Nutrition programme for children faces “unequal” uptake across US

According to a nationwide analysis of data from the US federal Child and Adult Care Food Program (CACFP), current participation rates by licensed child care centres point to programme “underutilisation and unequal access”.

CACFP is one of the 15 federal nutrition assistance programmes created with the intent to reduce food insecurity and improve nutrition. It provides reimbursements for meals and snacks served to participating childcare centres, family daycare homes, emergency shelters, after-school programmes, and adult daycare centres. According to the study, CACFP reached 4.58 million individuals in fiscal year 2022 but with researchers claiming it is being “underutilised”, this number could grow if the programme was used differently.

The study was published by Elsevier in the American Journal of Preventive Medicine, with Lead Investigator Tatiana Andreyeva, PhD, Department of Agricultural and Resource Economics, Rudd Center for Food Policy and Health, University of Connecticut, stating that CACFP is “underutilised and underappreciated.

“Despite offering robust programme benefits, including better nutrition for children, help for families, food cost reimbursement for childcare providers, and the local infusion of federal dollars, our study found that participation – averaging only 36.5 percent across all licensed centres and 57.5 percent in low-income areas – lags behind other federal nutrition assistance programs and is unequal across states,” said Andreyeva.

In fact, the full-study sample revealed that participation rates across states varied from 15.2 percent to 65.3 percent. This percentage gap grew wider when analysing low-income areas where the gap stood between from 15.7 percent to 85.7 percent.

Meanwhile, the researchers found that higher-income areas had an average participation rate of 31.8 percent. However, differences were observed in CACFP participation rates across USDA regions, with the highest rates observed in the Southeast and lowest in the West and Mountain Plains regions.

To carry out the study, data was gathered from state agencies that oversee licensing and CACFP and merged with data that included sociodemographics to assess household income in communities where centres were located. The researchers identified CACFP-eligible childcare centres based on their location in low-income areas.

Three states were not included in the research including Alabama, Montana and North Carolina, as they “not provide adequate data”.

Looking at contributing factors to CACFP’s “inconsistent uptake”, Andreyeva said: “States have power to increase access to the programme that would help so many young children and their care providers.

“Understanding factors shaping the decisions of child care centres to provide meals and participate in CACFP should be a priority for the USDA, state agencies, and advocates seeking to improve child nutrition and food security.”

USDA commits to nutrition security and behavioural health research

Recommendations include encouraging states to regularly assess and track participation among eligible providers and emphasise programme outreach. In addition, federal policymakers “can and should play a much larger role in expanding access to CACFP”, explained the researchers, who believe that “at the federal level, CACFP does not appear to receive the attention and funding that other nutrition assistance programmes do”.

“CACFP has potential to help feed so many young kids, but we see evidence that the program is not being used consistently. We want to acknowledge the states that do a phenomenal job in getting providers to join the program and feed kids,” concluded Co-Investigator Erica L. Kenney, ScD, Department of Nutrition, Harvard T.H. Chan School of Public Health.