Opportunity beyond the first 1000 days: school feeding and child health in rural China

Health inequalities often originate in early childhood, but millions of children miss the critical intervention window of the first 1000 days of life. We investigate whether nutritional investments during the school years can help these children recover. To do so, we analyze China’s Nutrition Improvement Program (NIP), the world’s third-largest school feeding program. Using nationally representative longitudinal data from 2010 to 2018 and difference-in-differences models, we find substantial and cumulative gains in height-for-age and reductions in stunting. The program also lowers overweight and obesity, suggesting that school feeding can alleviate undernutrition without exacerbating overnutrition. Moreover, children with poorer nutritional status and lower socioeconomic status experience greater improvements from the NIP; among them, those with better access to healthcare services in early life are more likely to recover from stunting. Shifts in dietary patterns and reduced morbidity likely drive the program’s effects. Our findings indicate that interventions targeting school-age children can generate meaningful growth recovery and reduce health disparities that emerge early in life.