Policy in perspective: Assessing the relationship between malnourishment in children and school meal legislation since the early 20th Century

Abstract

Malnourishment in children has been a cause of governmental concern for over a century. However, the nature of malnourishment has shifted during the 20th Century. Around the time of the Boer War there were concerns that children were not receiving sufficient nutrition which caused under-nourishment whereas today the concern is related to the opposite end of the malnourishment spectrum with increasing numbers of children suffering from over-nourishment. In the early 20th Century the government introduced legislation to allow Local Education Authorities to provide school meals to under-nourished children in order to prevent associated malaise and allow them to benefit from the education they were receiving. School meal legislation has been altered and amended over the course of a century to shape our children’s bodies and minds.

This thesis analyses whether government policies for school meals have, since their introduction in 1906 in England, had a genuine impact (either positive or negative) on observed, longitudinal changes in childhood nutrition. The thesis assesses a series of cross-sectional data for children’s height and weight collected in the UK from 1908 to the present in order to estimate changes in malnutrition (including underweight, overweight, and obesity) for UK children. This quantitative analysis is contextualised with qualitative data on the development of legislation relating to school meals and interviews/focus groups with school cooks in an attempt to identify potential relationships. The thesis discusses observed fluctuations in the nutritional status of children in relation to the changes in government legislation on school meals and contextualises the findings with the wider literature.

The findings suggest that fluctuations in child malnourishment are not easily attributed to changes in one category of government legislation. However, when placed into the context of wider sociological changes the increasing prevalence of childhood obesity seen from the mid-1980s appears to be strongly associated with changes in government welfare provision, of which the school meal forms a small part.
Moreover, this thesis suggests that contemporary associations between low socio-economic status and overweight and obesity prevalence may not have manifested until after 1994. Children who received a free school meal between 1972 and 1994 had, on average, a lower body mass index (BMI) Z-score than children who had a paid school meal, had a packed lunch or went home. Additionally, there were strong relationships between low BMI Z-score and parent’s social class. Overweight and obesity in children rose sharply from the mid-1980s onwards during a period of legislative changes which, according to school cooks, significantly affected the quality of school meals. However, it was not possible to directly attribute these rises to the changes in school meal legislation.

Although the school meal has been used as a tool for governing child malnourishment it is not possible to untangle rises in obesity and overweight from wider sociological phenomena which may have also influenced these increases. This thesis suggests that while legislation for school meals may be protective against under-nourishment in children it is currently unclear to what extent this affects childhood obesity.