Larger WIC Cash Value Benefit for Vegetables and Fruit Is Associated With Lower Food Insecurity and Improved Participant Satisfaction in WIC Families With Children

Abstract

Objectives In response to the COVID-19 pandemic, the USDA announced a temporary augmentation of the cash value benefit (CVB) for vegetables and fruits across all Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) agencies nationally, increasing the child CVB from $9 to $35/month for 4 months in the summer of 2021. The augmentation has continued since October 2021, with children ages 1 to 4 years receiving a CVB of $24/month. This study aimed to understand if augmenting the value of the WIC CVB for vegetables and fruits is associated with access to fruits and vegetables, fruit and vegetable intake (FVI), household food insecurity, and WIC program satisfaction among WIC participants from Los Angeles County, California. Methods This longitudinal, observational study of the 2021 CVB augmentation involved data collection using surveys at three time points: baseline (May 2021), midpoint (September 2021, before the CVB reduced from $35 to $24/month) and endpoint (May 2022, to be conducted). Detailed data on child FVI (using the NHANES Dietary Screener Questionnaire), household food security (using the USDA 6-item food security screener), and parental perception of the CVB changes were collected. Descriptive statistics and changes in study outcomes for respondents from baseline to midpoint were calculated in the full sample and stratified by race and ethnicity. Results 1,673 families completed both baseline and midpoint surveys. Following the increased CVB amount ($9 to $35), the proportion of families reporting the benefit was ‘not enough’ decreased (89% to 23%) and the proportion saying the benefit was ‘just right’ increased (7% to 73%) (p < 0.0001). Household food insecurity decreased following the increase in CVB (55% to 44%, p < 0.0001). Child FVI decreased between baseline and midpoint surveys (2.43 vs 2.37 cups/day, p < 0.01). Baseline to midpoint change in FVI did not differ significantly by race and ethnicity (p = 0.19). Conclusions A short-term increase in WIC CVB was associated with improved participant experience and higher food security in California WIC participants. Longer-term increases in CVB may be needed to improve child fruit and vegetable intake. Funding Sources Robert Wood Johnson Foundation Healthy Eating Research Program and The David and Lucile Packard Foundation.

Caregivers’ Perceived Impact of WIC’s Temporary Cash-Value Benefit (CVB) Increases on Fruit and Vegetable Purchasing, Consumption, and Access in Massachusetts

“…These findings align with those recently reported from studies conducted in other states, with unique retail contexts and diverse participant needs [ 25 , 26 , 27 , 28 ]. Studies to date on caregiver perceptions of this temporary increase demonstrate a consensus: WIC caregivers associate this increase in CVB with an increase in FV purchasing and consumption, as well as an increase in satisfaction with the WIC food package [ 25 , 26 , 27 , 28 ].…”

“…These findings align with those recently reported from studies conducted in other states, with unique retail contexts and diverse participant needs [ 25 , 26 , 27 , 28 ]. Studies to date on caregiver perceptions of this temporary increase demonstrate a consensus: WIC caregivers associate this increase in CVB with an increase in FV purchasing and consumption, as well as an increase in satisfaction with the WIC food package [ 25 , 26 , 27 , 28 ]. CVB may thus serve not only as a nutrition policy tool for increasing FV consumption among households at high risk of low FV consumption due to cost and access, but CVB may also as a strategic target for policy and advocacy efforts in addressing suboptimal WIC retention and redemption [ 32 ].…”

“…Moreover, this study found that the perceived benefits of the CVB increase on FV purchasing and FV consumption appear to have been equitably distributed in terms of race/ethnicity, caregivers’ food access environments, and food security status, as others have reported [ 26 ]. The differences by race/ethnicity in perceived benefit to reduced out-of-pocket cost may be reflective of the differences in average monthly grocery expenses reported by the families in this sample; Hispanic caregivers were more likely to report spending over $201/month out-of-pocket on groceries (post-CVB-increase) than NH White or NH Black caregivers (18.1%, 12.8%, 6.8%, respectively), and therefore may have been less sensitive to the financial benefit of the CVB enhancement.…”

“…Few differences in the probability of reporting improved outcomes were observed by race/ethnicity, market access, or food security status, though future research is necessary to confirm. These preliminary findings add to a growing body of literature in support of making this temporary benefit enhancement permanent [ 25 , 26 , 27 , 28 ], as a means of ensuring that the WIC food package continues to meet the evolving needs of low-income women, infants, and children in the United States.…”

“…Recent studies in California [ 25 , 26 ], North Carolina [ 27 ], and Delaware [ 28 ] suggest that this temporary increase is highly valued by WIC caregivers and may be linked with improvements in FV affordability, purchasing, and consumption, as well as overall WIC satisfaction. However, research on the perceived impact of this emergent temporary increase remains limited to mostly qualitative studies [ 25 , 27 , 28 ].…”