Taber Daniel R, Chriqui Jamie F, Powell Lisa M, Perna Frank M, Robinson Whitney R, Chaloupka Frank J
University of Texas Health Science Center at Houston-Austin Regional Campus, 1616 Guadalupe St., Suite 6.300, Austin, TX 78701.
University of Illinois at Chicago, 1747 W. Roosevelt Rd., Chicago, IL 60608.
J Sch Health. 2015 Sep;85(9):578-86. doi: 10.1111/josh.12288.
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.
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.
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.
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.
社会经济地位（SES）较低的学校往往销售较少的健康竞争性食品/饮料。本研究调查了州竞争性食品法律是否可能减少此类差异。
五、八年级的学校管理人员报告了学校销售的食品和饮料。根据这些数据构建了食品/饮料环境的指数衡量指标。学校根据学生邮政编码所在地区的家庭收入中位数被分为社会经济地位三分位数。回归模型用于估计（1）健康学校食品环境指数（HSFEI）得分、健康学校饮料环境指数（HSBEI）得分以及特定食品/饮料销售方面的社会经济地位差异，以及（2）州竞争性食品/饮料法律与HSFEI得分、HSBEI得分以及特定食品/饮料销售之间的关联。
无论社会经济地位如何，强有力的竞争性食品法律与八年级的HSFEI呈正相关。强有力的竞争性饮料法律与HSBEI呈正相关，尤其是在八年级的低社会经济地位学校。这些关联归因于学校销售的不健康食品减少，而非提供了健康的替代选择。无论州法律如何，高社会经济地位学校比低社会经济地位学校销售更多的健康食品。
强有力的竞争性食品法律可能会减少中学获取不健康食品/饮料的机会，但需要额外的举措为学生提供健康选择，尤其是在低社会经济地位地区。
