Date of Conferral





Public Health


Michael S. Dunn


The rapid rise in U.S. high school student obesity rates to 20.8% in 2018 presented significant risks to the health and well-being of American children and foreshadowed increased future healthcare costs. To address high school obesity, Congress passed the Healthy Hunger-Free Kids Act (HHFKA) in 2010 that mandated the U.S. Department of Agriculture develop regulations to nutrition to improve the nutrition of school cafeteria breakfasts and lunches. The purpose of this quantitative study was to test for changes between 2009 and 2016 in high school obesity rates attributable to the HHFKA using Youth Risk Behavior Surveillance System data, adjusted for known covariates of median income, population density, and ethnicity. A quantitative explanatory research design was employed to evaluate the efficacy of USDA 2010 Nutritional Guideline compliance to reduce high school obesity rates. Mean differences between state-level obesity rates were tested with paired t tests conducted with SPSS 24®. Twenty-seven (54%) states achieved 100% compliance with USDA 2010 Nutritional Guideline and 23 (46%) states were, on average, 86% compliant. During the period from 2000 to 2016, mean high school obesity rates increased by 2.5% from 12.5% (SD = 2.4%) to 14.8% (SD = 2.9%), p > .000. The increase in mean high school obesity rates were significant (p < .000) after controlling for median income, population density, and ethnicity. The causes of high school obesity are complex and intractable. While the HHFKA was a commonsense approach to addressing obesity, mean high school obesity rates continued to climb. The devastating personal and societal cost of high school obesity demands additional research and interventions to improve students’ lives.