Strategy overview

  • Reducing cost and distance barriers: Programs focused on increasing access to healthy food tend to focus on eliminating specific barriers that families and children face. These include free meal programs at schools, mobile and farmers markets in underserved areas, and fruit and vegetable incentives programs, which provide subsidies to families and businesses to purchase and stock healthy foods, respectively.
  • Reaching children and families at school: Successful healthy food access programs are often based in schools. With many children receiving breakfast and lunch on site, meal delivery provides an opportunity for increased healthy food consumption. This may be supplemented with programs such as fruit and vegetable gardens attached to a school’s playground.
  • Incentivizing healthy food purchases: Another approach relies on financial incentives, subsidies, and discounts for individual consumers shopping at grocery stores. Such incentives can often be provided in tandem with SNAP benefits, though they are often funded by nonprofits. Many programs also include grants, subsidies, and educational opportunities for business owners to strengthen their ability to stock fresh and healthy foods.
  • Supplementing access with education: Beyond increasing physical access to healthy food, some programs provide education to encourage long-term healthy habits. This can include public awareness campaigns on the benefits of healthy diets, recipes and cooking techniques for preparing healthier foods, subsidized exercise classes, and access to a nutritionist, such as in school-based clinics.

Multiple comprehensive reviews found that interventions increasing access to healthy food are associated with significant improvements in nutrition, physical activity, healthy habit formation, and physical health.

  • A 2021 systematic review found that universal school meals improved nutritional content of meals eaten, food security, and academic performance.

  • A 2020 research synthesis found that investing in school gardens is associated with increased consumption of fruits and vegetables among students, improved overall nutrition and physical health through increased physical activity, and decreased instances of obesity.

  • A 2020 research review found that fruit and vegetable incentive programs increase purchases and consumption of fruits and vegetables and other healthy foods and improve food security. Effects were largest when initiatives included a nutritional education program and proactively distributed incentives to use at farmers markets and other stores.

  • A 2016 systematic review found that school-based interventions which focus on providing healthier foods for snacks or meals decreased rates of overweight/obesity and increase fruit and vegetable consumption.

Before making investments in school-based supports for child health and well-being, city and county leaders should ensure this strategy addresses local needs.

Mathematica has developed indicator frameworks to help local leaders assess conditions related to upward mobility, identify barriers, and guide investments to address these challenges. This indicator framework can serve as a starting point for self-assessment, not as a comprehensive evaluation, and should be complemented by other forms of local knowledge.

Mathematica's Education-to-Workforce (E-W) Indicator Framework helps local leaders identify the data that matter most in helping students and young adults succeed. Local leaders can use the E-W framework to better understand education and workforce conditions in their communities and to identify strategies that can improve outcomes in these areas.

One indicator in the E-W Framework may be improved with investments in this strategy. To measure this indicator and determine if investments in this strategy could help, examine the following:

  • Food securityPercentage of individuals with high or marginal food security, as measured by the U.S. Department of Agriculture’s (USDA) Food Security Survey Module or percentage of individuals living in a census track with low access to healthy food, as defined by the USDA’s Food Access Research Atlas.

  • Increasing food stability: Healthy food programs can increase food stability for children and their families. Food stability is a key factor in short- and long-term economic mobility outcomes for children, including improved health, academic performance, and ultimately, workforce readiness.
  • Reducing obesity: Access to healthy food can reduce childhood obesity and related health problems. Research shows health problems associated with obesity can result in worse labor market outcomes, including lower wages and reduced productivity.

  • Eliminate logistical barriers: Prioritize geographic convenience and the consumer experience through a deliberate program design. This can include ensuring incentive programs are compatible with SNAP and other public benefits, expanding hours at farmers markets or participating grocery stores, accepting a wide range of payment types (including SNAP and electronic transfers), and ensuring programs are located in underserved neighborhoods or in central, transit accessible locations.
  • Incorporate healthy foods into school activities: Schools can serve as the primary access point to healthy dietary habits within a community. Collaborate with school leaders and teachers to improve the nutrition of on-site meals and snacks, and identify additional educational opportunities, such as through school gardens.
  • Supplement access programs with other healthy habits: Include fitness and nutrition education components to the program, such as discounts on gym memberships or free sessions with a nutritionist. Such efforts can create a virtuous cycle resulting in a healthier overall lifestyle.
  • Ensure cultural relevance: Healthy meal programs and incentives should include culturally important foods consistent with the values and traditions of program participants. Solicit feedback from community members to ensure the program design is compatible with cultural needs.
  • Raise awareness and support: Amplify the effects of an initiative by investing in community engagement and uptake. For instance, dedicate a portion of the budget to advertising for farmers markets; send home flyers advertising free healthy school meals; and include information on fruit and vegetable incentives alongside public benefits. Additional efforts can include general public service announcements on healthy habits and reducing stigmas around free meals.

Evidence-based examples

Plots of land owned by local governments, non-profits, or other groups that are dedicated as a gardening space for public use on a membership basis
Supportive neighborhoods Stable and healthy families
Incentives, subsidies, or price discounts for healthy foods and beverages and disincentives or price increases for unhealthy or less nutritious foods and beverages
Supportive neighborhoods Stable and healthy families
Weekly markets in public spaces offering fresh fruits and vegetables, nutrition education, and more
Supportive neighborhoods
Offering low-income residents matching funds to purchase healthy foods, especially fresh fruits and vegetables
Supportive neighborhoods Stable and healthy families
Healthy living and nutrition education classes, increased physical activity opportunities, and school-wide promotion of healthy food options
Elementary and middle school success High school graduation Stable and healthy families

Evidence varies across specific models

Fully-subsidized and nutritious breakfast at school, often involving culturally relevant practices and food options
Kindergarten readiness Elementary and middle school success High school graduation Stable and healthy families
School-based gardens that host programming including nutrition education, food preparation lessons, and tasting opportunities
Elementary and middle school success High school graduation Stable and healthy families
Behavioral intervention to increase SNAP up-take.
Stable and healthy families