By: Hope A. Lane-Gavin, Fellow, Health Equity, The Center for Community SolutionsKatherine Ungar, Policy Associate, Children’s Defense Fund - Ohio
With increased national attention and resources directed to the maternal and infant health crisis in our country, that is, women in the United States remaining the most likely to die from complications related to pregnancy or childbirth in the developed world[1], we continue to seek solutions not only improve outcomes but tackle disparities. Our work has included efforts to expand and diversify the perinatal workforce to increase provider-patient racial concordance, advocating for improved data collection and lobbying for 12-months of postpartum insurance coverage for birthing individuals.
We understand that tackling the maternal and infant health crisis in our state will require a multi-faceted approach.
The Center for Community Solutions and Children’s Defense Fund-Ohio share the goals of improving maternal and infant health outcomes and strengthening the health and human service safety net, intersect at the Special Supplemental Nutrition Assistance Program for Women, Infants, and Children (WIC). Therefore, we are teaming up to ensure all WIC eligible families have access to the program and that the program is working as intended.
Establishment of WIC
The WIC program began as a federal pilot program in the early 1970s as a response to a growing concern over malnutrition among poverty-stricken mothers and their young children. By the mid-1970s the program was expanded and made permanent. WIC is now one of the largest nutrition-assistance programs in the country, serving about half of all infants born in the United States.[2] Like many other nutrition assistance programs such as the well-known Supplemental Nutrition Assistance Program (SNAP), WIC is housed at the Food and Nutrition Services (FNS) arm of the United States Department of Agriculture (USDA). However, unlike SNAP, WIC operates as a block grant, similar to the Temporary Assistance for Needy Families (TANF) program, with grants being provided to states individually and administered at the local level by county or city health departments, hospitals, schools, and sometimes private nonprofits.
Who can participate in the WIC program?
WIC was designed as a short-term public health intervention program for low-income pregnant and post-partum women, infants, and children up to age 5 who are deemed at nutritional risk. (Important to acknowledge here, for non-birthing parents and guardians including fathers, kinship, foster, adopt and/or non-breastfeeding mothers, WIC, like TANF, has child-only cases.)
Participants must have a household gross income at or below 185 percent of the federal poverty line and/or be enrolled in TANF, SNAP, or Medicaid. While applicants must live in the state in which they apply, unlike many other public assistance programs, WIC does not require proof of citizenship or alien status.
Additionally, WIC applicants are screened by medical professionals for medically-based risks (such as smoking, weight, maternal age) as well as for diet-based risks such as not consuming the U.S. Dietary Guidelines recommended amount of protein or iron in their regular diet.[3] This health screening is free to program applicants.
How do I apply for the WIC program?
Pregnant and postpartum birthing people may learn about or be referred to WIC through various outlets, including doctors’ offices, advertisements, family or friends, other public benefit programs like SNAP or foodbank assistance or parent support programs. Help Me Grow, for example, is an evidence-based parent support program focused on early prenatal and well-baby care and parenting education on child wellbeing and development. The program includes early intervention services and home visiting. Through early intervention, families are paired with an early intervention team consisting of service coordination and service providers. The team then works to develop a coordinated plan to ensure families are connected to existing supports and resources, such as WIC. Families may also learn about WIC through a home visit supported through Help Me Grow. During a home visit, well-trained professionals visit the home of a pregnant woman or new parents and discuss individual family needs and supports to encourage a healthy baby and mother. Nutrition is an important part of these conversations and may lead to a WIC referral. In 2019, over 120,000 home visits were provided across the state, serving 11,500 families and 14,420 children.
In 2019, over 120,000 home visits were provided across the state, serving 11,500 families and 14,420 children.
Families may also be referred to WIC by their or their child’s physician. MetroHealth, for example, administers the WIC program in Cuyahoga County, operating 22 nutrition education sites. Notably, MetroHealth has a WIC clinic on site at the hospital, so parents referred to WIC during a doctor’s appointment can go straight to the WIC clinic in that same visit. For a list of all WIC clinics in the state, please visit: Find Local WIC Clinics | Ohio Department of Health.
I was approved for WIC benefits, now what?
Similar to SNAP, Ohio WIC beneficiaries are given an electronic benefit transfer (EBT) card that can be used with a pin number to purchase WIC approved foods at eligible WIC-retailers. WIC beneficiaries are assigned a monthly “food package” to supplement their diets to better meet the nutritional needs of the WIC participant. These food packages are based on numerous factors including age, culture and identified nutritional risk and are prescriptive of size and ingredients.Examples of WIC approved foods include:
- Juice
- Formula
- Baby food
- Breakfast cereal
- Eggs
- Milk
- Cheese
- Whole wheat bread
- Fish
- Peanut butter
- BeansSee a list of WIC foods, allowable alternatives and the key nutrients they provide.
In addition to a monthly food package, WIC beneficiaries also receive other resources to help support a healthy lifestyle. This includes, but is not limited to, practical nutrition education around topics such as breastfeeding support, making good eating choices, snacking tips as well as referrals to additional services such as The Ohio Health Homes and Lead Poisoning Prevention Program, and smoking cessation programming.
The impact of WIC on birth outcomes
Research demonstrates WIC’s effectiveness at improving health and nutritional outcomes of both women and children.
WIC enrollment reduces infant mortality, especially for Black participants. A recent study looked at the rates of infant mortality in babies whose mothers participates in WIC during pregnancy and found that the infant mortality rate was 5.2 deaths per 1,000 live births among those who had received WIC benefits, compared to 8.2 deaths among those who did not — a 36.6 percent reduction. A study published in 2010, analyzing infant mortality rates and WIC program participation in Hamilton County, Ohio found a lower infant mortality rate among WIC participants (8.0 infant deaths per 1,000 live births) than non-WIC participants (10.6). This finding was even more significant when researchers looked at Black individuals participating in WIC, where they saw an infant mortality rate of 9.6 among WIC participants compared to 21.0 among non-WIC participants.
- WIC helps mothers give birth to healthier babies compared to eligible non-participants.
WIC Works
- WIC helps mothers give birth to healthier babies compared to eligible non-participants. Research demonstrates that participation in WIC increased average birth weight and reduced the incidence of low and very low birth weight.
- The WIC program helps participants make stronger connections to preventive health care. Low-income children participating in WIC are more likely to receive preventive medical care than other low-income children and are just as likely to be immunized as more affluent children.
- WIC helps support nutritious diets and infant feeding practices.Over the next several months we will be diving into how the program and its participants have navigated the COVID-19 pandemic, analyzing enrollment data and comparing Ohio’s data with other states. We will also be talking with WIC participants and administrators to identify challenges with ensuring WIC eligible families have access to and remain enrolled in the program, seeking their lived expertise to inform policy solutions we can propose that will help. We understand that tackling the maternal and infant health crisis in our state will require a multi-faceted approach and we, both Children’s Defense Fund – Ohio and The Center for Community Solutions, are up to the challenge because we know Ohio’s next generation depends on it.
[1] https://www.commonwealthfund.org/publications/issue-briefs/2020/nov/maternal-mortality-maternity-care-us-compared-10-countries
