Women, Infants, and Children Program

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The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) provides nutritious food, nutrition education, breastfeeding support, and referral to health care and social services for low-income, nutritionally at risk, pregnant, and postpartum women, and for infants and children under the age of five.

WIC was funded at $4 billion for 2001, serving about 7.2 million women and young children. WIC operates nationwide through 1,800 local health departments, community health centers, hospitals, and health or social-service agencies. Some thirty inter-tribal organizations operate WIC programs, and the program also operates in Puerto Rico and in several U.S. territories. The United States Department of Agriculture operates WIC at the federal level, and state health departments administer the program in conjunction with local agencies.

WIC services include foods containing nutrients that are often lacking in the diets of low-income pregnant women and young children; nutrition assessment and nutrition education; and referral to health insurance and social programs like food stamps. WIC promotes breastfeeding through classes and individual counseling done by peer counselors and lactation consultants. In many communities, WIC operates closely with health programs for women and children including immunization programs. Public health issues such as smoking and obesity are incorporated into the WIC educational efforts of many agencies.

Numerous evaluations have found that WIC improves health status and reduces medical costs. Studies have found that women who participate in WIC have longer pregnancies leading to fewer premature births; WIC lowers the incidence of late fetal deaths by up to one-third; WIC contributes to decreases in anemia; every dollar invested in WIC for pregnant women produces $1.92 to $4.21 in Medicaid savings; and that WIC increases prenatal and well-child care use.

(SEE ALSO: Child Health Services; Maternal and Child Health; Nutrition; Poverty; Women's Health)

— STEFAN HARVEY

The Special Supplemental Nutrition Program for Women, Infants, and Children, commonly referred to as WIC, is a Federally funded nutrition-intervention program administered by the Food and Nutrition Service of the U.S. Department of Agriculture. WIC began as a two-year pilot program in 1972 under an amendment to the Child Nutrition Act of 1966, and was made permanent in 1974. Its mission is to provide supplemental food, nutrition education, and health-care referrals to low-income pregnant or postpartum women, their infants, and children up to the age of five, to improve their health outcomes.

WIC is available in all fifty states, the District of Columbia, thirty-two Indian Tribal Organizations, Puerto Rico, the Virgin Islands, American Samoa, and Guam. WIC is the third-largest national food assistance program, following the Food Stamp and National School Lunch programs, and accounts for 12 percent of total Federal expenditures in this area. In fiscal year 2001, WIC served an average of 7.3 million participants per month, 75 percent of whom were infants and children; annual expenditures exceeded $4 billion (see Table 1). WIC does not guarantee participation for all eligible women, infants, and children who apply, and the number of people the program serves is determined by annual levels of Federal funding. In recent years, WIC has been fully funded, and all eligible persons have been able to participate.

To qualify for WIC, applicants must first meet income guidelines and a state residency requirement, and they must be at nutritional risk as determined by a doctor, nurse, or nutritionist. Guidelines state that the gross income of the applicant must fall at or below 185 percent of the Federal poverty-guideline figure, although each state can reduce income-limit standards. Participants in other benefit programs such as the Food Stamp Program, Medicaid, or Temporary Assistance for Needy Families automatically meet income requirements. To be at nutritional risk for WIC, one must have either a medically based risk such as underweight, anemia, or previous poor pregnancy outcomes, or a diet-based risk such as a dietary pattern deemed inadequate compared with U.S. Dietary Guidelines.

Participants in WIC receive benefits in the form of checks, vouchers, or electronic benefits transfer (EBT) cards that are redeemable monthly at certain retail food stores. In 2001, average monthly benefits per person were about $34. Participants may use these benefits to purchase specific foods designated as important to supplementing the diet of this population. Only nutrient-dense foods that are high in one or more of particular nutrients—protein, calcium, iron, and vitamins A and C—are included, although the food package is not intended to fulfill all of the nutrient needs of the participants. Examples of foods available using WIC include iron-fortified infant formula, iron-fortified infant and adult cereals, fruit or vegetable juice rich in vitamin C, eggs, milk, cheese, peanut butter, dried beans or peas, tuna fish, and carrots. Foods are substituted where there are medically necessary dietary modifications. Participants also receive nutrition education and necessary referrals to health-care services.

WIC is one of the most cost-effective and successful nutrition-assistance programs in U.S. history. Several studies have concluded that, for every $1 spent on pregnant women under WIC, between $1.77 and $3.13 in Medicaid costs were saved over the first sixty days after childbirth. Research consistently shows that WIC participation results in improved birth outcomes and savings in health-care costs, improved diet and diet-related outcomes, improved infant-feeding practices, increased immunization rates, and improved cognitive development for children.

Table 1

Bibliography

United States Department of Agriculture, Economic Research Service. Food Assistance Landscape. Available at http://www.ers.usda.gov/

United States Department of Agriculture, Food and Nutrition Service. Women, Infants, and Children. Available at www.fns.usda.gov/wic

United States Department of Agriculture and United States Department of Health and Human Services. Nutrition and Your Health: Dietary Guidelines for Americans. Home and Garden Bulletin No. 232. Washington, D.C.: U.S. Government Printing Office, 2000.

United States General Accounting Office. Early Intervention: Federal Investments Like WIC Can Produce Savings. Document HRD92-18. Washington, D.C.: U.S. Government Printing Office, April 1992.

—Jamillah Hoy Rosas; L. Beth Dixon