Written by: Emily McGraw, MAT, MPH Student, Cornell MPH Program

Public health gives us the tools to support healthy people living in healthy communities. In my previous career as an educator, I came to understand the importance of strong systems. Without analyzing the bigger picture, we might not see the real issues, and we might not solve the right problem.

This semester, my peers and I are all working on ‘applied projects’ with community partners, where I have come to realize how important systems are in the world of public health as well. In this work, we meaningfully engage with community partners to unpack an issue of focus while applying systems thinking and an ethics framework to co-develop plans for change. Through this work, I am able to make connections with my past work – understanding how and why some things worked well under my leadership and realizing the value of sharing my experiences with classmates who are trying to address similar issues.

Before finding public health, I was a principal at a middle school in Brooklyn – a role I stepped into nine weeks into the school year. Student hunger, inattentiveness, moodiness, and restlessness were pervasive during morning classes. So, I decided to observe the morning flow, to better understand the problems. I saw that students bypassed poorly placed lunch-bags outside of classrooms, most forgoing breakfast altogether. Those that did eat “breakfast” tended to pull out sour pour straws or Takis from their bookbag. Not exactly the ideal scenario for a place where students come each day to learn, especially given the impact breakfast can have on increased attention, improved memory recall, and enhanced cognitive function. I knew something needed to change, and fast.

In 2003, New York City adopted universal school breakfast for all regardless of income. In theory? This sounds great. In practice? There are some problems. Research shows that implementation of universal breakfast only led to small changes in breakfast participation rates, particularly amongst low-income children.¹ Even with New York City’s expansion to breakfast in classroom programs in 2015, breakfast consumption remains low in New York City schools at only 33%, which is particularly troubling given that 1 in 5 students in New York City are food insecure.¹ Within my own school in Brooklyn, rates of food security were even higher, at approximately 60%.

To address the issue we identified, my team and I worked to re-design our entire morning arrival system to encourage morning breakfast, starting with students first point of entry. Every morning, students first greeted me at the door, where I enthusiastically reminded students to get a breakfast when they got to class and let students know what they would have to eat once they were in the room. Overdramatic? Probably, but it helped. Every teacher or administrator they passed along the way also would remind students to grab a breakfast. Once students got upstairs, breakfast was in the room, not just near the room. Teachers gave repeat reminders and created an environment where students happily ate breakfast, socialized, and listened to calm music before the start of the instructional day. We also implemented strategies for students who arrived late. Every student could have access to breakfast at school, every day.

In our school, breakfast became celebrated, ultimately decreasing stigma associated with free breakfast and offering a specific time for social-emotional learning. These little nudges had a big impact: breakfast consumption increased dramatically in my school, from approximately 10% in October to 80% by the end of December.

What I learned, and what I helped my peers learn, is that traditional breakfast programs may not be enough to reach all students. The best solutions will likely be school-specific, and there are many strong examples out there that others are trying. For example, “Breakfast after the Bell”, which offers grab and go breakfasts options to students after first period improves student access to nutritious breakfast and increases breakfast consumption.² During the 2019 school year, public schools in New York State with more than 70% of students eligible for free or reduced-price meals adopted Breakfast after the Bell, following a pilot study in Newburgh, NY which saw a 133% increase in breakfast participation rates.^1,2

As a former teacher and principal, I’ve seen the value of breakfast first hand, on both academic achievement and student behavior, and luckily, I’ve got the research to back me up. Students who eat breakfast not only perform better in school, but also have fewer disciplinary issues, improved school attendance, and better overall diet quality, therefore leading to fewer vitamin deficiencies and chronic illnesses.³ Ultimately, hunger impacts a child’s ability to learn in school.

By working with schools to understand their context, constraints, and vision, the right approach can be selected to ensure that all students can have access to healthy food for breakfast, no matter what time they arrive to school.

1. School Breakfast Report. Hunger Solut N Y. https://hungersolutionsny.org/school-meals-hub-ny-0/school-breakfast-program/school-breakfast-report/. Accessed April 2, 2019.
2. A simple solution for New York’s child-hunger problem. Crain’s New York Business. https://www.crainsnewyork.com/article/20171227/OPINION/171229971/breakfast-after-the-bell-is-a-simple-solution-for-new-york-s-child-hunger-problem. Published December 21, 2017. Accessed April 2, 2019.
3. Leos-Urbel J, Schwartz AE, Weinstein M, Corcoran S. Not just for poor kids: The impact of universal free school breakfast on meal participation and student outcomes. Econ Educ Rev. 2013;36:88-107. doi:10.1016/j.econedurev.2013.06.007