The Make America Healthy Again (MAHA) movement that emerged during the 2024 general election season has focused a lot of its energy on improving the nutritional quality of the food served in school meal programs around the country, and there is certainly room for improvement there. However, with the average cost of preparing a school meal estimated to be between $2.95 and $3.58, school administrators have found themselves relying heavily on pre-packaged, processed foods to give to students to keep costs down. While incorporating more fresh fruits and vegetables and whole grain foods into school menus is more desirable from a nutritional point of view, these foods are also more expensive. The National School Lunch program feeds around 30 million students on a regular basis every year.
However, public schools are not the only institutions in the United States that serve meals to large numbers of people in controlled settings, and past analyses suggest that many of the people being served in those settings are not receiving good quality, nutritious food in those meals, at least on a consistent basis.
According to data collected by the non-profit Prison Policy Initiative, there are approximately 1.97 million people currently being held in federal and state prisons as well as local jails, juvenile detention facilities, and immigration detention facilities within the United States. The share of incarcerated people in the United States has typically been just above 500 per 100,000 residents, which is well above the shares found in other developed countries in Europe, North America and East Asia. For example, the comparable share in Canada is only 85 per 100,000 residents and only 36 per 100,000 residents in Japan.
The average age of prisoners held in federal facilities is 42 years, and about 10 percent of them are aged 60 years or older. At the state level, the average age is somewhat younger, at 36 years old, with a similar share (about 10 percent) 60 years or older.
There are also at least 2.5 million senior citizens living in either certified nursing facilities or long-term care facilities in the United States, the majority of whom receive meals regularly through custodial care arrangements. The mean age for people entering such facilities is 84 years old, and new residents are often facing severe disabilities or health problems even before they arrive.
Data provided by both state and federal prison systems indicate that most states spend less than $3.00 per day to feed their inmates, and the federal Bureau of Prisons (BOP) estimates that it spends between $3.00 and $4.00 per day for each prisoner. This amount is mandated to account for three meals per day in most jurisdictions, so the food served typically consists of a lot of carbohydrates for each meal–cold cereal or oatmeal for breakfast, and rice, potatoes, or pasta for lunches and dinners, often incorporating low-cost protein such as eggs, cheese, and ground beef. To the extent that prisoners get to eat fruits and vegetables, they are typically canned or frozen products.
Past federal court rulings have determined that prisons are required to provide their inmates with ‘nutritionally adequate food on a regular basis’, or risk violations of the inmates’ constitutional protections against cruel and unusual punishment (Eighth Amendment). In the last few decades, there have been hundreds of lawsuits filed against both publicly and privately operated prison dining systems on such grounds, but only a few have been successful, in part due to the vagueness of the ‘nutritionally adequate’ language in those earlier rulings. Some judges have explicitly ruled that prisons cannot use a deliberately inadequate dietary regime to punish individual prisoners for infractions.
Inmates have the opportunity to supplement their meals with food products purchased at their prison commissaries, but not all prisoners have access to the financial resources from the outside necessary to afford such transactions on a regular basis. Most prisoners earn some money in prison industry jobs while incarcerated, but hourly wages for such work are quite low, typically well under $1.00, which doesn’t go very far in buying items at commissaries. In addition, the food available in such outlets typically fall into the category of shelf stable processed foods such as Ramen noodles and canned tuna, as well as numerous snack foods such as chips, cookies, and sodas. While consuming such foods may add to inmates’ caloric count, it does not seem likely to improve their overall diet quality.
The average U.S. nursing home spends between $10 and $12 per day on food provided to residents, with some spending as little as $4-$6 per day. There are currently no federal mandates that dictate how much such facilities must spend on food for residents, although they are legally required to serve residents three meals a day at established times, and that the meals be “nourishing, palatable, well-balanced, and meet national dietary allowances.”
The types of food served in nursing homes and related facilities do not differ substantially from those described above for prison inmates, although with the higher daily rate, fresh fruits and vegetables are served more frequently, as well as cooked vegetables. The proteins served in these facilities are also likely to be of somewhat better quality, typically lean meats, poultry, and fish. Dairy products are also provided in many of these facilities, unlike the state and federal prisons. These facilities are also supposed to provide specialized diets to address specific health/medical conditions of residents when appropriate.
With respect to all of these institutional settings, one of the main obstacles to serving more nutritional meals is the lack of appropriate kitchen facilities and trained personnel in many of these places, thus necessitating a heavy reliance on serving pre-packaged foods which often consist of ultra-processed foods that lack key vitamins and nutrients.
