In October 2018, I formed a grass-roots advocacy group called The NYC Healthy School Food Alliance. I was working hard to convince New York City’s Office of Food and Nutrition Services to dump the highly-processed bag-to-oven foods they were serving 1.1 million children a day and to transition to more healthful scratch-cooked meals—real food cooked by real people. By March of this year, I had been meeting with the DOE and elected officials and had a scratch-cooking implementation bill before our City Council to move this goal along. Its vote has been postponed for now due to COVID-19.
Now, we are in a world blighted by pandemic, where the City has slashed budgets to continue to offset the costs of fighting this horrible disease. Mayor Bill de Blasio has proposed over $827 million in cuts from the education department, and the Chancellor has already said there is no room for additional cuts without painful effects on classrooms.
School meals will be part of these cuts. The proposed budget includes $15.6 million in savings from "Programmatic Underspending Savings"—described as a re-estimate of annual program expenses including school food and adult education; a directive that "School Food Reduces the budget to align closer to actual spending"—which will lead to $9.6 million in cuts per year for 4 years; and Food Contract Efficiencies Savings, which "will be achieved from lower costs associated with a food contract" at $4M/year for 4 years.
But cuts to school food are short sited and will cost us far more in the long term. That's been made crystal clear by this pandemic.
Diet-Related Disease and COVID
While there are many mysteries surrounding COVID, this much is true: low-income black and brown individuals are being hit hardest. That's because of structural racism that has led to, among other things, a higher percentage of diet-related disease in black and brown families. And diet-related disease is what's making COVD-19 deadly for so many.
A paper published in the journal JAMA about New York State’s largest health system found that of those who died of COVID-related complications, 57 percent had hypertension, 41 percent were obese and 34 percent had diabetes. In her most recent story for the Times, the health and science journalist Jane Brody spoke about the correlation between diet and disease, and more specifically this disease, COVID-19. In her piece, she interviewed Dr. Dariush Mozaffarian, Dean of the Freidman School of Nutrition Science and Policy at Tufts University, who cited a recent national report describing poor diet as “now the leading cause of poor health in the U.S.” and the cause of more than half a million deaths per year.
“Only 12 percent of Americans are without high blood pressure, high cholesterol, diabetes or pre-diabetes,” Dr. Mozaffarian continued. “The statistics are horrifying, but unlike COVID they happened gradually enough that people just shrugged their shoulders. However, beyond age, these are the biggest risk factors for illness and death from Covid-19.”
Given how tightly high blood pressure, high cholesterol, diabetes and pre-diabetes are tied to COVID-19, and that the pandemic is disproportionately affecting populations already experiencing health and wealth disparities—mainly low income and communities of color—we must use this pandemic as a wake up call to prioritize the health of our children and bring back real scratch-cooked meals to every public school.
Why Scratch Cooking?
The influence of school lunch on our children cannot be underestimated. Children spend an average of 6.64 hours per day in school and consume up to one half of their daily calories at school. The Office of Food and Nutrition Services in NYC relies on hyper-palatable, pre-packaged, ready to heat, branded, longer shelf life foods that are contributing to the global prevalence of obesity and other diet-related diseases.
The dangers of highly-processed foods have been documented in peer reviewed journals and highlighted in a slew of recent research. Ultra-processed foods are associated with obesity, diabetes, inflammatory diseases, gastrointestinal disorders, hypertension, coronary and cerebrovascular diseases, and total and breast cancer.
A recent study published in JAMA Internal Medicine, showed an association between ultra-processed consumption and overall higher mortality risks. A 10% increase in the proportion of ultra-processed foods consumed was associated with a 14% higher risk of mortality, regardless of the cause. This research rings a siren call for change away from processed foods, particularly in the age of COVD-19.
Poor nutrition has contributed to the rising burden of diet-related diseases in the United States. These include cardiovascular disease, high blood pressure, type 2 diabetes, obesity, and cancer. A recent report from the Harvard T.H. Chan School of Public Health published in The New York Journal of Medicine predicts that by 2030, nearly 1 in 2 adults in the United States will be obese, and nearly 1 in 4 will be severely obese. Moreover, severe obesity is forecasted to become as prevalent as overall obesity was in the 1990s, becoming the most common BMI among women, non-Hispanic black adults, and low- income adults. The associated medical treatments will bring healthcare costs to staggering highs. In 2016, the direct and indirect costs of chronic diseases as a result of obesity were $1.72 trillion — almost 10 percent of the nation’s gross domestic product.
These future adults are our today’s children. Nearly one-third of children and youth in the state of New York are obese or overweight. In the state of New York, childhood obesity has tripled within the state over the past three decades. Within NYC, 40% of NYC public school students aged 6 to 12 are overweight or obese. These high rates increase health risks among growing children. Scratch-cooked meals can reverse this trend and set our children on a course to healthier lives full of opportunity.
An Issue of Equity
School food is not just an issue of health and quality of life; it is an issue of equity. Those ultra-processed, fast food school lunches aren’t eaten by every child in the lunchroom; two-thirds of kids eating school meals don’t have the option of bringing packed lunch from home. The lack of accessible, affordable, healthy food for children living in low-income neighborhoods results in diets containing fast foods and convenience store items. These are the children who receive a significant portion of their daily nutrition requirements at school. All of our children deserve better, not just those who are privileged enough to have families with the means to provide lunch from home.
Healthier Meals Means Better Academic Success
Healthier lunches not only lead to better health outcomes for children, they also impact brain development and academic success. According to a report from the Brookings Institute, when a school contracts with a healthy lunch company, students at the school score better on end-of-year academic tests. On average, student test scores were about 4 percentile points higher. Not only that, the test score increases are about 40 percent larger for students who qualify for reduced-price or free school lunches.
Beyond the physical, the increased consumption of processed foods is linked to a greater likelihood of or risk for anxiety and depression in adults. A study published in the American Journal of Public Health found evidence of a significant relationship between unhealthy dietary patterns and poorer mental health in children and adolescents.
The Way Forward
Imagine for a moment with me. Instead of mozzarella sticks and hot pockets, Tostitos Taco Bowls and microwaved "egg" sandwiches, caramel-colored burger pucks zapped in soggy buns, cheese fries and turkey roll-up heated and left to congeal, imagine a school lunchroom with fresh homemade, scratch-cooked food on every plate—bowls of grains and greens, spaghetti and homemade meatballs, spiced curries and fat dumplings, barbecued chicken and summer corn, homemade mac and cheese, plates of fruit and warm cookies fresh from the oven. This is possible.
Sure it will take effort. And money, too. Scratch-cooking will require significant capital investment in infrastructure, staff training, as well as a shift in procurement away from processed foods to fresh ingredients, a pilot program in the Bronx has proven that all of this is possible in New York City. Researchers from Columbia University have found that returning to scratch cooking is an attainable goal for the nation’s largest school district, New York City, which feeds over 900,000 public school children a day.
Their report — Cooking Outside the Box: How a Scratch Cooking Pilot in the Bronx is Reshaping Meals In New York City Schools — evaluated a scratch-cooking pilot run by chef Daniel Giusti’s Brigaid at several public schools in the Bronx during the 2018–2019 school year.
The study found that the pilot program was a success and could be scaled. The researchers emphasized that both food and labor costs increased initially, but leveled off with time and scale. “This pilot demonstrates a successful shift away from processed foods currently on the menu is possible,” said Pam Koch, executive director of Columbia University’s Laurie M. Tisch Center for Food, Education & Policy. “The potential positive impacts of scratch cooking on students’ diets, health, academic achievement, and sense of community are enormous.”
The bottom line is this: scratch cooking can be achieved. It will not happen overnight and it will take time, significant investment, and perhaps most importantly, leadership with a long view and a strong desire for change.
This pandemic has shown us all too clearly the price of poor nutrition and diet-related disease. We cannot afford cuts to school food. We must do what we can to fund a school food revolution now, whether that means bringing in private investment and imposing higher taxes on the wealthy, or following the lead of Denver’s Healthy Food Food Denver Kids Campaign, which established a nominal sales tax (less than a penny on any $10 purchase) to fund healthy food access and education programs for youth in Denver over a 10-year period. It is expected to yield $11.2 million in the first year and as much as $100 million over the full 10 years—to Denver organizations that are already working to get more healthy food to children in low-income families.
What we cannot do is throw up our hands and cry uncle in the face of this pandemic. We cannot allow this disease to prevent us from moving forward and making changes that will save lives and livelihoods. We must prioritize the health of our children so that the next pandemic does not take them.