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The problem
Intervention: Universal free school meal (UFM) policy adoption providing free breakfast and lunch to all students
Who it was tested with: 131,851 children continuously enrolled in Medicaid in Arkansas schools that adopted UFM policies.
Children or communities are compared with a group that did not receive the intervention, or followed over years. This is the design that best separates what the intervention did from everything else that changed.
"Using linked Arkansas education and Medicaid claims data (2013-2020) and a stacked difference-in-differences design across 4 UFM adoption cohorts, we examined changes in Medicaid spending among 131 851 continuously enrolled Medicaid children before and after school-level UFM adoption." This is an experimental design with a comparison approach (difference-in-differences with multiple adoption cohorts), allowing causal inference about the policy effect on health spending.
Study shows correlation in Medicaid claims data, not confirmed causal mechanisms; limited to one state's Medicaid population; changes in mental health spending may reflect utilization shifts rather than health improvements; no information on whether dietary quality improvements directly drove mental health changes.
Across countries and designs
3 studies · 2 countries
