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WIC: strengthening America’s families for 40 years

The Special Supplemental Nutrition Program for Women, Infants and Children (WIC) is a proven cost-effective investment in strengthening families and promoting lifetime health1,2,3. In 2014, WIC celebrated 40 years of providing nutrition education, breastfeeding promotion, supplemental foods and referrals as part of the United States Department of Agriculture’s (USDA) 15 nutrition assistance programs. WIC serves approximately half the births in the United States and has grown to be the leading public health nutrition program for many limited resource families. It is often the important first access point to healthcare and social service systems for these families. WIC provides anticipatory guidance, connects families to community resources, and promotes medical/dental homes. WIC helps achieve national public health goals such as reducing premature births and infant mortality, increasing breastfeeding, and reducing maternal and childhood overweight. Findings demonstrate that WIC improves birth outcomes2,6,7, diets and diet-related outcomes3,9,infant feeding practices5, and immunization rates4 of income-eligible, nutritionally at-risk women, infants and children up to age five.

Core WIC nutrition messages encourage families to eat more fruits, vegetables, whole grains and fiber; consume less fat, cholesterol, juice and sweetened beverages; and to breastfeed. Once enrolled, WIC provides a monthly food package designed for nutritional value to ensure good health, growth and development. The package was changed in 2009 based on an Institute of Medicine study to align with the Dietary Guidelines for Americans, including fruit and vegetable cash value vouchers (CVV) for the first time8. States must allow fresh fruits and vegetable purchases; frozen, canned and/or dried fruits and vegetables are however allowed at the discretion of the individual state. The monthly CVV ranges from $15 for exclusively breastfeeding mothers of multiples, to $10 for pregnant or postpartum women to $8 for children. States also have the discretion to allow fresh bananas for infants. In addition to fruits and vegetables, the food package includes low-fat dairy, cheese, soy products, beans, peanut butter, eggs, and whole grains. Each state agency develops a list of WIC authorized foods based on USDA guidelines and regulations that serve as a basis, with exact types and quantities of food based on categories of pregnant women, postpartum women, breastfeeding women, infants, and children. Families redeem food packages at authorized retail grocery stores in most states with some states allowing CVV redemptions at authorized farmers’ markets.

WIC families are allowed to pay for fruits and vegetables using a combination of WIC checks or EBT, cash, or credit/debit cards, including Supplemental Nutrition Assistance Program EBT. Because fresh produce is often priced per pound, families may have problems redeeming the CVV for full face value without going over the amount. To assist WIC families in using CVVs, Hawaii’s WIC Approved Food List includes a helpful chart to help estimate costs of fresh produce. Adding costs of frozen, canned or dried fruits and vegetables is easier than weighing produce and multiplying cost per pound.

In Hawaii, CVVs are allowed for fresh and frozen produce (no canned or dried). Taro, taro leaves and poi (a pounded taro product) are culturally significant for indigenous Hawaiians; all are allowed products. Hawaii WIC also allows fresh bananas for infants. However, no farmers’ markets are currently authorized for CVV redemption.

Visit www.health.hawaii.gov/wic for the current Approved
Food List. In the fiscal year (FY) ending 30 September 2014, Hawaii WIC served an average of 33,923 women, infants and children monthly, each receiving an average monthly food benefit of $69.15. Total WIC check redemptions totaled approximately $28,148,852 of which $1,811,206 was spent on fruits and vegetables. Unfortunately, the dollar value of fresh bananas for infants is not available because the WIC check has other items. In Hawaii redemption of CVVs has remained steady (83.1%, 83.7%, 82.7% and 81.5% of issuance) in FYs 2011 through 2014.

In conclusion, WIC has helped improve the health of American women, infants and children for 40 years. WIC looks forward to continued change to better address the needs of the target population and to incorporate evidencebased practices while controlling food costs.

  1. Anderson J, Hayes D, Chock L. Characteristics of overweight and obesity at age two and the association with breastfeeding in Hawaii Women, Infants and Children (WIC) participants. Matern Child Health J. 2013.
  2. Avruch S, Cackley AP. Savings achieved by giving WIC benefi ts to women prenatally. Public Health Report. 1995;110:27-34.
  3. Basiotis PP, Karmer-LeBlanc CS, Kennedy ET. Maintaining nutrition security and diet quality: the role of the Food Stamp Program and WIC. Family Economics and Nutrition Review, 11(1.2):4-16.
  4. Cortese MM, Diaz PS, Samala U, et al. Underimmunization in Chicago children who dropped out of WIC. Am J Prev Med. 2004;26(1):29-33.
  5. Gross SM, Resnik AK, Cross-Barnet C, et al. The differential impact of WIC peer counseling programs on breastfeeding initiation across the state of Maryland. J Hum Lact. 2009;25(4):435-443.
  6. Khanani I, Elam J, Hearn R., et al. The impact of prenatal WIC participation on infant mortality and racial disparities. Am J Public Health. 2010;100(Supp1):S204-S209.
  7. Kowaleski-Jones L, Duncan GJ. Effects of participation in the WIC Program on birthweight: evidence from the national longitudinal survey of youth. Am J Public Health. 2002;92(5):799-804.
  8. National Research Council. WIC Food Packages: Time for a Change. The National Academies Press, 2005, Washington, DC
  9. Sherry B, Mei Z, Yip R. Continuation of the decline in prevalence of anemia in low-income infants and children in fi ve states. Pediatrics. 2001;107(4):677-682.