This study examines child care food subsidies provided through the Child and Adult Care Food Program (CACFP). Because of the very limited prior research on the CACFP, the study addresses three basic questions about participation in and effects of the program:
Does the CACFP reach targeted children?
How do participating families and child care providers differ from nonparticipating families and providers?
What is the association between attending CACFP-participating child care and children’s food consumption, food insecurity, and body weight?
To answer these questions, the study uses a nationally representative sample of children and child care providers from the Early Childhood Longitudinal Study, Birth Cohort (ECLS-B). In 2001, the ECLS-B sampled newborns from Vital Statistics birth records from nearly every State. The child’s primary nonparental child care provider was contacted for an interview when the child was age 2 and again at age 4. ZIP Code information is used to link information on the child’s area of residence to the ECLS-B data. This area analysis is motivated by program rules that base provider eligibility, in part, on area characteristics (such as local poverty rates and participation in school meal programs).
Does the CACFP reach targeted children? Results on program targeting indicate both that CACFP misses many targeted (poor) children and that it serves a sizable fraction of nonpoor children. Targeting of benefits to needy 2-year-olds is particularly problematic because over 80 percent of 2-year-olds are cared for by parents at home or in an unlicensed child care home, yet children in those settings are generally ineligible. Targeting of needy 4-year-olds is better because many spend time in Head Start centers, where CACFP participation is nearly universal, or in other participating centers. Still, poor children who live outside of high-poverty areas and are cared for in centers are much less likely to receive CACFP than similar children in high-poverty areas. Moreover, even at age 4, nearly 40 percent of children are cared for by parents at home or in an unlicensed child care home, and a substantial proportion of these children are poor.
How do participating families and child care providers differ from nonparticipating families and providers? Family and provider characteristics, including location, are associated with participation in CACFP. Participation is higher among parents who work long hours, who emphasize child care quality, and those of lower socioeconomic status. Provider characteristics also clearly matter. Large, licensed, accredited and nonprofit centers are more likely to participate, as are those connected to Head Start through referrals (or that serve children who participate in Head Start).
What is the association between attending CACFP-participating child care and children’s food consumption, food insecurity, and body weight? Among low-income 4-year-olds in centers, participation in CACFP is associated with increased milk, vegetable, and fruit consumption (two or more servings per day) and lower risk of underweight status. There is little evidence that CACFP increases the prevalence of overweight among this group of 4-year-olds or that CACFP is associated with food insecurity.
Although additional research is needed to replicate our results, ideally with a stronger causal design, evidence of an association of CACFP with these positive nutritional outcomes for disadvantaged children should give additional emphasis to improved targeting of the program. Highest priority should go to reaching poor children cared for outside of licensed homes and child care centers and to those who reside in areas where market forces may work against participation by providers, such as lower poverty areas.
Direct inquiries about this study to the Project Contact listed above.