title: Disparities persist in nutrition policies and practices in Minnesota secondary schools.
abstract: Access to healthy foods among secondary school students is patterned by individual-level socioeconomic status, but few studies have examined how school nutrition policies and practices are patterned by school-level characteristics. The objective of our study was to examine school nutrition policies and practices by school characteristics (eg, location, racial/ethnic composition, and free/reduced priced lunch eligibility) in Minnesota secondary schools between 2008 and 2012. Data from the 2008 to 2012 Minnesota School Health Profiles survey were used to assess school nutrition policies and practices, and National Center for Educational Statistics data were used for school characteristics (n=505 secondary schools). Nutrition policies and practices included the availability of low-nutrient, energy dense (LNED) items, strategies to engage students in healthy eating, and restrictions on advertisements of LNED products in areas around the school. Among school-level characteristics, school location was most strongly related to school nutrition policies. Across all years, city schools were less likely than town/rural schools to have vending machines/school stores (prevalence difference [PD] -13.7, 95% CI -25.0 to -2.3), and less likely to sell sport drinks (PD -36.3, 95% CI -51.8 to -20.7). City schools were also more likely to prohibit advertisements for LNED products in school buildings (PD 17.7, 95% CI 5.5 to 29.9) and on school grounds (PD 15.6, 95% CI 1.7 to 29.5). Between 2008 and 2012, the prevalence of some healthy eating policies/practices (eg, limiting salty snacks, offering taste testing, and banning unhealthy food advertisements in school publications) declined in city schools only, where these policies/practices had previously been more common. Monitoring of these trends is needed to understand the influence of these policies on student outcomes across school settings.
authors.forename: Caitlin E
authors.initials: CE
authors.lastname: Caspi
authors.forename: Cynthia
authors.initials: C
authors.lastname: Davey
authors.forename: Toben F
authors.initials: TF
authors.lastname: Nelson
authors.forename: Nicole
authors.initials: N
authors.lastname: Larson
authors.forename: Martha Y
authors.initials: MY
authors.lastname: Kubik
authors.forename: Brandon
authors.initials: B
authors.lastname: Coombes
authors.forename: Marilyn S
authors.initials: MS
authors.lastname: Nanney
mesh_terms: D005247:Feeding Behavior; D005509:Food Dispensers, Automatic; D005522:Food Services / Q000592:standards*; D006801:Humans; D008910:Minnesota; D018673:Nutrition Policy; D012424:Rural Population; D012574:Schools / Q000592:standards*; D062410:Snacks; D013334:Students; D013383:Suburban Population; D014505:Urban Population
keywords: Adolescent obesity; Health disparities; Nutrition-related policies; Rural health; Secondary schools