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In 2019, the National School Lunch Program and School Breakfast Program served approximately 15 million breakfasts and 30 million lunches daily at low or no cost to students. Access to these meals has been disrupted as a result of long-term school closures related to the COVID-19 pandemic, potentially decreasing both student nutrient intake and household food security. By the week of March 23, 2020, all states had mandated statewide school closures as a result of the pandemic, and the number of weekly missed breakfasts and lunches served at school reached a peak of approximately 169.6 million; this weekly estimate remained steady through the final week of April. We highlight strategies that states and school districts are using to replace these missed meals, including a case study from Maryland and the US Department of Agriculture waivers that, in many cases, have introduced flexibility to allow for innovation. Also, we explore lessons learned from the pandemic with the goal of informing and strengthening future school nutrition policies for out-of-school time, such as over the summer. (Am J Public Health. Published online ahead of print September 17, 2020: e1–e9. https://doi.org/10.2105/AJPH.2020.305875 )

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BACKGROUND: Approximately 8% of schoolchildren in the United States experience potentially life-threatening food allergies.They must diligently avoid allergenic foods and have prompt access to epinephrine to treat anaphylaxis. These prevention strategies must be sustained without interruption, posing a range of challenges at school. METHODS:We conducted semi-structured interviews with 178 participants about their experiences managing food allergies outside the home. Interviews were transcribed and analyzed using an iterative approach in NVivo 10. RESULTS:Participants reported highly varied school experiences across the ecological model. They described the need to be proactive and self-sufficient to manage food allergies. Whereas food allergy-related social exclusion was common, participants also described positive peer interactions, including intensive peer engagement and support. They perceived that formal school policies were limited in scope and inconsistently implemented. Prevention-oriented policies were more common in lower grades than in higher grades. CONCLUSIONS:Poorly defined and implemented policies disrupted students' social and educational experiences at school, families' relationships with school staff, and, ultimately, the safety and wellbeing of students with allergies. Given the high prevalence of food allergies among children, these findings demonstrate the need for multiple layers of support to facilitate safe, socially inclusive food allergy management at schools. F ood allergy prevalence is on the rise, and an estimated 8% of children ages 0-17 in the United States are affected. 1 Food-induced anaphylaxis, a severe, life-threatening allergic reaction, resulted in a 285% increase in pediatric (ages 5-17) emergency department visits between 2005 and 2014. 2 Food allergy management demands diligent avoidance of allergenic foods and uninterrupted access to life-saving epinephrine. Both strategies require sustained behavioral control, presenting particular challenges for adolescents. Approximately 18% of children with food allergies experience a reaction at school over

One in seven Americans participates in the Supplemental Nutrition Assistance Program (SNAP), making it the largest federally funded food assistance program. SNAP benefits are distributed once per month and both food spending and calorie consumption tend to decrease as time from benefit distribution increases. The monthly SNAP benefit cycle has serious implications for the health and financial stability of low-income families, a growing number of whom rely on SNAP as their sole source of income. Relatively little is known about the specific coping strategies households use to manage the SNAP cycle. The purpose of this study is to provide a critical exploration of the nature and timing of coping strategies for managing the SNAP cycle, including implications these coping mechanisms have for health and financial stability. This paper presents data from a prospective cohort study of mothers (n = 12) receiving SNAP benefits in Philadelphia between 2016 and 17. Both in-depth qualitative and survey methods were used. Participants reported on a variety of coping strategies they used to manage the SNAP cycle, including adjustments to shopping and eating patterns, mental accounting, emotional resilience, and social support. Instrumental social support was particularly vital in the final days of the benefit cycle, as were skipping meals and purchasing less expensive, energy-dense foods. Constant vigilance was required throughout the month to manage financial instability. The coping strategies for managing the SNAP cycle have short-term benefits, such as buffering against hunger and financial instability, however these survival strategies may have negative long-term repercussions for physical and financial health.