title: Socioeconomic Differences in the Association Between Competitive Food Laws and the School Food Environment.
abstract: BACKGROUND
  Schools of low socioeconomic status (SES) tend to sell fewer healthy competitive foods/beverages. This study examined whether state competitive food laws may reduce such disparities.
  
  
  METHODS
  School administrators for fifth- and eighth grade reported foods and beverages sold in school. Index measures of the food/beverage environments were constructed from these data. Schools were classified into SES tertiles based on median household income of students' postal zip code. Regression models were used to estimate SES differences in (1) Healthy School Food Environment Index (HSFEI) score, Healthy School Beverage Environment Index (HSBEI) score, and specific food/beverage sales, and (2) associations between state competitive food/beverage laws and HSFEI score, HSBEI score, and specific food/beverage sales.
  
  
  RESULTS
  Strong competitive food laws were positively associated with HSFEI in eighth grade, regardless of SES. Strong competitive beverage laws were positively associated with HSBEI particularly in low-SES schools in eighth grade. These associations were attributable to schools selling fewer unhealthy items, not providing healthy alternatives. High-SES schools sold more healthy items than low-SES schools regardless of state laws.
  
  
  CONCLUSIONS
  Strong competitive food laws may reduce access to unhealthy foods/beverages in middle schools, but additional initiatives are needed to provide students with healthy options, particularly in low-SES areas.
authors.affiliation: University of Texas Health Science Center at Houston-Austin Regional Campus, 1616 Guadalupe St., Suite 6.300, Austin, TX 78701. Daniel.Taber@uth.tmc.edu.
authors.forename: Daniel R
authors.initials: DR
authors.lastname: Taber
authors.affiliation: University of Illinois at Chicago, 1747 W. Roosevelt Rd., Chicago, IL 60608. jchriqui@uic.edu.
authors.forename: Jamie F
authors.initials: JF
authors.lastname: Chriqui
authors.affiliation: University of Illinois at Chicago, 1747 W. Roosevelt Rd., Chicago, IL 60608. powelll@uic.edu.
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Powell
authors.affiliation: Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, 9609 Medical Center Dr., Room 3E104, Rockville, MD 20850. pernafm@mail.nih.gov.
authors.forename: Frank M
authors.initials: FM
authors.lastname: Perna
authors.affiliation: Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 2104B McGavran-Greenberg Hall, Chapel Hill, NC 27599-7435. whitney_robinson@unc.edu.
authors.forename: Whitney R
authors.initials: WR
authors.lastname: Robinson
authors.affiliation: University of Illinois at Chicago, 1747 W. Roosevelt Rd., Chicago, IL 60608. fjc@uic.edu.
authors.forename: Frank J
authors.initials: FJ
authors.lastname: Chaloupka
mesh_terms: D002648:Child; D004465:Economic Competition / Q000331:legislation & jurisprudence; D005522:Food Services / Q000331:legislation & jurisprudence*; D006801:Humans; D007881:Legislation, Food / Q000191:economics*; D012572:School Health Services / Q000331:legislation & jurisprudence*; D012959:Socioeconomic Factors; D013219:State Government; D014481:United States
keywords: child and adolescent health; evaluation; health policy; nutrition and diet; public health