Abstract:BACKGROUND AND OBJECTIVES:
The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), one of the largest US safety net programs, was revised in 2009 to be more congruent with dietary guidelines. We hypothesize that this revision led to improvements in child development.
METHODS:
Data were drawn from a cohort of women and children enrolled in the Conditions Affecting Neurocognitive Development and Learn… Show more
“…For instance, prior studies have found that the revision led to improvements in proximal outcomes including dietary quality and access to healthy foods [6,9]. Additionally, a smaller number of studies have looked at perinatal health in sub-national samples [14][15][16]. As a specific example, one previous study found positive improvements in gestational weight gain following the revision [14].…”
Section: Discussionmentioning
confidence: 99%
“…Second, we evaluated change in parent-reported health similar to the question for adults described above. Finally, results from a systematic review suggest that improvements to overall dietary quality led to improvements in mental health for children [ 31 ], while another study found that the 2009 WIC revision improved child development outcomes among recipient children [ 16 ]. Therefore, we additionally evaluated changes to children’s mental health, which was measured for children aged 2–3 years with the Mental Health Indicator (MHI) score.…”
Section: Methodsmentioning
confidence: 99%
“…Since the 2009 WIC revision was implemented, several studies have documented the positive effects of the new food package on retail food availability [6][7][8][9], women's and children's dietary quality [9][10][11][12][13], and maternal nutrition [6]. There has been less research on downstream health effects, with studies in California and South Carolina finding improvements on perinatal and birth outcomes [14,15] and studies in Tennessee finding improvements in children's growth and cognitive development [16]. No studies to our knowledge have examined the downstream effects of the revision on women's and children's health at a national level.…”
Background:
The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) was revised in 2009 to be more congruent with national dietary guidelines. There is limited research examining effects of the revision on women’s and children’s health. The objective of this study was to evaluate whether the revised WIC food package was associated with various indicators of physical and mental health for women and children.
Methods:
We used 1998–2017 waves of the National Health Interview Survey (N = 81,771 women and 27,780 children) to estimate effects of the revised WIC food package on indicators of health for both women (self-reported health and body mass index) and children (anemia, mental health, and parent-reported health). We used difference-in-differences analysis, a quasi-experimental technique that assessed pre-post differences in outcomes among WIC-recipients while “differencing out” the secular underlying trends among a control group of non-recipients.
Results:
For all outcomes evaluated for women and children, we were unable to rule out the null hypothesis that there was no effect of receiving the revised WIC food package. These findings were confirmed across several secondary analyses conducted to assess heterogeneity of effects and robustness of results.
Conclusion:
While we did not find effects of the revised WIC food package on downstream health indicators, studies using similarly robust methods in other datasets have found shorter-term effects on more proximal outcomes related to diet and nutrition. Effects of the modest WIC revisions may be less impactful on longer-term indicators of health, and future studies should examine the larger COVID-19-era expansion.
“…For instance, prior studies have found that the revision led to improvements in proximal outcomes including dietary quality and access to healthy foods [6,9]. Additionally, a smaller number of studies have looked at perinatal health in sub-national samples [14][15][16]. As a specific example, one previous study found positive improvements in gestational weight gain following the revision [14].…”
Section: Discussionmentioning
confidence: 99%
“…Second, we evaluated change in parent-reported health similar to the question for adults described above. Finally, results from a systematic review suggest that improvements to overall dietary quality led to improvements in mental health for children [ 31 ], while another study found that the 2009 WIC revision improved child development outcomes among recipient children [ 16 ]. Therefore, we additionally evaluated changes to children’s mental health, which was measured for children aged 2–3 years with the Mental Health Indicator (MHI) score.…”
Section: Methodsmentioning
confidence: 99%
“…Since the 2009 WIC revision was implemented, several studies have documented the positive effects of the new food package on retail food availability [6][7][8][9], women's and children's dietary quality [9][10][11][12][13], and maternal nutrition [6]. There has been less research on downstream health effects, with studies in California and South Carolina finding improvements on perinatal and birth outcomes [14,15] and studies in Tennessee finding improvements in children's growth and cognitive development [16]. No studies to our knowledge have examined the downstream effects of the revision on women's and children's health at a national level.…”
Background:
The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) was revised in 2009 to be more congruent with national dietary guidelines. There is limited research examining effects of the revision on women’s and children’s health. The objective of this study was to evaluate whether the revised WIC food package was associated with various indicators of physical and mental health for women and children.
Methods:
We used 1998–2017 waves of the National Health Interview Survey (N = 81,771 women and 27,780 children) to estimate effects of the revised WIC food package on indicators of health for both women (self-reported health and body mass index) and children (anemia, mental health, and parent-reported health). We used difference-in-differences analysis, a quasi-experimental technique that assessed pre-post differences in outcomes among WIC-recipients while “differencing out” the secular underlying trends among a control group of non-recipients.
Results:
For all outcomes evaluated for women and children, we were unable to rule out the null hypothesis that there was no effect of receiving the revised WIC food package. These findings were confirmed across several secondary analyses conducted to assess heterogeneity of effects and robustness of results.
Conclusion:
While we did not find effects of the revised WIC food package on downstream health indicators, studies using similarly robust methods in other datasets have found shorter-term effects on more proximal outcomes related to diet and nutrition. Effects of the modest WIC revisions may be less impactful on longer-term indicators of health, and future studies should examine the larger COVID-19-era expansion.
“…[21][22][23][24] Research on health outcomes has been limited, with a handful of studies finding that the revised WIC program improved maternal and child dietary quality, [25][26][27][28] GWG, infant birth weight, and measures of child growth and development. [29][30][31] Select studies involved rigorous, quasiexperimental designs, but used small samples or narrow geographies. Further research is needed to evaluate the effects of the revised WIC program in a more generalised sample to inform national policymaking.…”
Section: Department Of Agriculture Enacted Major Revisions To the Wicmentioning
confidence: 99%
“…Prior studies have found that the revised WIC program was associated with increased availability of healthy foods at neighbourhood stores 19,20 and increased household expenditures on healthy foods 21–24 . Research on health outcomes has been limited, with a handful of studies finding that the revised WIC program improved maternal and child dietary quality, 25–28 GWG, infant birth weight, and measures of child growth and development 29–31 . Select studies involved rigorous, quasi‐experimental designs, but used small samples or narrow geographies.…”
Background
The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is the largest U.S. nutrition program for low‐income pregnant women. It was revised in 2009, with the goal of improving nutritional content of food packages, enhancing nutrition education, and strengthening breast feeding support. Few studies have assessed the effects of this revision on perinatal health.
Objectives
To investigate the impact of the revised WIC program on maternal and child health in a large, multi‐state data set.
Methods
We conducted a quasi‐experimental difference‐in‐differences analysis, comparing the pre/post changes among WIC recipients to changes among non‐recipients. We adjusted for key sociodemographic covariates in multivariable linear models. We used data from the Pregnancy Risk Assessment Monitoring System (PRAMS) for 18 states from 2004 to 2017.
Results
The main analysis included 331,946 mother‐infant dyads. WIC recipients were more likely to be younger, Black or Hispanic/Latina, unmarried, and of greater parity. The revised WIC program was associated with reduced likelihood of more‐than‐recommended GWG (−1.29% points, 95% confidence interval [CI] −2.03, −0.56) and increased likelihood of ever breast fed (1.18% points, 95% CI 0.28, 2.08). We also identified heterogeneous effects on GWG, with more pronounced associations among women 35 and older. There were no associations with foetal growth.
Conclusions
The revised WIC program was associated with improvements in women's gestational weight gain and infant breast feeding.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.