At just 10 years old, Nicole used to light up the exam room with her cheerful personality. Now, her voice was hushed and her eyes were dull. These subtle signs were immediate red flags for us as medical trainees. Her medical chart illustrated a dire loss in weight from the 50th to the 20th percentile. Her mother’s admission about the increasing difficulty of putting meals on the table solved the puzzle and revealed the underlying issue: childhood food insecurity.
Childhood food insecurity is defined as individuals under 18 years of age experiencing reductions in dietary quality and reduced food intake, often because families cannot afford adequate nutrition. In 2022, an estimated 8.8% of U.S. households with children experienced food insecurity. In Georgia, that rate was 13.3% of households, with its effects being felt across the state. Strikingly, 63% of these households live above the federal poverty line, rendering them ineligible for food assistance programs such as free or reduced lunch. Approximately one-third of parents who pay full or reduced price for school lunch report financial hardship and inability to routinely feed their children at school as a result of school lunch costs, with Georgia having a school meal debt among families of around $90 million.
Credit: Handout
Credit: Handout
Credit: Handout
Credit: Handout
Credit: Handout
Credit: Handout
For children like Nicole, the consequences of childhood food insecurity are devastating. They include impaired memory and interpersonal skills, lower math and reading scores, and increased school absenteeism — all of which hinder educational achievement. The effects also extend to poorer physical health, higher risk of obesity and mental illness, increased emergency room visits and a higher risk of chronic diseases. Financially, these consequences account for $53 billion annually in health care costs.
Georgia must address this crisis by implementing a universal school meals program and the Summer Electronic Benefits for Children initiative. These two policies could dramatically reduce food insecurity and its associated consequences, fostering a healthier, more productive future for Georgia’s youth.
Universal school meals programs ensure free breakfast and lunch for all K-12 students regardless of family income, eliminating stigma, improving classroom behavior and boosting academic performance. States that have adopted universal school meals, such as Colorado and Minnesota, report increased meal participation rates, better attendance, improved classroom engagement and improved physical and mental health among students.
In Georgia, there are efforts to combat childhood food insecurity, such as the Community Eligibility Provisions. CEP offers free school meals to students and has found that schools involved with CEP spend less on meals while retaining the same nutritional quality. However, CEP is nonexistent in 69 Georgia counties and is limited to schools with a significant low-income student population. Expanding to a universal model would bridge this gap, benefiting every child regardless of income.
Even with universal school meals, food insecurity persists during the summer months when school is out. In fact, school-age children experience higher rates of food insecurity during the summer months, a problem that might not be addressed by a universal school meals program.
SEBTC, a federal program that extends Supplemental Nutrition Assistance Program benefits to families of eligible students during the summer, has proved to be a lifeline. A national pilot of SEBTC reduced food insecurity by one-third and improved nutritional outcomes. Yet, Georgia has opted out, citing concerns over SEBTC costs and the existence of community-based summer meal programs. However, these programs often face logistic challenges, including limited transportation for families to meal sites and inconvenient distribution times, leaving many families underserved. Similarly, temporary solutions, such as food banks, have faced food shortages because of rising demand and might lack adequate nutrition for children.
Given these challenges, implementing universal school meals and SEBTC in Georgia is worth the cost, and especially so given the significant return on investment. Healthier, well-fed children are more likely to succeed academically and decrease the length of hospitalization. In turn, there will be reduced health care spending because malnourished children disproportionately use health care services even into adulthood. Universal school meal programs, specifically, can reduce administrative costs and burden faced by staff by eliminating the need for means-testing students that qualify for free or reduced lunch.
In funding SEBTC, the Georgia state government would only need to cover 50% of administrative fees in return for receiving full federal funding to distribute to families. Meanwhile, for universal school meals, Michigan, a state with a similar child population to Georgia, spent $160 million in providing free school meals to public school students and found a litany of improved child health outcomes as a result.
With potential rollbacks in federal funding and stricter eligibility requirements threatening social welfare programs in the Trump administration, it is more urgent than ever for Georgia to protect its children. We urge Georgia’s policymakers to prioritize the health of our children by implementing these programs, which have been endorsed by the American Medical Association and the American Academy of Pediatrics, two leading medical organizations dedicated to promoting child health. The cost of inaction — in lost potential, higher health care expenses and societal inequities — is far greater than the cost of these solutions.
Let’s ensure that no child in Georgia goes hungry, and that Nicole’s story is one that is not repeated. Universal school meals and SEBTC are not just programs; they are lifelines for children and investments in Georgia’s future.
Nicholas Wilson is a medical student at Morehouse School of Medicine. Brendan Pulsifer is a medical student at Emory University School of Medicine. Vishal Panchigar is a medical student at Philadelphia College of Osteopathic Medicine in Georgia.
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