Federal regulations prohibit the sale of certain
competitive foods, known as foods of minimal nutritional value
(FMNV),[Footnote 5] during meal periods in school cafeterias and other
food service areas. FMNV, as defined by USDA, include soda, chewing
gum, and hard candy, for example (see fig. 1). Other than this
restriction, federal regulations do not prohibit or limit the sale of
any other competitive foods anywhere on school grounds at any
time.[Footnote 6] In contrast, from 1980 to 1983, federal regulations
prohibited the sale of FMNV anywhere in the school from the beginning
of the school day until the last meal period. In National Soft Drink
Ass'n v. Block, 721 F. 2d 1348 (D.C. Cir. 1983), the Court of Appeals
for the District of Columbia overturned this regulation and construed a
1977 amendment to the Child Nutrition Act as allowing USDA to regulate
the sale of competitive foods only in food service areas during meal
periods. Following this decision, USDA amended its regulation to limit
the prohibition of these foods to food service areas during meal
periods.
Figure 1: Categories and Sources of Competitive Foods in Schools:
[See PDF for image]
[End of figure]
According to federal regulations, states and SFAs may impose further
restrictions on all foods sold at any time throughout their schools. As
of April 2005, 28 states have made efforts to restrict the sale of
competitive foods beyond USDA regulations (see fig. 2). Five state
policies do not restrict particular food items, but instead typically
address the competitive food environment more broadly. For example,
some of these states have created committees to develop policies
concerning competitive foods in schools or have encouraged schools to
find ways to improve their competitive food environments. The remaining
23 of these state policies place some form of specific restrictions on
competitive foods, though they differ in the type and extent of
restrictions.[Footnote 7] The majority of these policies restrict some,
but not all, competitive foods and restrict foods only at times
associated with school meal periods, rather than during the entire
school day.[Footnote 8]
Figure 2: States That Have Made Efforts to Restrict Competitive Foods
in Schools beyond USDA Regulations, as of April 2005:
[See PDF for image]
[End of figure]
Recent Federal Initiatives to Promote Better Nutrition in Schools:
The federal government has an interest in improving child nutrition in
order to promote the health and wellness of the nation's children.
Moreover, the current child obesity trend poses public health risks
because of the relationship of obesity to serious illnesses, such as
type 2 diabetes and hypertension. These illnesses can result in
substantial long-term costs to society. In response, USDA has recently
developed initiatives to support school efforts to provide a healthy
nutrition environment, including competitive food sales. Beginning in
1995, USDA introduced the School Meals Initiative for Healthy Children
in an effort to improve the nutritional quality of meals served through
the NSLP and the School Breakfast Program. That same year, in order to
assist with implementation of the School Meals Initiative, USDA
launched Team Nutrition to focus on schools and promote the nutritional
health of the nation's children. Team Nutrition provides schools with
nutrition education materials for children and families, technical
assistance materials for school food services, and materials to build
school and community support for healthy eating and physical
activity.[Footnote 9] Since 1995, USDA has also created additional
resources to help schools improve student nutrition, address
competitive foods, and foster long-term health, sometimes in
collaboration with other federal agencies (see table 1).[Footnote 10]
Table 1: Select USDA Initiatives That Promote Child Nutrition and
Address the Competitive Food Environment:
Initiative: Changing the Scene-Improving the School Nutrition
Environment (2000);
Description: Toolkit that focuses on improving the school nutrition
environment and serves as a guide to local action, developed with input
from 16 education, nutrition, and health organizations.
Initiative: Fruits and Vegetables Galore (2004);
Description: Toolkit for school food service professionals that
contains tips on promoting fruits and vegetables to children.
Initiative: HealthierUS School Challenge (2004);
Description: Effort to recognize schools that have met higher standards
for nutrition and physical activity than those required by the federal
government, and to encourage other schools to achieve such results.
Initiative: Making it Happen! School Nutrition Success Stories (2005);
Description: Report that shares stories from 32 schools and school
districts that have made innovative changes to improve the nutritional
quality of all foods and beverages sold on school campuses, including
competitive foods, developed in collaboration with CDC and supported by
the Department of Education.
Source: GAO.
[End of table]
The Department of Health and Human Services (HHS) has also focused on
the school nutrition environment through various initiatives by CDC.
These include:
* an eight-component coordinated health model for schools that includes
school nutrition services as one component, and:
* a School Health Index designed to help schools assess their
environments and improve the effectiveness of their health and safety
policies and programs.[Footnote 11]
In addition to these efforts to support a healthy school nutrition
environment, the National Academy of Sciences' Institute of Medicine
recently released a broad-based report on preventing childhood obesity.
Among other things, the institute recommended that the current federal
funding structure of school meals and the policies and practices of
selling competitive foods in schools be examined for improvements that
would encourage students to consume nutritious foods and beverages, and
that nutritional standards be developed and implemented for all
competitive foods sold or served in schools.
On the Horizon: School Wellness Policies and Research on Nutritional
Standards:
The Child Nutrition and WIC Reauthorization Act of 2004 requires school
districts that participate in the federal meal programs to establish
local wellness policies by the first day of the 2006-2007 school
year.[Footnote 12] Congress added this requirement, in part, in order
to promote nutrition and address child obesity by encouraging
localities to provide healthy school environments. These policies must
include nutrition guidelines for all foods available on each school
campus during the school day and goals for nutrition education and
physical activity, as well as establish a plan for measuring
implementation of the local wellness policy. Further, the local
wellness policies must be developed in collaboration with the
community--including a combination of school officials, parents,
students, and the public. The act also requires that USDA, HHS--through
CDC--and the Department of Education provide technical assistance to
districts regarding wellness policies. In addition, in order to assist
schools in setting appropriate nutrition standards for foods available
in schools, Congress--through the Conference Report of the Consolidated
Appropriations Act of 2005--provided $1 million to the Institute of
Medicine. With these funds, the institute will conduct a study and
provide recommendations regarding appropriate nutritional standards for
the availability, sale, content, and consumption of all foods at
school, with a particular emphasis on competitive foods.
Almost All Schools Sold Competitive Foods in 2003-2004, and Middle
School Availability Has Increased over the Last 5 Years:
Nearly 9 out of 10 schools sold competitive foods to students in 2003-
2004, and over the last 5 years, the availability of competitive foods
has increased both in middle schools and in a la carte lines in many
schools. While competitive foods were commonly available in all school
levels, students in high schools and middle schools had greater access
to these foods than students in elementary schools. The competitive
foods available ranged from nutritious items such as fruit and milk to
less nutritious items such as soda and candy. Between 1998-1999 and
2003-2004, the availability of competitive foods increased in middle
schools, and the volume and variety of a la carte foods sold increased
in many schools.
Competitive Foods Were Available in Almost All Schools and Were More
Common in High Schools and Middle Schools:
We estimate that almost 90 percent of schools sold competitive foods to
students in 2003-2004 through one or more of the following venues: a la
carte lines, vending machines, and school stores.[Footnote 13]
Considering each type of venue individually, a majority of schools sold
foods through a la carte lines and vending machines, as shown in figure
3.
Figure 3: Estimated Percentage of Schools Selling Competitive Foods
through Each Type of Venue in 2003-2004:
[See PDF for image]
[End of figure]
High schools and middle schools were more likely to sell competitive
foods than elementary schools. Table 2 shows the percentage of
elementary, middle, and high schools selling competitive foods through
each type of venue and through one or more venues.
Table 2: Estimated Percentage of Schools of Different Levels with Each
Competitive Food Venue in 2003-2004:
A la carte;
Elementary schools: 67;
Middle schools: 88;
High schools: 91.
Vending machines;
Elementary schools: 46;
Middle schools: 87;
High schools: 91.
School stores;
Elementary schools: 15;
Middle schools: 25;
High schools: 54.
One or more of the above venues;
Elementary schools: 83;
Middle schools: 97;
High schools: 99.
Source: GAO.
[End of table]
In addition to the competitive food venues regularly available in
schools, students in some schools also were able to purchase
competitive foods through on-campus fund-raisers. For example, more
than 4 out of 10 schools allowed fund-raising--such as seasonal candy
sales or short-term sales of baked goods raising revenues for school
organizations--through the sale of foods to students during the school
day in 2003-2004. Such fund-raisers were permitted in two-thirds of
high schools and less than 40 percent of middle and elementary schools.
While federal regulations restrict access to FMNV--a subset of
competitive foods--in food service areas during meal periods, many
types of competitive foods are allowed to be sold in these locations at
meal times. According to our survey, competitive foods sold in 2003-
2004 through a la carte lines, vending machines, and school stores were
frequently available for purchase in or near school cafeterias and
during lunch.[Footnote 14]
* A la carte items were available to students in the cafeterias of
schools that offered them and were available to students during lunch
in 94 percent of those schools.
* One-half of schools with vending machines had machines in or near the
cafeteria, and one-third of schools with vending machines had machines
that were available to students during lunch.
* Nearly half of schools with stores had such stores in or near the
cafeteria, and about one-third of schools with stores sold competitive
foods through these stores during lunch.
Although schools that sold competitive foods through a la carte lines
or school stores often sold these foods in just one physical location,
schools with vending machines typically had multiple machines available
throughout the school, ranging from 1 to 25 machines. For example, the
quarter of high schools with the most vending machines had 10 or more
machines, the top quarter of middle schools had 7 or more machines, and
the top quarter of elementary schools had 3 or more machines.[Footnote
15] Schools generally had more beverage vending machines than snack
vending machines.
Further, in many schools, particularly high schools, beverages sold in
vending machines or elsewhere in the school were provided through an
exclusive beverage contract--a contract granting a company exclusive
rights to sell beverages to students in that school. In addition to
covering vending machine sales, these contracts may require schools to
provide beverages through the contracted company in other venues, such
as school stores or athletic event concessions. Nearly half of all
schools in 2003-2004 had an exclusive beverage contract. In over a
third of schools with exclusive beverage contracts, the contracts
covered 5 years or more, with some covering at least 10 years[Footnote
16]. Nearly 75 percent of high schools, 65 percent of middle schools,
and 30 percent of elementary schools had exclusive beverage contracts.
Types of Competitive Foods Ranged from Nutritious to Less Nutritious,
with High and Middle Schools Selling a Wider Variety of Items:
Competitive foods available through a la carte lines, vending machines,
and school stores ranged from nutritious items, such as vegetables and
salad, to less nutritious items, such as soda and candy. Nutritious
foods were more frequently available through a la carte lines than
through vending machines and school stores. For example, as shown in
table 3, we estimate that many of the types of foods commonly available
through a la carte sales were nutritious foods and beverages, such as
fruit and milk. However, types of less nutritious items, such as sweet
baked goods and salty snacks not low in fat, were also available
through a la carte lines in at least one-third of schools. Furthermore,
many of the types of foods commonly available through vending machines
and school stores were less nutritious ones, such as soda and salty
snacks.[Footnote 17]
Table 3: Types of Competitive Foods Often or Always Available through
Each Venue in Schools, by Nutrition Category:
[See PDF for image]
Note: The nutrition categories, as signified by the shading, are
general descriptions of the foods in each category. GAO created these
nutrition categories to generally reflect the Dietary Guidelines for
Americans, recognizing that they apply to many but not all foods of
each type--nutritional content can vary depending on the ingredients
and the methods used to prepare foods. Four of the estimates in this
figure have margins of error that exceed plus or minus 15 percent. See
table 6 in appendix I for more information.
[End of figure]
In addition, our data suggest that students may have had increased
access to more types of competitive foods as they progressed from
elementary school to middle school and high school. While nutritious
foods were commonly available in schools of each level, students in
high schools and middle schools had access to a greater variety of
types of less nutritious foods than students in elementary schools. For
example, salty snacks, sweet baked goods, soda, and candy were
available in at least one-third of high schools and middle schools with
competitive foods but in less than one-third of such elementary
schools, as shown in table 4.[Footnote 18]
Table 4: Types of Competitive Foods Often or Always Available through
Any Venue in Schools, by School Level and Nutrition Category:
[See PDF for image]
Note: The nutrition categories, as signified by the shading, are
general descriptions of the foods in each category. GAO created these
nutrition categories to generally reflect the Dietary Guidelines for
Americans, recognizing that they apply to many but not all foods of
each type--nutritional content can vary depending on the ingredients
and the methods used to prepare foods.
[End of figure]
Over the Last 5 Years, the Availability of Competitive Foods Sold in
Middle Schools and through a la Carte Lines Increased:
According to our survey, the availability of competitive food venues in
middle schools increased during the period between 1998-1999 and 2003-
2004.
* The percentage of middle schools offering competitive foods through a
la carte lines, vending machines, or school stores increased from 83 to
97 percent during this time period.[Footnote 19]
* The percentage of middle schools with exclusive beverage contracts
increased between 1998-1999 and 2003-2004.[Footnote 20]
* The number of vending machines per school increased between 1998-1999
and 2003-2004 in more than one-third of middle schools that had vending
machines.[Footnote 21] In addition, the number of vending machines per
school increased in more than half of high schools that had vending
machines.
In addition, the availability of a la carte items, particularly the
volume sold and the variety available for purchase, increased between
1998-1999 and 2003-2004 in many schools.
* The volume of a la carte items sold--that is, the overall amount of
all a la carte items sold--increased in more than two-thirds of high
schools, more than half of middle schools, and nearly one-third of
elementary schools that had a la carte sales.[Footnote 22]
* The variety--that is, the number of different types--of a la carte
items available to students increased in about one-half of all schools
that had a la carte sales.
According to SFA directors, reasons for the increases in a la carte
volume and variety between 1998-1999 and 2003-2004 included responding
to student demand, providing more nutritious foods, making foods more
appealing to students, and generating additional revenue for the food
service.
Aside from increases in the availability of competitive foods sold in
middle school and through a la carte lines, we did not find that the
availability of competitive foods in schools changed considerably
during the period between 1998-1999 and 2003-2004. For example,
according to our survey, there have not been considerable changes in
the percentage of high schools or elementary schools offering
competitive foods through a la carte lines, vending machines, or school
stores during this time period. Further, in a majority of all schools
with school stores or vending machines, the number of different types
of food offered for sale through these venues stayed the same.
Many People Made Decisions about Competitive Food Sales, but No One
Person Commonly Had Responsibility over All Sales in a School:
Many people, including district and school officials as well as members
of groups selling foods in schools, made decisions about competitive
food sales, but no one person consistently had responsibility for all
competitive food sales at the school level. The decisions ranged from
broad policies about the school nutrition environment to decisions
about which foods to sell at a specific venue or event. In 2003-2004, a
majority of schools had policies in place that restricted competitive
food sales to students, and these policies were often set at the
district level by superintendents and school boards. Regarding the
actual selection and sale of competitive foods in schools, SFA
directors were commonly involved in decisions related to a la carte
sales, while principals often had final approval over other competitive
food sales. In addition, many different groups were directly involved
in selling competitive foods in schools in 2003-2004, and these groups
could make decisions about which foods to sell and when to make them
available. The number and variety of groups involved in these sales
typically increased as the school level increased.
District and School Officials Made Decisions about Competitive Food
Policies:
According to principals, an estimated 60 percent of schools had written
policies in place that restricted competitive foods accessible to
students in 2003-2004, and most often, districts enacted those policies
(see fig. 4).[Footnote 23] In contrast, 40 percent of schools had no
such policies.
Figure 4: Estimated Percentage of Schools with a Written Competitive
Food Policy in 2003-2004 Enacted by Districts and Schools:
[See PDF for image]
[End of figure]
In addition to superintendents and school boards that were involved in
making these competitive food policy decisions for a district, both SFA
directors and school principals commonly made policy decisions about
actual food sales at the school level, resulting in no one person
having responsibility over all sales. Specifically, district SFA
directors often made ongoing decisions about policies affecting the
school nutrition environment. For example, SFA directors provided many
of the foods available to students through their administration of the
federal meal programs and typically decided which foods to serve
through school a la carte sales. In addition, SFA directors were also
often concerned with other competitive food sales in the schools, such
as those through vending machines, school stores, and fund-raising
sales. According to our survey, 84 percent of SFA directors in 2003-
2004 considered addressing the competitive food environment in schools
to be part of their responsibilities. More than three-quarters of those
directors considered it a priority.
Moreover, principals also made decisions about competitive food
policies in their schools. For example, as shown in figure 4, aside
from the more than three-quarters of schools with competitive food
policies developed by their districts, school principals enacted
policies in conjunction with their districts in an additional 10
percent of schools and enacted their own policies in another 2 percent
of schools with policies. Regarding operational decisions, principals
in more than half of schools with competitive food sales reported in
our survey that they provided final approval over the foods and
beverages sold through vending machines, school stores, and fund-
raisers in their schools. Also, similar to SFA directors, principals in
a majority of schools reported that they considered addressing the
competitive food environment one of their responsibilities.
Many Different Groups Were Directly Involved in Deciding What to Sell
and Selling Competitive Foods:
In addition to the district and school officials involved in decisions
related to competitive food policy, myriad individuals and groups were
directly involved in the sale of competitive foods. These groups could
make decisions about which specific foods to sell to students and when
to conduct sales. During 2003-2004, groups such as students, parent-
teacher associations, and booster groups--in addition to SFA directors
and school principals--were most commonly involved in sales, according
to our survey.
The number of groups involved in sales typically increased as the
school level increased. For example, three or more different groups
were much more likely to be involved in competitive food sales in high
schools than in middle and elementary schools in 2003-2004 (see fig. 5).
Figure 5: Number of Groups Directly Involved in Competitive Food Sales
in 2003-2004, Reported as an Estimated Percentage of Schools with Sales:
[See PDF for image]
Note: The estimates for elementary schools and one estimate for middle
schools in this figure have margins of error that exceed plus or minus
15 percent. See table 6 in appendix I for more information.
[End of figure]
The groups directly involved in sales varied by school level. In
elementary schools, the SFA/school food service and student
associations/clubs were commonly involved in sales.[Footnote 24] In
middle schools, in addition to these groups, school officials/
administrators were most commonly involved.[Footnote 25] In high
schools, where the greatest number of competitive food venues was
typically available, these three groups and a variety of others were
directly involved in sales. Consequently, within a high school that has
a number of competitive food sales occurring simultaneously, a student
at lunchtime could be faced with many different food options sold by a
variety of different groups through several venues (see fig. 6).
Figure 6: Groups Most Frequently Involved in Various Competitive Food
Venues Commonly Available in High Schools:
[See PDF for image]
Note: The competitive food venues shown were estimated to be available
in a majority of high schools, according to our survey. The groups
listed with these venues were estimated to be directly involved in
competitive food sales through the specified venue in at least 25
percent of high schools.
[End of figure]
Many Schools Raised a Substantial Amount of Revenue through Competitive
Food Sales and Used It to Support Food Service Operations and Student
Activities:
Many schools generated substantial revenue through competitive food
sales in 2003-2004, often using this revenue to support food service
operations and student activities. High schools and middle schools
generally raised more revenue from competitive food sales than
elementary schools, reflecting the greater availability of competitive
foods in high and middle schools. Across all competitive food sales,
food services generated more revenue than other school groups, largely
through a la carte sales. Some food service directors said they relied
on this revenue to support overall food service operations, while other
school groups primarily used their competitive food revenues to fund
student activities.
Total Competitive Food Revenue Varied by School Level From More than
$125,000 in Some High Schools to More than $5,000 in Some Elementary
Schools:
Many schools generated a substantial amount of revenue through
competitive food sales in 2003-2004.[Footnote 26] Total revenue
generated through competitive food venues varied by school level,
reflecting, among other things, the greater availability of competitive
foods in high schools and middle schools than in elementary
schools.[Footnote 27] In particular, we estimate that about 30 percent
of all high schools generated more than $125,000 per school through
competitive food sales in 2003-2004, while about 30 percent of all
elementary schools generated more than $5,000 per school through these
sales (see fig. 7). These estimates of total competitive food revenue
are conservative, as they are based on the sum of the minimums of
specified revenue ranges.[Footnote 28] Therefore, many schools likely
generated more total revenue from competitive food sales than our
analysis reflects.
Figure 7: Estimated Percentage of Schools Generating Different Minimum
Amounts of Total Competitive Food Revenue in 2003-2004, by School Level:
[See PDF for image]
Note: See appendix I for more information on this analysis, which used
data obtained from the matched responses. One of the estimates in the
high school figure has a margin of error that exceeds plus or minus 15
percent. See table 6 in appendix I for more information.
[End of figure]
Food Services Generated More Revenue through These Sales than Other
School Groups, with Food Services Using Revenue for Their Operations
and Other School Groups Using Revenue for Student Activities:
Across all competitive food sales, food services generated more revenue
than other school groups, such as school administrators, student
associations, and booster groups.[Footnote 29] Specifically, food
services generated a greater amount of revenue through a la carte sales
than through any other type of competitive food sale. Other school
groups raised a greater amount of revenue through exclusive beverage
contracts than through any other type of competitive food
sale.[Footnote 30] In addition to raising varying amounts of
competitive food revenues through different types of sales, food
services and other school groups generally used their revenues for
different purposes.
Food Services:
The revenue food services generated through a la carte sales was
substantial in many schools. For example, we estimate that 40 percent
of high school food services and nearly a quarter of middle school food
services selling competitive foods through a la carte lines generated
more than $50,000 per school through these sales in 2003-2004.
Furthermore, food services in 20 percent of high schools selling a la
carte items generated more than $125,000 per school through a la carte
sales, as shown in figure 8.
Figure 8: Estimated Percentage of High Schools in Which Food Services
Generated Different Amounts of Revenue through a la Carte Sales in 2003-
2004:
[See PDF for image]
Note: Estimated percentages do not add to 100 because some SFA
directors were unsure how much revenue they generated through a la
carte sales.
[End of figure]
Food services typically used their substantial a la carte revenue to
support overall food service operations, supplementing revenue earned
through the sale of school meals. According to our survey of SFA
directors, in 2003-2004, food services in 40 percent of schools earned
less revenue than they spent, generating a loss, and food services in
an additional 20 percent of schools broke even. Food services in the
remaining 40 percent of schools generated more revenue than they spent
in 2003-2004, yielding a gain.[Footnote 31] From the data we collected,
it is not clear what proportion of this food service revenue came from
federal reimbursement for meals served and what proportion came from
revenue generated through competitive food sales.[Footnote 32] In our
previous work, we found that food services in some states had a small
but increasing shortfall in total revenue compared with expenses
between school years 1996-1997 and 2000-2001 and that a la carte sales
had become an increasingly important source for augmenting total food
service revenue.[Footnote 33] Moreover, some SFA directors told us in
survey comments for this study that they sold competitive foods in
order to maintain balanced budgets. For example, one food service
director commented that the food service would not be able to maintain
a balanced budget without the substantial revenue generated through a
la carte sales. Another commented that the district food service
generated nearly half of its revenue through competitive food sales.
Other School Groups:
Other school groups raised more revenue through exclusive beverage
contracts than through any other type of competitive food sales. In
particular, we estimate that school groups in nearly one-quarter of
high schools with exclusive beverage contracts generated more than
$15,000 per school through these contracts in 2003-2004, as shown in
figure 9. However, it is important to note that 15 percent of high
school principals did not know how much revenue exclusive beverage
contracts generated for their schools in 2003-2004.
Figure 9: Estimated Percentage of High Schools in Which Other School
Groups Generated Different Amounts of Revenue through Exclusive
Beverage Contracts in 2003-2004:
[See PDF for image]
Note: Estimated percentages do not add to 100 because some school
principals were unsure how much revenue other school groups generated
through exclusive beverage contracts.
[End of figure]
Exclusive beverage contracts also provided some schools with noncash
benefits--goods and services such as athletic scoreboards and in-kind
support of school events. In particular, nearly 30 percent of schools
of all levels selling competitive foods through exclusive beverage
contracts received noncash benefits. Nearly one-third of those schools
received athletic equipment, facilities, or uniforms, and a small
number of schools also received support for assemblies and programs,
scholarships, and personal items for students and school staff, such as
cups and coolers. The value of those items was sometimes considerable:
in one-quarter of those schools receiving noncash benefits through
exclusive beverage contracts in 2003-2004, the benefits were worth more
than $5,000 per school.[Footnote 34]
School groups other than food services most commonly used their
competitive food revenues to support student activities such as field
trips and assemblies, as shown in figure 10. Similarly, groups in many
schools spent competitive food revenues on athletic equipment,
facilities, or uniforms. However, some used revenues to meet school
needs such as expenses associated with general school overhead or with
textbooks and school supplies.
Figure 10: Estimated Percentage of Schools Using Competitive Food
Revenue, Excluding Food Service Revenue, for Various Purposes in 2003-
2004:
[See PDF for image]
Note: General school overhead includes facilities and grounds
maintenance. Respondents in 22 percent of schools said they spent
competitive food revenues on other uses, such as student rewards and
incentives.
[End of figure]
School Districts We Visited Substituted Healthy Competitive Foods for
Less Nutritious Items while Overcoming Obstacles to Change, and the
Effects on Revenue Were Unclear:
The six school districts we visited all recently took steps to
substitute healthy competitive foods for less nutritious items while
overcoming several obstacles to change, and in the end, the effects of
these changes on revenue were unclear. Although the districts we
visited increased the availability of healthy competitive foods and
decreased less nutritious items through differing approaches,
perseverant and committed individuals took actions in each district to
initiate and lead the process of change while also taking steps to
involve and obtain support from those affected. At the same time,
officials noted that they faced several barriers to making changes,
including concerns about potential revenue losses, among others.
Concerning the effects of changes on sales revenues, none of the
districts we visited had sufficient data to examine these effects, and
few had planned for these effects before implementing changes.
Regardless of the limited data on revenue, many officials expressed
strong concerns about potential revenue losses largely because
competitive food sales have provided a source of flexible funding used
for a wide variety of purposes.
School Districts We Visited Substituted Healthy Competitive Foods for
Less Nutritious Items:
Though the six school districts we visited varied in terms of
socioeconomic status, student population size, and geographic location,
they were all able to take steps to restrict the availability of less
nutritious competitive foods in their schools. Further, rather than
just remove less nutritious competitive foods from their schools, these
districts continued to offer competitive foods to students by
substituting healthy fare for the items removed. In addition, these
districts all took steps beyond current federal and state competitive
food regulations, and while there were differences in the details of
changes, most districts' changes had similar characteristics.
Specifically, most, if not all, of the districts we visited:
* made changes to competitive foods in all of the schools in their
districts, rather than changes only to certain schools, such as
elementary;[Footnote 35]
* made changes to the availability of competitive foods throughout the
entire school day, rather than limiting availability only during
certain hours of the day;
* made changes to the availability of competitive foods in each of the
venues through which they were sold, including fund-raising;[Footnote
36]and,
* made simultaneous changes to foods served through school meal
programs.
Regarding districts' efforts to increase the availability of healthy
competitive foods, as they defined them, all of the districts we
visited recently took steps to make water and juice more available to
students in their schools. For example, districts and schools often
replaced soda in their vending machines with bottled water and juices
with higher concentrations of real fruit juice. Further, several
districts also replaced fried potato chips with baked potato chips, and
packaged desserts with granola bars or similar items. Several districts
also increased the variety of flavored milk available in schools to
encourage milk consumption.
All of the districts we visited also took steps to restrict less
nutritious items. The specific types of competitive foods restricted
varied by district, with two of the districts limiting the availability
of primarily soda and candy, and four districts limiting the
availability of competitive foods high in sugar and fat.[Footnote 37]
In these districts, different criteria were used by each district to
define foods high in sugar and fat. For example, in Fort Osage, all
competitive foods must be low-fat (no specified percentage) and cannot
have sugar listed as the first ingredient, while in Richland One, all
competitive foods must contain less than 40 percent sugar (or other
sweeteners) and less than 8 grams of fat per 1 ounce serving. In the
other two districts, New Haven and Independence, formulating specific
nutrition criteria has been an ongoing process.
In addition to making changes to the types of competitive foods sold in
schools, all of the districts we visited also made similar changes to
increase healthy foods available through school meals. For example,
SFAs in both Independence and Oakland recently removed deep fryers from
school cafeterias, and they now bake all foods. In Richland One, the
SFA decided to implement stricter standards for school meals than those
required by the federal government. Specifically, Richland One requires
school meal menus to meet the federal requirements for nutrients, fat,
and sugar intake on a daily basis, rather than averaging the
nutritional value of meal components over the course of a week. In
addition, several SFA directors stated that they would like to
introduce a greater variety of fresh fruits and vegetables into school
meal menus. However, they also expressed their opinion that the federal
school meal reimbursement is insufficient to provide these items more
frequently.[Footnote 38]
Individuals Who Initiated and Led Change Also Obtained the Support of
Multiple Groups:
While the characteristics of the six districts we visited differed, as
well as the process of change in each, districts typically noted
several key components to their success. These key components included
an enthusiastic initiator of change, leadership by dynamic and
committed individuals, and support from groups directly affected by
changes, such as teachers, parents, and students. Overall, those
involved in the process of change agreed on the importance of improving
student nutrition and health and directing resources and energy toward
achieving this goal. As shown in table 5, the types of individuals and
groups involved in the process of change varied across the districts
visited and often included individuals from the district, school, and
community.
Figure 11: District, School, and Community Groups Involved in the
Process of Changing Competitive Foods, by District Visited:
[See PDF for image]
Note: In Independence, New Haven, Oakland, and McComb, some of the
groups indicated were involved in the process of changing competitive
foods through districtwide committees to address school nutrition and
health issues.
[End of figure]
As shown in table 5, in the districts we visited, initiators of change
sometimes came from within the ranks of district staff and sometimes
from the community, while leaders of change often were district or
school staff. In some districts, one person or group acted as both the
initiator and leader of change, while in other cases, the initiator
pushed the idea of changing competitive foods forward and then the
leader took over implementation of the changes. For example, in several
districts, the superintendent or SFA director initiated and led changes
to competitive foods because of concerns about both student nutrition
and competition with the school food service. In another district,
changes were initiated and led largely by a middle school principal and
a physical education teacher. In contrast, in New Haven, a local
pediatrician who was also the district's medical adviser initiated
change to competitive foods, and then a committee of district staff,
school staff, and community members took over leadership of changes. In
all of the districts we visited, a strong leader helped formulate new
policies, reached out to parties affected by changes, and ensured that
policies were implemented.
While competitive food changes were often initiated and led by a few
individuals, all six districts realized that changes would be
successful only with the involvement of a variety of people in the
process in order to ensure their support for the changes and help
sustain changes. To address this need, some districts, such as Oakland
and New Haven, convened formal committees to provide recommendations on
school nutrition and health issues. In other districts, leaders took
steps to reach out individually to those parties affected by changes,
such as school principals, teachers, and students, to obtain support
before their enactment. This support was also instrumental to
sustaining changes. For example, the McComb superintendent noted that
successful implementation of the district's coordinated school health
program required both leadership as well as substantial community
involvement, including input from school officials and teachers,
parents, and health providers in the community. The involvement of
these groups in formulating changes helped ensure continued commitment
and support of the changes.
In addition to obtaining the support of a variety of groups before
implementing changes, many districts noted that obtaining student
acceptance of the changes was particularly important to the success of
change. To that end, some districts held nutrition and health fairs to
distribute related information to students and the broader community,
and others involved students in taste testing and voting on the foods
they preferred. For example, middle school students and parents in Fort
Osage taste-tested healthy competitive foods during parents' night and
the school's open house. In other districts, student feedback on policy
changes was sought by officials before their implementation, sometimes
by consulting the district's student advisory council.
Districts Faced Several Barriers to Changing Competitive Foods,
Including Schools' Concerns about Revenue Losses:
While the districts we visited all noted several key components to
successful change, they also cited several barriers to implementing
changes to competitive foods that they had commonly faced. In
particular, officials in almost all of the districts visited cited
opposition because of concerns about future revenue losses as a barrier
to changing the availability of competitive foods. In these cases,
school principals most frequently expressed these concerns because
competitive food revenues often provided discretionary money that was
otherwise unavailable to fund a variety of projects and needs at the
school level.
In addition, a lack of information on other districts' efforts to make
changes to competitive foods and a lack of nutritional guidelines for
these foods were also barriers to change in the districts we visited.
While a majority of the districts visited implemented their own changes
to competitive foods without knowledge of the steps taken by other
districts to make such changes, officials in Richland One and Oakland
conducted their own research on other state and district competitive
food policies in order to learn from the experiences of others. Related
to this, officials in Independence, Fort Osage, and New Haven noted
that the lack of agreed-upon nutrition guidelines for competitive foods
was an obstacle to change because they had to independently develop
their own nutrition standards. From our observations during these
visits, the absence of a clear set of standards defining healthy and
less nutritious foods can create a problem for districts making changes
to competitive foods as continual debates and disagreements on such
standards may slow the process of policy formation, particularly when
many groups are involved in the process.
Several districts mentioned additional barriers to making changes, such
as determining the full extent of competitive food sales in schools and
the groups involved in sales. For example, the SFA director in
Independence noted that the district's delay in developing nutrition
standards for competitive foods was largely due to the difficulty of
compiling a full picture of all competitive food sales occurring in
schools. Related to this, given the number of groups that can be
involved in these sales in each school, and the lack of clear roles and
responsibilities in this environment, she noted that it has been
difficult to determine the full extent of groups involved in sales
across the district. She emphasized that it is important for the groups
that have a stake in the revenues generated by these sales to be
involved in discussions concerning competitive food policy in order to
obtain support for the policy and successful implementation of changes.
Some districts also noted that the need to continually monitor
implementation of competitive food changes at the school level can be
an obstacle to change. Officials in both Oakland and Richland One
stated that monitoring adherence to their competitive food policies at
the school level has been difficult but is necessary to effective
implementation. Even when school-level groups were involved in the
process of developing changes, monitoring policy implementation was
difficult because of the involvement of many groups in competitive food
sales. In Richland One, the SFA director noted that she often relies on
observances by food service staff working in the schools to ensure that
the policy is being followed by all groups selling competitive foods.
Our own observations of the school food environment during our visits
to schools support the conclusion that districts have difficulty
monitoring the implementation of policies, as we noticed a few
deviations from district competitive food policies in some schools.
Even though school officials often seemed devoted to the goal of
improving the nutritional quality of foods available in their schools,
they typically faced many competing priorities during the school day.
Further, in many schools, it was unclear who was responsible for
ensuring that policies were effectively implemented.
Food service staff in Fort Osage and New Haven stated that the
difficulty of finding healthy foods that both meet district nutrition
goals and appeal to students was also a barrier to making changes to
competitive foods. They noted that some healthy foods students found
appealing were unavailable from vendors, while in other instances, the
healthy foods available were too expensive to sell to students. This
sentiment was echoed by students in several districts, as they
expressed their opinions that some of the newly introduced healthy
foods, such as bottles of flavored milk or juice, were too costly to
purchase as part of their lunch. In contrast to districts that
mentioned problems obtaining new healthy products from vendors, several
districts noted that they were able to work within their exclusive
beverage contracts to obtain healthier beverages to serve to students.
However, at least one mentioned that the major soft drink company with
whom the district had a contract offered few nonsoda options.
In addition, districts also faced the challenge of educating students
about healthy eating and encouraging students to change their behavior
by choosing healthy foods. In several of the districts, schools
reported providing students with nutrition information and education,
sometimes through classroom lessons, posters, and programs and
activities to promote healthy eating. During our visits, students we
spoke with frequently demonstrated their understanding of the
importance of healthy eating, and some noted that they would like to
see the addition of certain healthy foods to school offerings, such as
a greater variety of fresh fruits and vegetables. In addition, several
middle school students in Fort Osage and New Haven explained that after
changes were made to competitive foods and they began to learn more
about good nutrition in their schools, they went home and talked to
their parents about these issues.[Footnote 39] However, experts agree
that it is more difficult to change behavior than to educate
individuals.[Footnote 40] Related to this, high school students in most
of the districts we visited mentioned that some students continue to
purchase less nutritious foods before school and after school from
neighborhood stores and restaurants. In addition, during our visits to
schools, we observed students eating a wide range of both healthy and
unhealthy items during lunch, with younger students being more likely
to eat healthy foods than high school students.[Footnote 41]
As part of their role in helping districts develop wellness policies
that address, among other things, school nutrition, USDA has recently
taken several steps that may help districts overcome some of these
barriers.[Footnote 42] In March 2005, USDA, in partnership with HHS/CDC
and the Department of Education, sent a letter to state
superintendents, district superintendents, and SFA directors describing
the wellness policy requirements. Through this letter, the agencies
offered to provide technical assistance to districts, and they also
provided information on online resources available at the federal level
to help districts develop their policies. Specifically, these agencies,
in collaboration with several food and nutrition organizations, have
begun to compile resources that will provide districts with information
on state and local efforts to make changes to the school health and
nutrition environment, including examples of nutrition standards used
by states and localities that have already developed competitive food
policies.[Footnote 43] In addition to online resources, these three
agencies recently released Making it Happen! School Nutrition Success
Stories, a publication that describes local efforts to address the
school nutrition environment, in order to assist districts as they move
forward with their own changes.[Footnote 44]
The Effects of Changes to Competitive Foods on Revenues Were Often
Unclear because of Limited Data; Nonetheless, Many Officials Expressed
Concerns about Revenue Losses:
In the districts we visited, reliable data on how changes to
competitive food sales affected revenues were typically unavailable.
Schools and districts often did not maintain detailed revenue records
to enable the type of analyses needed to parcel out the direct effects
of competitive food changes on revenues. Nonetheless, most schools and
districts were able to provide partial data on revenue changes for
specific venues, and these limited data suggest that districts
experienced mixed revenue effects. Several schools we visited appear to
have lost revenue from competitive food sales after they made changes,
while at least one may have increased revenue. For example, after
increasing the availability of healthy a la carte foods and restricting
less nutritious items, SFA directors in both Independence and Richland
One recorded decreases in a la carte sales. In contrast, a middle
school in McComb reported that after removing soda from beverage
vending machines and changing the policy regarding the times sales were
allowed, vending revenues increased. However, these data did not
account for other factors that may also have affected revenues.
While the limited data available suggest that school districts
experienced mixed revenue effects after implementing competitive food
changes, they also illustrate the difficulty of tracking these effects.
Because the competitive food environment is complex, sometimes
involving many sales and many groups, the effects of changes on
revenues are often complicated and may differ for each group involved
in sales. Some groups may benefit from changes, others may lose. For
example, in Fort Osage, when the middle school decided to remove all
less nutritious competitive foods available in the school and replace
them with healthy items, it also simultaneously decided to stop using
outside vendors to supply its vending machines. Subsequently, the
district SFA took over operation of the middle school's vending
machines, and as a result, vending revenue began to accrue to the SFA
instead of school administrators. While the SFA director was unable to
compare the revenue before changes with that generated after changes,
she reported that the machines were self-supporting. In this instance,
because of the changes made to competitive foods and their sale, school
administrators lost a source of revenue while the SFA gained one.
In addition to the challenge of understanding the revenue effects of
competitive food changes on different groups in schools, the
relationship between changes in a la carte sales and school meal
participation adds complexity. Although food service programs rely on
reimbursement for school meal participation as a primary source of
funding, officials often cite the importance of using additional
revenue from a la carte sales to balance their budgets. Therefore,
officials take risks when they make changes to the competitive foods
available in schools, because changes may affect revenues from these
sales and they may also affect school meals participation. In the
districts we visited, competitive food changes were often accompanied
by increased school meals participation. In four districts, federal
reimbursements for meals subsequently increased, benefiting the SFA,
and in at least one instance, this increase more than made up for food
service losses in competitive food sales. While Richland One reported
losing approximately $300,000 in annual a la carte revenue after
implementing changes, school lunch participation and subsequent federal
reimbursements increased by approximately $400,000 in the same year.
Despite the lack of conclusive data on revenue effects, district and
school officials often expressed strong concerns about potential
revenue losses. Because food services often operate on tight budgets
and use competitive food revenues to support their operations, they
take the risk of losing important revenues when they make changes to
these foods.[Footnote 45] In addition, principals frequently stated
that competitive food revenues are used at the school level as
discretionary funding, and they do not typically have other sources of
flexible funding available to use for the wide variety of purposes
toward which competitive food revenues are directed. Therefore, when
making changes to competitive foods, principals also risk losing what
is an oftentimes important source of funding. For example, in the
schools we visited, many principals reported using competitive food
revenues for student activities and classroom supplies, and some
reported using these revenues to support school dances and assist needy
students.
Although data on revenue effects were limited and complicated by the
complex competitive food environment in the districts we visited, some
districts tried to lessen adverse revenue effects by the process
through which changes to competitive foods were implemented.
Specifically, a few districts and schools reported taking incremental
steps to change competitive foods in order to mitigate the severity of
the effects on revenue. For example, in one Independence high school,
incremental changes were being made to beverage vending machines to
phase in juice and water and phase out soda over a span of several
years. The high school principal reported that the school was
conducting this change slowly in order to avoid surprising students
with sudden changes and to maintain revenue. In addition, a few schools
noted that their efforts to include students in decisions about
changing food offerings may have helped ensure that the new foods would
be accepted by students and mitigate the effects on revenues. However,
many of the districts we visited did not fully plan for the effects on
sales revenues when they were considering changes to competitive food
policy, and several recognized that efforts to do so would have likely
eased the implementation of policies. Moreover, some principals
reported that their schools were able to find ways to support projects
previously funded with competitive food sales after changes were
implemented. For example, in several districts, principals reported
that after restrictions on fund-raiser food sales were implemented,
groups sold nonfood items like wrapping paper and candles, and also
raised funds by providing services, such as car washes.
In the publication Making it Happen! School Nutrition Success Stories,
key contacts in selected schools reported similar mixed revenue results
from their efforts to improve the school nutrition environment.
[Footnote 46] Of the group of schools that reported on revenue changes,
some experienced increases in revenue while others reported decreases
or no change. These schools used approaches similar to those in the
schools we visited, such as replacing less nutritious food with more
nutritious choices, obtaining input from the students, and using
marketing to encourage students to make healthy choices. In addition,
several of the schools reported increases in school meal participation.
Concluding Observations:
Our nation's schools are uniquely positioned to positively influence
the eating habits of children, yet almost all schools sell readily
available foods that are largely unregulated by the federal government
in terms of nutritional content. While not all of these competitive
foods are unhealthy, many are. Although schools cannot be expected to
solve the current problems with child nutrition and growing obesity
alone, many states and districts have begun efforts to improve the
nutritional environments in their schools.
As districts across the country develop their required wellness
policies by school year 2006-2007, they will likely face decisions and
challenges similar to those of the districts we studied and may benefit
from their lessons learned. Although each district took a different
approach, all of them recognized the value of including those parties
affected by the changes, such as parents, teachers, and other community
members, when developing new policies. In addition, they recognized
that students are the ultimate consumers of competitive foods and took
steps to consider their opinions.
Because districts reported they typically lacked a source of
recommended nutrition standards for competitive foods in schools,
officials were faced with difficult decisions about the criteria they
would use to determine which foods were considered adequately
nutritious to offer. The technical assistance available from FNS,
including multiple examples of nutrition standards developed by other
districts, as well as the Institute of Medicine's forthcoming
recommendations on nutritional standards for foods in schools, should
help district efforts to address this issue.
In addition, given the multiple groups that rely on sales of
competitive foods for revenue, districts may choose to consider the
possible revenue effects of changes in food offerings as they develop
and implement new policies. Since competitive food revenues are often
critical to food service operations and provide principals with
flexible funds relied on for a multitude of discretionary purposes,
making changes to competitive foods entails risks for both groups.
Districts we visited took varied steps that may mitigate potential
revenue changes, such as substituting healthy foods for less healthy
ones instead of removing all competitive foods, asking students to
taste and approve the more nutritious foods, offering alternate means
for fund-raising, or implementing change gradually. Lack of support
from the groups that use revenue from competitive food sales can
scuttle policy changes. Furthermore, the lack of a single person
responsible for the presence and sale of competitive foods in schools
complicates efforts to ensure that new policies will be implemented as
intended and maintained over time. Despite the complex food environment
in schools, new wellness policy requirements and USDA's efforts to
provide technical assistance to districts will provide an opportunity
for districts to plan and implement changes that recognize the needs of
the various groups and assign individuals with responsibility for
consistent and sustained implementation.
Agency Comments:
We provided a draft of this report to the U.S. Department of
Agriculture for review and comment. On June 17, 2005, FNS officials
provided us with their oral comments. The officials stated that they
were in general agreement with the findings as presented in the report
and offered technical comments that we have incorporated as
appropriate. In addition, the officials reiterated that the 1983 court
decision in National Soft Drink Ass'n v. Block is significant because
they believe it severely limits USDA's ability to restrict the sale of
competitive foods. FNS officials pointed out that prior to this ruling,
USDA regulations prohibited the sale of FMNV anywhere in the school
from the beginning of the school day until the last meal period.
Following the decision, USDA restricted the sale of FMNV only in food
service areas during meal periods. We agree that this ruling limited
USDA's ability to regulate competitive food sales as to time and place.
However, we believe the department has the authority to expand the
definition of FMNV to include additional foods with limited nutritional
value. Doing so could further limit the types of these foods available
in the cafeteria during meal times.
Second, officials discussed what is known about the use of revenue from
competitive food sales and reimbursable meals compared to their costs.
We did not determine if revenues generated by competitive food sales
were sufficient to cover the actual cost of the competitive foods sold.
The officials stressed that the 1994 School Lunch and Breakfast Cost
Study, the last definitive study of cost and revenue in the NSLP and
the School Breakfast Program, found that regardless of size, most
school food authorities failed to generate enough revenue to cover the
reported costs of nonreimbursable food sales.[Footnote 47] The mean
reported revenue-to-cost ratio was 71 percent for the study period. The
officials noted that this would equate to a loss of 41 cents for every
dollar received from the sale of nonreimbursable foods. Further, this
revenue-to-cost ratio did not include all costs for school food service
operations, such as uncharged labor costs, indirect costs, and
utilities. If these were included, the revenue to cost ratio would
generate even higher losses. FNS informed us that they are in the
process of contracting for a new school meal cost study.
We agree with FNS that our report focused on revenues generated by
competitive food sales and that we did not determine if revenues
generated by competitive food sales were sufficient to cover the actual
cost of the foods sold. However, our report and others have shown that
the availability of competitive foods, and particularly a la carte
items, has increased over time. In addition, the Cost Study's
definition of nonreimbursable meals included food sales such as adult
meals and special functions, as well as competitive foods, and
therefore, it is unclear how each of these types of sales contributed
to the mean reported revenue-to-cost ratio. Absent more current
information on the actual costs and revenues of providing competitive
foods and reimbursable school meals, we believe it is difficult to know
whether the results of the 1994 study are applicable today.
As agreed with your offices, unless you release the report's contents
earlier, we plan no further distribution of it until 30 days from its
issue date. We will send copies of this report to the Secretary of
Agriculture, appropriate congressional committees, and other interested
parties. In addition, the report will be available at no charge on
GAO's Web site at http://www.gao.gov.
If you or your staff have any questions about this report, please
contact me at (415) 904-2272 or bellisd@gao.gov. Contact points for our
Offices of Congressional Relations and Public Affairs may be found on
the last page of this report. Key contributors to this report are
listed in appendix II.
Signed by:
David D. Bellis:
Director, Education, Workforce, and Income Security Issues:
[End of section]
Appendix I: Scope and Methodology:
To obtain nationally representative information on competitive food
availability, policies, decision makers, groups involved in their sale,
and revenues generated by their sale, we conducted two Web-based
surveys. In addition, to gather information on strategies used by
school districts to restrict less nutritious competitive foods in their
schools, we visited six school districts. Further, to inform the design
of our study, we spoke with staff at the U.S. Department of Agriculture
(USDA) as well as the Centers for Disease Control and Prevention (CDC).
We also interviewed numerous researchers and organizations that have
been involved with child nutrition and school health environment issues
in recent years.[Footnote 48]
Surveys:
To better understand competitive foods in the school environment, we
designed and administered two Web-based surveys. For a random sample of
schools, we administered one survey to each school's school food
authority (SFA) director and a second survey to each school's
principal. We chose to survey these officials because we believed they
would be the most knowledgeable sources on competitive food issues in
schools. The surveys were conducted between October 19, 2004, and
February 11, 2005. We defined competitive foods as all foods or
beverages sold to students on school grounds during the school day that
are not part of federally reimbursable school meals.
While neither survey asked questions about the full range of
competitive food issues, together the two surveys were designed to
provide a broad picture of the competitive food environment. Both Web
surveys contained school background, a la carte, (beverage and snack)
vending machine, and school store and snack bar sections. However, each
survey had unique sections as well. The SFA directors' survey included
sections that asked questions about the SFA, the school food service,
and school meals participation. The principals' survey included unique
sections on school and district policies for competitive foods,
including fund-raising and exclusive beverage contracts.
A majority of the survey questions asked both SFA directors and
principals to consider school year 2003-2004. To gain a sense of change
for certain competitive food issues, a few questions asked SFA
directors and principals to consider school year 1998-1999 alone, make
comparisons between these reporting periods (1998-1999 versus 2003-
2004), or consider change in specific competitive food issues over the
entire time of these reporting periods (from 1998-1999 to 2003-2004).
Population:
The target population consisted of all public schools in the 50 states
and the District of Columbia that participated in the National School
Lunch Program (NSLP) for the 2003-2004 school year. We used the
Department of Education's Common Core of Data (CCD) Public Elementary/
Secondary School preliminary file for the 2002-2003 school year as a
basis for defining our population. On the basis of our review of these
data, we determined this source to be adequate for the purposes of our
work.
To define our sampling frame, we removed schools from the CCD that were
permanently or temporarily closed; not yet operational; special
education, vocational education, or alternative/other; run by the
Department of Defense or Bureau of Indian Affairs; or located in
American Samoa, Guam, Northern Marianas, Puerto Rico, or the Virgin
Islands. From this analysis, we obtained a sampling frame consisting of
85,569 regular public schools in the 50 states and the District of
Columbia. However, consistent information specifically identifying a
school's participation in the NSLP was not available in the CCD.
Sample Design and Errors:
The sample design for the Web surveys was a stratified random
probability sample of 656 schools that allows for estimates to be
calculated for each school level (elementary, middle, and high). We
stratified by school level, census region, and rural status, and we
produced estimates by school level. With this probability sample, each
school in the population had a known, nonzero probability of being
selected. Each selected school was subsequently weighted in the
analysis to account statistically for all the schools in the
population, including those that were not selected. Because each school
was randomly chosen, some SFA directors had more than one school under
their responsibility selected for our study, and they were therefore
asked to complete a separate survey for each school.
Because we surveyed a sample of schools, our results are estimates of a
population of schools and thus are subject to sample errors that are
associated with samples of this size and type. Our confidence in the
precision of the results from this sample is expressed in 95 percent
confidence intervals, which are expected to include the actual results
in 95 percent of the samples of this type. We calculated confidence
intervals for this sample based on methods that are appropriate for a
stratified probability sample.
Through a telephone survey of the schools selected in our sample, we
determined the number of schools selected in our sample that
participated in the NSLP. We estimate that 80,245 (94 percent) schools
in our population participated in the NSLP. All estimates produced from
the sample and presented in this report are for the estimated target
population of 80,245 schools that participated in the NSLP. All
percentage and numerical estimates included in this report have margins
of error of plus or minus 15 percentage points or less, except for
those shown in table 6.
Table 5: Sampling Error Calculations for Questions in Which the Error
Exceeded 15 Percent:
Page: 15;
Question: Percentage of elementary schools with vending machines that
had three or more vending machines in school year 2003- 2004;
Estimate: 29;
Lower bound: 15;
Upper bound: 47.
Page: 17;
Question: Percentage of schools with school stores in which salty
snacks (not low-fat) were often or always available for students to
purchase from these stores in school year 2003-2004;
Estimate: 45;
Lower bound: 29;
Upper bound: 61.
Page: 17;
Question: Percentage of schools with school stores in which sports
drinks were often or always available for students to purchase from
these stores in school year 2003-2004;
Estimate: 44;
Lower bound: 28;
Upper bound: 60.
Page: 17;
Question: Percentage of schools with school stores in which sweet baked
goods (not low-fat) were often or always available for students to
purchase from these stores in school year 2003-2004;
Estimate: 40;
Lower bound: 25;
Upper bound: 56.
Page: 17;
Question: Percentage of schools with school stores in which water was
often or always available for students to purchase from these stores in
school year 2003-2004;
Estimate: 47;
Lower bound: 32;
Upper bound: 62.
Page: 20;
Question: Percentage of middle schools with vending machines in which
the total number of vending machines on school grounds increased
between school years 1998-1999 and 2003-2004;
Estimate: 39;
Lower bound: 25;
Upper bound: 54.
Page: 20;
Question: Percentage of elementary schools with a la carte sales in
which the total volume of a la carte items sold to students increased
between school years 1998-1999 and 2003-2004;
Estimate: 31;
Lower bound: 19;
Upper bound: 47.
Page: 24;
Question: Percentage of elementary schools with one group directly
involved in competitive food sales in school year 2003-2004;
Estimate: 36;
Lower bound: 19;
Upper bound: 56.
Page: 24;
Question: Percentage of elementary schools with two groups directly
involved in competitive food sales in school year 2003-2004;
Estimate: 35;
Lower bound: 20;
Upper bound: 53.
Page: 24;
Question: Percentage of elementary schools with three or more groups
directly involved in competitive food sales in school year 2003- 2004;
Estimate: 29;
Lower bound: 14;
Upper bound: 48.
Page: 24;
Question: Percentage of middle schools with two groups directly
involved in competitive food sales in school year 2003-2004;
Estimate: 29;
Lower bound: 17;
Upper bound: 44.
Page: 24;
Question: Percentage of elementary schools with SFA/school food service
directly involved in competitive food sales in school year 2003-2004;
Estimate: 62;
Lower bound: 45;
Upper bound: 77.
Page: 24;
Question: Percentage of elementary schools with student
associations/clubs directly involved in competitive food sales in
school year 2003-2004;
Estimate: 35;
Lower bound: 19;
Upper bound: 52.
Page: 24;
Question: Percentage of middle schools with school officials or
administrators directly involved in competitive food sales;
Estimate: 35;
Lower bound: 21;
Upper bound: 51.
Page: 28;
Question: Percentage of high schools that generated total minimum
combined revenue of $25,001 to $50,000 through competitive food sales
in school year 2003-2004;
Estimate: 21;
Lower bound: 9;
Upper bound: 37.
Page: 32;
Question: Percentage of schools with exclusive beverage contracts that
received noncash benefits through these contracts that were valued at
over $5,000 in school year 2003-2004;
Estimate: 25;
Lower bound: 13;
Upper bound: 41.
Source: GAO.
[End of table]
Nonsampling Errors:
We took steps to minimize nonsampling errors that are not accounted for
through statistical tests, like sampling errors. Nonsampling errors
could figure into any data collection effort and involve a range of
issues that could affect data quality, including variations in how
respondents interpret questions and their willingness to offer accurate
responses.
In developing the Web surveys, we conducted several pretests of draft
instruments. We held pretest discussions of the principals' survey with
staff and members of the National Association of Elementary School
Principals and the National Association of Secondary School Principals.
We pretested the SFA survey with members of the American School Food
Service Association (now known as the School Nutrition Association). In
addition, both surveys were also pretested during a preliminary visit
to the SFA and an elementary school in Fairfax County, Virginia. All
pretests were conducted between July and September 2004.
For the survey pretests, we were generally interested in the clarity of
the questions and the flow and layout of the surveys. For example, we
wanted to ensure definitions used in the surveys were clear and known
to the respondents, categories provided in closed-ended questions were
complete and exclusive, and the ordering of the survey sections and the
questions within each section was appropriate. On the basis of our
pretests, the Web instruments underwent some slight revisions.
After the survey was closed, we also made comparisons between select
items from our competitive food Web-based survey data and other
national-level data sets.[Footnote 49] Our comparisons found our survey
data were reasonably consistent with the external sources. Of the basis
of our comparisons, we believe our survey data are sufficient for the
purposes of our work.
Using Web-based surveys also helped remove error in our data collection
effort. By allowing respondents to enter their responses directly into
an electronic instrument, this method automatically created a record
for each respondent in a data file and eliminated the need for and the
errors (and costs) associated with a manual data entry process. To
further minimize errors, programs used to analyze the survey data and
make estimations were independently verified to ensure the accuracy of
this work.
Response Rates:
For each school in our sample, we attempted to obtain valid e-mail
addresses for the principal and the SFA director. For the 656 schools
in our sample, we obtained valid e-mail addresses for 489 principals
and 455 SFA directors. We administered the surveys to those groups, and
we received completed surveys from 70 percent of the SFA directors and
65 percent of the principals who received the surveys. The response
rates for our sample of 656 schools, including those officials we were
unable to contact, were 51 percent for both principals and SFA
directors, excluding the 26 non-NSLP schools. We received responses
from both the SFA director and the principal for the same school
(matched responses) for 192 schools (30 percent of schools that
participated in the NSLP in our sample). Tables 7 and 8 summarize the
population and sample by school level for the SFA director and
principal surveys respectively.
Table 6: SFA Director Survey: Population and Sample by School Level:
School level: Elementary;
Schools in population: 51,997;
Schools in sample: 188;
Non-NSLP schools: 6;
No valid e-mail: 55;
NSLP schools surveyed: 127;
NSLP schools responding: 85.
School level: Middle;
Schools in population: 15,737;
Schools in sample: 188;
Non-NSLP schools: 3;
No valid e-mail: 45;
NSLP schools surveyed: 140;
NSLP schools responding: 96.
School level: High;
Schools in population: 14,979;
Schools in sample: 188;
Non-NSLP schools: 6;
No valid e-mail: 48;
NSLP schools surveyed: 134;
NSLP schools responding: 103.
School level: Other;
Schools in population: 2,856;
Schools in sample: 92;
Non-NSLP schools: 11;
No valid e-mail: 27;
NSLP schools surveyed: 54;
NSLP schools responding: 35.
School level: Total;
Schools in population: 85,569;
Schools in sample: 656;
Non-NSLP schools: 26;
No valid e-mail: 175;
NSLP schools surveyed: 455;
NSLP schools responding: 319.
[End of table]
Source: GAO.
Table 7: Principal Survey: Population and Sample by School Level:
School level: Elementary;
Schools in population: 51,997;
Schools in sample: 188;
Non-NSLP schools: 6;
No valid e-mail: 39;
NSLP schools surveyed: 143;
NSLP schools responding: 88.
School level: Middle;
Schools in population: 15,737;
Schools in sample: 188;
Non-NSLP schools: 3;
No valid e-mail: 39;
NSLP schools surveyed: 146;
NSLP schools responding: 91.
School level: High;
Schools in population: 14,979;
Schools in sample: 188;
Non-NSLP schools: 6;
No valid e-mail: 41;
NSLP schools surveyed: 141;
NSLP schools responding: 96.
School level: Other;
Schools in population: 2,856;
Schools in sample: 92;
Non-NSLP schools: 11;
No valid e-mail: 22;
NSLP schools surveyed: 59;
NSLP schools responding: 42.
School level: Total;
Schools in population: 85,569;
Schools in sample: 656;
Non-NSLP schools: 26;
No valid e-mail: 143;
NSLP schools surveyed: 489;
NSLP schools responding: 317.
Source: GAO.
[End of table]
While the majority of our estimates are calculated based on survey
responses from either the SFA directors' survey or the principals'
survey, we used the matched responses (192 schools) to calculate the
total combined minimum revenue estimates. Specifically, the amount of
revenue earned from each competitive food venue within a school was
reported by SFA directors and principals in multiple ranges. For
example, SFA directors reported revenue generated by food services
through competitive food sales, such as a la carte sales, and
principals reported revenue generated by all other competitive food
sales in the school. To estimate the combined competitive food revenue
for a school, we defined the minimum for each of the school's venues as
the lower bound of the revenue range reported by SFA directors and
principals. We then summed the minimum revenue across all venues for
each school.
Survey Nonresponse Issues:
Another type of nonsampling error is nonresponse or, in the case of our
work, those SFA directors and principals from schools in our sample who
did not provide a complete survey. To increase survey responses, after
the Web surveys were initially deployed, we made several follow-ups
with nonrespondent SFA directors and principals via e-mail and phone to
remind them of their respective surveys.
After the surveys were closed, we analyzed each set of survey
respondents (SFA directors, principals, and the matched responses) to
determine if there were any differences between the responding schools,
the nonresponding schools, and the population.[Footnote 50] We
performed this analysis for four characteristics--total number of
students enrolled, total number eligible for free lunch, total number
eligible for reduced price lunch, and total number eligible for either
free or reduced price lunch. We determined whether sample-based
estimates of these characteristics compared favorably with the known
population values, and we also tested the differences of the estimates
for survey respondents and nonrespondents. We performed this analysis
for all schools and separately for each school level (high, middle, and
elementary). For each set of survey respondents, the population value
for all of the characteristics we examined fell within the 95 percent
confidence intervals for the estimates. We also determined that there
were no significant differences between estimates from the respondents
and nonrespondents.
Additionally, we compared the distribution of several demographic
variables, including region, school level, and rural status, for survey
respondents and nonrespondents. On the basis of this analysis, we found
no significant distributional differences between respondents and
nonrespondents. Although the characteristics were selected because they
may be related to other school characteristics asked for on our
surveys, we do not know the extent to which the respondents reflect the
population characteristics for our specific survey questions. On the
basis of both sets of analyses, we chose to include the survey results
in our report and produce sample-based estimates to the population of
schools that participated in the NSLP.
Site Visits:
To gather information on local efforts to restrict the availability of
less nutritious competitive foods, we conducted site visits to six
districts between September 21 and December 9, 2004. The districts
visited included Independence School District (Independence, Missouri),
Fort Osage R-1 School District (Independence, Missouri), New Haven
Public Schools (New Haven, Connecticut), Richland County School
District One (Columbia, South Carolina), Oakland Unified School
District (Oakland, California), and McComb School District (McComb,
Mississippi). We selected these districts from a list of approximately
100 districts and schools recognized as making efforts to restrict
access to less nutritious competitive foods. This list was compiled by
reviewing recently released reports, studies, and articles that
described local efforts to make changes to competitive foods. The six
districts visited were selected because they used different strategies
to restrict competitive foods, and when viewed as a group, they
provided variation across characteristics such as geographic location,
district size, and socioeconomic status.
During the site visits, we interviewed district officials, including
the superintendent and SFA director, as well as visited one or two
schools within each district. At the schools, we interviewed
principals, food service staff, and health and physical education
teachers, as well as others involved with the school food environment.
From these interviews, we gathered information on the district and
school food environment, strategies used to restrict competitive foods,
individuals and groups involved in implementing changes, facilitators
and barriers to change, revenues generated by competitive foods,
ongoing efforts, students' reactions to changes, and opinions on the
school wellness policies mandated in the 2004 Child Nutrition and WIC
Reauthorization Act. In addition to our interviews with district and
school officials, we also met with students to collect their opinions
regarding nutrition and healthy eating, competitive foods in schools,
and school meals. Further, we observed at least one lunch period in
each school visited, in order to better understand the school nutrition
environment and the choices students make at lunch.
[End of section]
Appendix II: GAO Contacts and Staff Acknowledgments:
GAO Contacts:
David Bellis, Director, (415) 904-2272, bellisd@gao.gov:
Staff Acknowledgments:
Kay E. Brown, Assistant Director, and Rachel Frisk, Analyst in Charge,
managed this assignment and made significant contributions to all
aspects of this report. Marissa Jones, Avani Locke, Kevin Jackson, and
Jim Ashley also made significant contributions to this report. In
addition, Daniel Schwimer assisted in the legal analysis, Amber Edwards
assisted in the analysis of local efforts to restrict competitive foods
across the country, and Susan Bernstein assisted in the message and
report development.
[End of section]
Related GAO Products:
Commercial Activities in Schools: Use of Student Data is Limited and
Additional Dissemination of Guidance Could Help Districts Develop
Policies. GAO-04-810. Washington, D.C.: August 20, 2004.
Nutrition Education: USDA Provides Services through Multiple Programs,
but Stronger Linkages among Efforts Are Needed. GAO-04-528. Washington,
D.C.: April 27, 2004.
School Meal Programs: Competitive Foods Are Available in Many Schools;
Actions Taken to Restrict Them Differ by State and Locality. GAO-04-
673. Washington, D.C.: April 23, 2004.
School Lunch Program: Efforts Needed to Improve Nutrition and Encourage
Healthy Eating. GAO-03-506. Washington, D.C.: May 9, 2003.
School Meal Programs: Revenue and Expense Information from Selected
States. GAO-03-569. Washington, D.C.: May 9, 2003.
FOOTNOTES
[1] See GAO, School Meal Programs: Competitive Foods Are Available in
Many Schools; Actions Taken to Restrict Them Differ by State and
Locality, GAO-04-673 (Washington, D.C.: April 23, 2004).
[2] These percentages reflect those principals and SFA directors who
actually received the Web surveys. We were unable to contact a subset
of principals and SFA directors selected in our sample of 656 schools.
See appendix I for detailed information on response rates for each
survey.
[3] These data are based on the fiscal year 2004 average daily
participation in the NSLP and the School Breakfast Program, according
to the FNS Program Information Report for December 2004 from USDA.
[4] These requirements for the federal meal programs were established
by Congress in 1994 through the passage of the Healthy Meals for
Healthy Americans Act, Pub. L. No. 103-448, § 106 (1994).
[5] FMNV are defined in regulations for the NSLP (7 C.F.R. § 210.11)
and listed in appendix B of those regulations. USDA has the authority
to change the definition of FMNV and also has established procedures to
amend the list of these foods.
[6] According to regulations, all income from the sale of competitive
foods in the food service area must accrue to the nonprofit food
service provider, the school, or an organization approved by the school.
[7] See GAO-04-673 for more information on the type and extent of
restrictions implemented by state competitive food policies in place as
of March 2004.
[8] For example, some states restrict competitive foods for one half
hour before and after each school meal period, while others restrict
competitive foods from the start of the school day until the end of the
last lunch period.
[9] For more information on federally funded nutrition education
programs, including Team Nutrition, see GAO, Nutrition Education: USDA
Provides Services through Multiple Programs, but Stronger Linkages
among Efforts Are Needed, GAO-04-528 (Washington, D.C.: April 27,
2004).
[10] In addition, USDA published its School Nutrition Dietary
Assessment Study II in 2001, providing information on the nutritional
quality of meals served in public schools that participate in the NSLP
and the School Breakfast Program. This study found that students in
school year 1998-1999 had access to a variety of breakfast and lunch
options other than the federal meal programs.
[11] CDC also reported in its 2000 School Health Policies and Programs
Study that competitive foods were widely available in schools.
[12] WIC is the acronym commonly used to refer to the Special
Supplemental Nutrition Program for Women, Infants, and Children.
[13] We asked survey respondents questions about "school stores and/or
snack bars." Throughout this report, we will use the term "school
stores" to refer to both school stores and snack bars.
[14] A la carte foods, vending machines, and school stores were also
available in some schools during other periods of the school day. In
addition, vending machines and school stores were available in other
locations in some schools, such as outside school buildings.
[15] The elementary school estimate has a margin of error that exceeds
plus or minus 15 percent. See table 6 in appendix I for more
information.
[16] While contracts could be negotiated by the school district, the
school, the school food service, or a combination of those groups, over
half of schools with exclusive beverage contracts had a contract that
was negotiated with the school district.
[17] While the federal government prohibits the sale of soda and
certain candy in cafeterias and food service areas during mealtimes,
these foods can be sold in other locations and during other periods of
the school day. Other less nutritious items, such as sweet baked goods
and salty snacks, can be sold in any school location during any period
of the day.
[18] However, less nutritious foods were available in some elementary
schools. For example, frozen desserts not low in fat were available in
nearly a quarter of elementary schools with competitive foods.
[19] For this analysis, we compared the percentage of middle schools
that had any competitive food venues between school years 1998-1999 and
2003-2004 with the percentage that had any venues in 2003-2004.
[20] According to our survey, the percentage of middle schools with
exclusive beverage contracts increased to 65 percent in 2003-2004 from
26 percent in 1998-1999. An additional 31 percent of middle school
principals were unsure if their school had an exclusive beverage
contract in 1998-1999.
[21] This estimate has a margin of error that exceeds plus or minus 15
percent. See table 6 in appendix I for more information.
[22] The elementary school estimate has a margin of error that exceeds
plus or minus 15 percent. See table 6 in appendix I for more
information.
[23] We did not collect information on the type and extent of
restrictions placed on competitive foods by these policies or on the
enforcement of these policies.
[24] The estimates for SFA/school food service and student
associations/clubs have margins of error that exceed plus or minus 15
percent. See table 6 in appendix I for more information.
[25] The estimate for school officials/administrators has a margin of
error that exceeds plus or minus 15 percent. See table 6 in appendix I
for more information.
[26] Throughout this report, revenue for each type of competitive food
venue includes all revenue generated through competitive food sales. We
did not ask survey respondents for information on profits retained
after covering expenses.
[27] While the number of students in each school likely affects the
amount of revenue generated through competitive foods, our data do not
allow us to determine the effect of school size on revenue.
[28] Total revenue reflects the combined minimums of revenue ranges
reported by schools for a la carte lines, vending machines, school
stores, and exclusive beverage contracts. To conduct this analysis, we
used matched survey responses, which combined the principal and SFA
director's responses for each specific school. We defined the minimum
for each venue as the lower bound of the revenue range selected by the
respondent, and we then summed the minimum revenues across all venues
for each school. See appendix I for a description of this analysis.
[29] For the purposes of this discussion, revenue generated by food
services refers to revenue that was raised by both the school and
district food services.
[30] Many schools also held fund-raisers to generate revenue for
activities and programs, but this revenue is difficult to measure
because of the involvement of numerous groups, and it is not included
in our analysis.
[31] In addition, food services in 20 percent of schools received
supplemental funds from the district or school in 2003-2004, while food
services in 21 percent of schools transferred funds to the district or
school in that year.
[32] Further, because we did not collect information on total school
food service revenue, we were not able to compare food services'
competitive food revenue with their total revenue in 2003-2004 in order
to determine the effect of competitive food revenue on food service
budgets.
[33] GAO, School Meal Programs: Revenue and Expense Information from
Selected States, GAO-03-569 (Washington, D.C.: May 9, 2003). This
report analyzed revenue and expense data from six selected states.
[34] This estimate has a margin of error that exceeds plus or minus 15
percent. See table 6 in appendix I for more information.
[35] We selected Fort Osage School District as one of our site visits
because of the changes made to competitive foods at Fire Prairie Middle
School, and all references to Fort Osage in this report reflect only
the changes made at Fire Prairie.
[36] The only exception to this was Independence, where districtwide
changes had been made to only those competitive foods sold by the SFA
through a la carte lines and vending machines at the time of our visit.
[37] Independence, one of the four districts restricting competitive
foods high in sugar and fat, restricted many, but not all, of these
foods. Further, as noted earlier, Independence made changes to only
those competitive foods sold by the SFA.
[38] In recognition of the importance of fruits and vegetables in
children's diets, Congress included the Fruit and Vegetable Pilot
Program in the 2002 Farm Bill and expanded and made the program
permanent in the 2004 Child Nutrition and WIC Reauthorization Act. This
program provides federal grants to schools in eight states and on three
Indian reservations to provide free fruits and vegetables to students
in order to improve student nutrition and introduce healthy snack
options.
[39] Related to this, students we met with made comments reflecting
their awareness that, in addition to schools, families and the broader
community play a key role in teaching children about good nutrition.
[40] For more information on federally funded nutrition education
programs and efforts to increase healthy eating in schools, see GAO-04-
528 and GAO, School Lunch Program: Efforts Needed to Improve Nutrition
and Encourage Healthy Eating, GAO-03-506 (Washington, D.C.: May 9,
2003).
[41] Specifically, we noticed that pizza appeared to be the most
popular item purchased for lunch by students in almost all of the
schools we visited. Burgers and fresh fruits and vegetables appeared to
be the next most popular items, as they were purchased and eaten by
students during lunch in almost half of the schools we visited. In the
lunch periods we observed, these foods were sometimes sold as
competitive foods and were sometimes served as components of the school
lunch.
[42] McComb used federal resources to assist its own process of
changing competitive foods. Changes in McComb were modeled on the CDC-
developed coordinated school health model.
[43] USDA stated that Action for Healthy Kids, the School Nutrition
Association, and the Food Research and Action Center are among the
organizations that have assisted with these efforts.
[44] Food and Nutrition Service, USDA; CDC, HHS; and the U.S.
Department of Education. Making it Happen! School Nutrition Success
Stories. Alexandria, Va., January 2005.
[45] In the districts we visited, most SFA directors did not express
concerns about potential revenue losses resulting from changes to
competitive foods, possibly because they were often significantly
involved and invested in the process of making these changes.
[46] This publication contains self-reported information by key
contacts from 32 schools and districts nationwide.
[47] Abt Associates, Inc. School Lunch and Breakfast Cost Study-Final
Report, a special report prepared at the request of USDA (Cambridge,
Mass.: October 1994).
[48] We spoke with staff of Mathematica Policy Research Inc., Abt
Associates Inc., Nutrition for the Future Inc., University of
Minnesota--School of Public Health, School Nutrition Association, the
National Association of Secondary School Principals, the National
Association of Elementary School Principals, Samuels & Associates, the
Association of School Business Officials International, the Council of
Chief State School Officers, the National Association of State Boards
of Education, and the National School Boards Association.
[49] We compared our Web-based survey data to data on competitive foods
reported by USDA in the School Nutrition and Dietary Assessment Study
II (1998-1999) and the School Meals Implementation Initiative--Third
Year Report (2002), and by CDC in the School Health Policies and
Programs Study (2000).
[50] Nonresponding schools include both schools for which we were
unable to obtain valid e-mail addresses and schools that received the
survey but did not respond.
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