What are the long-term benefits of Sweden’s universal free school meals scheme?

Professor Petter Lundborg is one of three researchers who recently studied the long-term benefits of that policy in Sweden, finding that both the children and wider society benefited significantly. We spoke to Professor Lundborg about the findings and how they could be interpreted here in England, where we, along with campaign partners, have been calling for school food for all. 

Why did Sweden introduce universal primary free school meals?

Sweden started introducing universal primary free school meals (UPFSM) in 1946 because policymakers at the time were extremely worried that the food children were bringing in from home contained very little nutrition. The concerns ranged from children struggling to learn at school to citizens being too physically weak to defend the country at a time of unrest. The government commissioned a 300-page report to analyse the contents of children’s lunch bags to address what they deemed to be a serious threat to public health.

It’s important to note that the policy was not about children going hungry. Practically everybody had access to food, with Sweden then one of the top five richest countries in the world. The issue was strictly the nutritional content of that food. About two-thirds of the pupils had a lunch brought from home consisting only of milk and cheese sandwiches. The government felt it needed to step in and put this right.

Can you explain how Sweden went about implementing universalism?

In 1946, parliament decided that if a municipality wanted to offer school lunches, the government would provide subsidies to cover the entire cost, not only for the food but also building the kitchens and hiring staff. In order to access the funding, there were certain requirements the municipalities had to fulfil. School food menus had to be strictly followed as they were designed to deliver the nutrition that children needed. To access funding, receipts were required as evidence of compliance.

Gradually, more and more municipalities applied for this funding and were offering school lunches to all primary children. The state reduced the subsidies in the following years before phasing them out completely in the late 60s, by which time every municipality had implemented UPFSM. There was no law saying that municipalities had to continue providing school meals for all, but they continued owing to the clear success of the programme.

Fast forward to today, all municipalities have to provide school meals universally by law to children in primary schools. They no longer have to comply with strict school food menus, but schools are expected to follow the Nordic Nutrition Recommendations.

What made you interested in studying the long-term benefits of UPFSM?

Professor Dan-Olof Rooth and I are old-time colleagues and friends. We’re both economists who do research around labour, health and education, and we’ve always been interested in evaluating the long-term impact of policies. We found UPFSM in Sweden to be a particularly fascinating one to look at. In Sweden, we had a unique opportunity to do this, as few countries have a very well-thought-out school lunch system that reaches every child.

How did you go about your research?

We quickly realised this was not going to be an easy thing to analyse. UPFSM rolled out across Sweden from 1946 to 1969, but nobody knew when exactly the policy arrived in each municipality. So we teamed up with one of my PhD students at the time - Dr Jesper Alex-Petersen - who spent several months in the national archives outside Stockholm finding receipts that the municipalities handed into the government to get their state subsidies.

We were then able to see when each municipality introduced UPFSM and link up that information to data from the national registry, which told us where every pupil would have been living. Essentially, we knew who had access to school lunches and who didn’t at any time. That was our starting point.

In Sweden, everyone has a personal ID number. Researchers, with ethical approval, can request Statistics Sweden to connect these IDs to health, education, and tax records. This allowed us to analyse the long-term outcomes of children receiving school meals, comparing those with a full nine years of access to free meals, to those with fewer years or none at all.

What did you find?

The earliest outcome we could see was that pupils who benefitted from the school lunch programme became significantly taller, reflecting improved nutritional intake and overall health. Boys and girls grew about 0.8 and 0.6 centimetres respectively after nine years of accessing the programme. Boys were also more likely to have near-perfect health at the age of 18, when they would get their military enlistment health check. We however found little variation in health outcomes over the longer term - when they reached their 50s and 60s - which could be explained by multiple factors.

We saw that the longer pupils received school lunches, the more likely they were to stay in school or go to university. Those who had them throughout primary school stayed in education for an additional 0.28 years. It would have been great to have been able to see the impact on test results, but that data wasn’t available anywhere, unfortunately.

Children from the poorest families who had school lunches throughout primary school ended up earning 6% more in their lifetime. That's a lot when you think about different social policies designed to equalise society. But we also found positive effects for children from the most affluent families.

Your research mentions there being some initial opposition to UPFSM. Can you talk about that?

We read up on why it was that some municipalities introduced the UPFSM policy early on while others took some time. We found that there was initially a lot of resistance, especially in the southern part of Sweden, where it was believed that it was not the business of the state to feed children, but rather that it was something for parents to do themselves. And so the rollout started more in the north part of the country where some school meals schemes already existed for the poorest families. At some point, even the southern regions started to change their mind, because they started hearing about the perceived benefits - that children became calmer and more attentive in class etc. Today, the universal school lunch policy is supported across the political spectrum. There’s now a conversation about introducing universal breakfasts as well, however, some of those negative opinions have resurfaced.

Your study says your findings are ‘relevant for Western countries today’. How so?

Sweden introduced the UPFSM policy all those years ago to address poor nutrition and raise awareness around eating well, and today, we see a lot of those same concerns across the Western world. There are some differences, the key one being that we didn’t have a high rate of obesity back then. But that doesn’t change the fundamental idea that schools are places where you can ensure children get healthy, nutritious food.

In England today, lots of children are arriving at school hungry. Is the case for universalism stronger because of this?

Our study found providing school food for all children in Sweden had significant positive long-term effects, particularly among the poorest. It likely follows that universalism will have even greater benefits in a country where there are more disadvantaged children. And it could create large gains for society as a whole in comparison to other social policies you can think of. In a sense, you could say it's very costly not to have this policy in place.

At School Food Matters we would certainly agree with Professor Lundborg’s final point which is why we’re campaigning for school food for all. Our thanks to Professor Lundborg for taking the time to share this compelling case study.