Special Supplemental Nutrition Program for Women, Infants, and Children Participation and Infants’ Growth and Health: A Multisite Surveillance Study
* Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland
Hennepin County Medical Center, Minneapolis, Minnesota
Boston University School of Medicine/Public Health, Boston, Massachusetts
|| Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas
¶ Harbor-UCLA, Los Angeles, California
# Mary’s Center for Maternal and Child Health, Washington, District of Columbia
Context. The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is the largest food supplement program in the United States, serving almost 7 500 000 participants in 2002. Because the program is a grant program, rather than an entitlement program, Congress is not mandated to allocate funds to serve all eligible participants. Little is known about the effects of WIC on infant growth, health, and food security.
Objective. To examine associations between WIC participation and indicators of underweight, overweight, length, caregiver-perceived health, and household food security among infants 
12 months of age, at 6 urban hospitals and clinics.
Design and Setting. A multisite study with cross-sectional surveys administered at urban medical centers in 5 states and Washington, DC, from August 1998 though December 2001.
Participants. A total of 5923 WIC-eligible caregivers of infants 12 months of age were interviewed at hospital clinics and emergency departments.
Main Outcome Measures. Weight-for-age, length-for-age, weight-for-length, caregiver’s perception of infant’s health, and household food security.
Results. Ninety-one percent of WIC-eligible families were receiving WIC assistance. Of the eligible families not receiving WIC assistance, 64% reported access problems and 36% denied a need for WIC. The weight and length of WIC assistance recipients, adjusted for age and gender, were consistent with national normative values. With control for potential confounding family variables (site, housing subsidy, employment status, education, and receipt of food stamps or Temporary Assistance for Needy Families) and infant variables (race/ethnicity, birth weight, months breastfed, and age), infants who did not receive WIC assistance because of access problems were more likely to be underweight (weight-for-age z score = –0.23 vs 0.009), short (length-for-age z score = –0.23 vs –0.02), and perceived as having fair or poor health (adjusted odds ratio: 1.92; 95% confidence interval: 1.29–2.87), compared with WIC assistance recipients. Rates of overweight, based on weight-for-length of >95th percentile, varied from 7% to 9% and did not differ among the 3 groups but were higher than the 5% expected from national growth charts. Rates of food insecurity were consistent with national data for minority households with children. Families that did not receive WIC assistance because of access problems had higher rates of food insecurity (28%) than did WIC participants (23%), although differences were not significant after covariate control. Caregivers who did not perceive a need for WIC services had more economic and personal resources than did WIC participants and were less likely to be food-insecure, but there were no differences in infants’ weight-for-age, perceived health, or overweight between families that did not perceive a need for WIC services and those that received WIC assistance.
Conclusions. Infants 12 months of age benefit from WIC participation. Health care providers should promote WIC utilization for eligible families and advocate that WIC receive support to reduce waiting lists and eliminate barriers that interfere with access.
Key Words: WIC • growth • health • food security • infants
Abbreviations: WIC, Special Supplemental Nutrition Program for Women, Infants, and Children • TANF, Temporary Assistance for Needy Families • USDA, United States Department of Agriculture
Received for publication Aug 8, 2003; Accepted Feb 10, 2004.
CiteULike 
Connotea 
Del.icio.us 
Digg 
Facebook 
Reddit 
Technorati 
Twitter What's this?
This article has been cited by other articles:
|
|
 |
|
  M. Chilton, M. M. Black, C. Berkowitz, P. H. Casey, J. Cook, D. Cutts, R. R. Jacobs, T. Heeren, S. E. de Cuba, S. Coleman, et al. Food Insecurity and Risk of Poor Health Among US-Born Children of Immigrants Am J Public Health, March 1, 2009; 99(3): 556 - 562. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. M Schneider, M. L Fujii, C. L Lamp, B. Lonnerdal, K. G Dewey, and S. Zidenberg-Cherr The use of multiple logistic regression to identify risk factors associated with anemia and iron deficiency in a convenience sample of 12-36-mo-old children from low-income families Am. J. Clinical Nutrition, March 1, 2008; 87(3): 614 - 620. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. Rose-Jacobs, M. M. Black, P. H. Casey, J. T. Cook, D. B. Cutts, M. Chilton, T. Heeren, S. M. Levenson, A. F. Meyers, and D. A. Frank Household Food Insecurity: Associations With At-Risk Infant and Toddler Development Pediatrics, January 1, 2008; 121(1): 65 - 72. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. M. Black, H. Dubowitz, A. Krishnakumar, and R. H. Starr Jr Early Intervention and Recovery Among Children With Failure to Thrive: Follow-up at Age 8 Pediatrics, July 1, 2007; 120(1): 59 - 69. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Y. Wang and M. A. Beydoun The Obesity Epidemic in the United States--Gender, Age, Socioeconomic, Racial/Ethnic, and Geographic Characteristics: A Systematic Review and Meta-Regression Analysis Epidemiol. Rev., May 17, 2007; (2007) mxm007v1. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. T. Kimbro, J. Brooks-Gunn, and S. McLanahan Racial and Ethnic Differentials in Overweight and Obesity Among 3-Year-Old Children Am J Public Health, February 1, 2007; 97(2): 298 - 305. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. A. Hanks Community Empowerment: A Partnership Approach to Public Health Program Implementation Policy Politics Nursing Practice, November 1, 2006; 7(4): 297 - 306. [Abstract] [PDF]
|
|
|
|
|
|
R. C. Whitaker, S. M. Phillips, and S. M. Orzol Food Insecurity and the Risks of Depression and Anxiety in Mothers and Behavior Problems in their Preschool-Aged Children Pediatrics, September 1, 2006; 118(3): e859 - e868. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. Rose, J. N. Bodor, and M. Chilton Has the WIC Incentive to Formula-Feed Led to an Increase in Overweight Children? J. Nutr., April 1, 2006; 136(4): 1086 - 1090. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. M. Black, H. Dubowitz, P. H. Casey, D. Cutts, R. F. Drewett, D. Drotar, D. A. Frank, R. Karp, D. B. Kessler, A. F. Meyers, et al. Failure to Thrive as Distinct From Child Neglect Pediatrics, April 1, 2006; 117(4): 1456 - 1458. [Full Text] [PDF]
|
|
|
|
 |
|
 C M Wright, K N Parkinson, and R F Drewett The influence of maternal socioeconomic and emotional factors on infant weight gain and weight faltering (failure to thrive): data from a prospective birth cohort Arch. Dis. Child., April 1, 2006; 91(4): 312 - 317. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Meyers, D. Cutts, D. A. Frank, S. Levenson, A. Skalicky, T. Heeren, J. Cook, C. Berkowitz, M. Black, P. Casey, et al. Subsidized Housing and Children's Nutritional Status: Data From a Multisite Surveillance Study Arch Pediatr Adolesc Med, June 1, 2005; 159(6): 551 - 556. [Abstract] [Full Text] [PDF]
|
|
