The WIC Program
ERS Reports
The WIC Program: Background, Trends, and Economic Issues—This report presents comprehensive background information on the WIC program—how the program works, its history, trends, and the characteristics of the population served. Also examined are current issues facing WIC, focusing mainly on those with important economic implications. (April 2009)
WIC and the Battle Against Childhood Overweight—The number of children at risk of being overweight has grown in the past two decades, as has the number of young children whose families participate in the WIC Program. Are these increases connected? The answer appears to be “no.” However, children in low-income families, especially low-income, Mexican-American families, are more likely to be overweight. (April 2009)
Economic Linkages Between the WIC Program and the Farm Sector—In fiscal 2008, the $4.6 billion of food purchased with vouchers from WIC generated $1.3 billion in farm revenue. Because WIC participants would have purchased some of these foods with their own money in the absence of the program, the net addition to farm revenue from WIC is estimated at $331 million and the net increase in full-time-equivalent farm jobs at 2,640. The study uses an Input-Output Multiplier Model to derive these estimates and assumes that recent revisions in the WIC food packages were implemented in all States. (March 2009)
Informing Food and Nutrition Assistance Policy: 10 Years of Research at ERS—Since 1998, Congress has provided funds to ERS to study and evaluate the Nation’s domestic food and nutrition assistance programs. ERS has become the premier source of food and nutrition assistance research in the United States, sponsoring over 600 publications on a wide range of topics related to food and nutrition assistance. This report highlights some of the key research conducted during the FANRP program’s first decade. (December 2007)
Recent Trends and Economic Issues in the WIC Infant Formula Rebate Program—Over half of all infant formula sold in the United States is purchased through the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). Typically, WIC State agencies obtain substantial discounts in the form of rebates from infant formula manufacturers for each can of formula purchased through the program. This analysis suggests that retail markup accounts for most of the cost to WIC of infant formula in most States. Both retail markup and net wholesale price, however, have increased over time, with the recent increase coinciding with the introduction of higher priced supplemented infant formulas. (August 2006)
Nutrient Adequacy of Children Participating in WIC—WIC food packages were initially designed to include foods rich in nutrients often lacking in the diets of low-income participants. This brief summarizes two recent ERS-sponsored studies that provide new assessments of the nutrient intakes of WIC children, income-eligible children not participating in the program, and children ineligible for the program. (April 2006)
WIC and the Retail Price of Infant
Formula—Rebates from infant
formula manufacturers to State WIC agencies support over one-quarter
of all WIC participants. However, WIC and its infant formula rebate program
may significantly affect the infant formula prices faced by non-WIC consumers.
This report presents findings from the most comprehensive national study
of infant formula prices at the retail level. For a given set of wholesale
prices, WIC and its infant formula rebate program resulted in modest
increases in the supermarket price of infant formula, especially in States
with a high percentage of WIC formula-fed infants. However, lower priced
infant formulas are available to non-WIC consumers in most areas of the
country, and the number of lower priced alternatives has increased. (January 2005)
 Interstate Variation in WIC Food Package
Costs: The Role of Food Prices, Caseload Composition, and Cost-Containment
Practices—Food prices
within Statesaffect average monthly costs of State food benefits packages
provided by the WIC program more than variations in WIC caseload composition
do. In addition, cost-containment practices by State WIC agencies provide
different levels of cost savings in different areas, contributing to
interstate variation in benefits package costs. This study is one of
the few to examine the degree to which food prices, caseloads, and cost-containment
practices influence costs of State WIC food benefits packages. Because
limited data exist on the actual food items that WIC participants purchase,
the study used a scanner dataset of supermarket transactions and other
sources to estimate the average monthly cost of WIC food benefits in
several areas. (January 2005)
Contractor and Cooperator Reports
Impact of the WIC Program on the Infant Formula Market—This research examines the impact of providing infant formula through the WIC program on the wholesale price of infant formula. The findings show that providing free formula to low-income families is the primary factor in the growth in real wholesale prices of formula but that sole-source contracts not only have reduced the cost of formula to the Government but also have mediated wholesale price growth.
(January 2009)
 Effects of Food Assistance and Nutrition Programs on Nutrition and Health: Volume 3, Literature Review—This report provides a comprehensive review and synthesis of published research on the impact of USDA’s food and nutrition assistance programs, including WIC, on participants’ diet and health outcomes. The report is one of four volumes produced by a larger study, including Volume 1, Research Design; Volume 2, Data Sources; and Volume 4, Executive Summary of the Literature Review. (December 2004)
Factors Associated with Iron Status Among WIC Infants and Toddlers in Rural West Virginia—Iron deficiency severe enough to cause anemia may affect children’s ability to grow and learn and, consequently, their lifelong productivity and earnings. This study conducted blood screenings of infants and toddlers ages 6-24 months participating in The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) in West Virginia. Results show that 12 of the 57 infants and toddlers (21 percent) were iron deficient, considerably more than the 4 of 49 (8 percent) with anemia. Because routine screenings are unable to detect iron deficiency before it progresses to anemia, primary prevention of iron deficiency is the only option that may be universally applied. Expert feeding recommendations—such as introducing iron-rich complementary foods after 6 months of age and limiting consumption of milk among children ages 12-24 months to no more than 24 ounces—are useful for promoting adequate intake of readily-available iron and may help prevent iron deficiency. (December 2007)
An Assessment of the Impact of Medicaid Managed Care on WIC Program Coordination With Primary Care Services—Coordination between the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) and Medicaid has been an important component to ensuring access to primary care services for WIC clients. This study examines how increased use of managed care in the Medicaid program has affected WIC program coordination efforts. According to the study sample, 72 percent of State Medicaid agencies report that Managed Care Organizations (MCOs) are required to inform their members about WIC. About 43 percent of State WIC agencies sampled in the study have a formal agreement with a State Medicaid agency, generally revolving around data sharing, referrals, and provision of special metabolic infant formulas. The agreements, however, often lack specific details on how services should be coordinated. Some local WIC agencies and MCOs have implemented innovative approaches to coordination such as including Medicaid staff at WIC clinics to help clients with enrollment, information sharing to promote targeted outreach efforts, helping clients identify providers and resources, and transportation costs paid by MCOs for WIC clients to attend WIC appointments. (September 2007)
 Using Point-of-Purchase Data To Evaluate Local WIC Nutrition Education Interventions: Feasibility Study—The effect of nutrition education—an important component of many Federal food assistance programs—on participants’ food consumption behavior is difficult to ascertain. This study finds that combining point-of-purchase data with State data on the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is a feasible method to assess behavioral changes in WIC participants. The major obstacle to using these data to evaluate WIC participant food-purchasing behaviors is the recruitment of a large enough sample of stores for a representative sample of WIC participants. (January 2007)
Amber Waves
Amber Waves, ERS’s magazine,
is a window into the agency’s broad research
program, covering production agriculture, food safety and nutrition,
the food industry, rural economies, agricultural trade, and farm-related
environmental issues. Published four times a year in web and print editions,
Amber Waves contains in-depth feature articles, research findings, previews
of research in the works, and statistics, including a variety of articles
related to WIC and other food and nutrition assistance programs. The following articles
are particularly relevant to WIC:
RIDGE (formerly Small Grants) WIC Projects
FANRP’s
RIDGE Program has funded
several research projects of relevance to WIC, including those listed
below:
Bitler, M., and J. Currie. Medicaid
at Birth, WIC Take Up, and Children’s
Outcomes. A Final Report to the IRP/USDA Small Grants Program. 
Chatterji, P., K. Bonuck, S. Dhawan, and N. Deb. WIC
Participation and the Initiation and Duration of Breastfeeding.
Dewey, K.G., M.J. Heinig, and K. Kavanagh-Prochaska. Educational
Intervention to Modify Bottle-feeding Behaviors Among Formula Feeding
Mothers in
the WIC Program: Impact on Infant Formula Intake, Weight Gain, and Fatness.
Herman, D., G. Harrison, A. Afifi, and E. Jenks. Are
Economic Incentives Useful for Improving Dietary Quality Among WIC
Participants and Their
Families?
Ishdorj, A., H.H. Jensen, and J. Tobias. Intra-Household
Allocation and Consumption of WIC Approved Foods.
Joyce, T., and D. Gibson. The
Use of Twins to Understand the Effect of WIC on Birth Outcomes.
Kranz, S., and J. Findeis. Policy
Implications of WIC or Food Stamp Program Participation on Children’s Diet Quality and the Risk for Childhood
Obesity.
Swann, C. The
Dynamics of WIC Prenatal Participation.
Journal Articles
Tiehen, L. and A. Jacknowitz. “Why Wait? Examining Delayed WIC Participation Among Pregnant Women,” Contemporary Economic Policy, 26(4), October 2008.
Joyce, T., A. Racine and C. Yunzal-Butler. “Reassessing the WIC Effect: Evidence from the Pregnancy Nutrition Surveillance System,” Journal of Policy Analysis and Management, 27(2), Spring 2008.
Kavanagh, K., R. Cohen, M. Heinig, and K. Dewey. “Educational Intervention to Modify Bottle-feeding Behaviors among Formula-feeding Mothers in the WIC Program: Impact on Infant Formula Intake and Weight Gain,” Journal of Nutrition Education and Behavior, 40(4). July/August 2008.
Bitler, M.P., and J. Currie. “The Changing Association Between Prenatal Participation in WIC and Birth Outcomes in New York City: What Does It Mean?” Journal of Policy Analysis and Management, 24(4):687-90, Fall 2005.
Bitler, M.P., and J. Currie. “Does WIC Work? The Effects of WIC on Pregnancy and Birth Outcomes,” Journal of Policy Analysis and Management, 24(1):73-91, Winter 2005.
Bonuck, K., M. Trombley, K. Freeman, and D. McKee. “Randomized, Controlled Trial of a Prenatal and Postnatal Lactation Consultant Intervention on Duration and Intensity of Breastfeeding Up to 12 Months,” Pediatrics, 116(6):1413-26, December 2005.
Dennison, B., L. Edmunds, H. Stratton, and R. Pruzek. “Rapid Infant Weight Gain Predicts Childhood Overweight,” Obesity, 14(3):491-99, March 2006.
Edmunds, L., M. Woelfel, B. Dennison, H. Stratton, R. Pruzek, and R. Abusasha. “Overweight Trends among Children Enrolled in the New York State Special Supplemental Nutrition Program for Women, Infants and Children,” Journal of the American Dietetic Association, 106(1):113-17, January 2006.
Herman, D.R., G.G. Harrison, and E. Jenks. “Choices Made by Low-Income Women Provided with an Economic Supplement for Fresh Fruit and Vegetable Purchase,” Journal of the American Dietetic Association, Vol. 106(5):740-44, May 2006.
Jacknowitz, A., D. Novillo, and L. Tiehen. “Special Supplemental Nutrition Program for Women, Infants, and Children and Infant Feeding Practices,” Pediatrics, 119(2):281-89, February 2007.
Joyce, T., D. Gibson, and S. Colman. “The Changing Association Between Prenatal Participation in WIC and Birth Outcomes in New York City,” Journal of Policy Analysis and Management, 24(4):661-85, Fall 2005.
Murphy, S., J. Foote, L. Wilkens, P. Basiotis, A. Carlson, K. White, and K. Yonemori. “Simple Measures of Dietary Variety Are Associated with Improved Dietary Quality,” Journal of the American Dietetic Association, 106(3):425-429, March 2006.
 Nord, M., and E. Leibtag. “Is the 'Cost of Enough Food' Lower in Rural Areas?” The Review of Regional Studies, 35(3):291-310, Winter 2005.
Rose, D., J. Bodor, and M. Chilton. “Has the WIC Incentive to Formula-Feed Led to an Increase in Overweight Children?” Journal of Nutrition, 136(4):1086-90, April 2006.
Schneider, J., M. Fujii, C. Lamp, B. Lonnerdal, K. Dewey and S. Zidenberg-Cherr. “Anemia, Iron Deficiency and Iron Deficiency Anemia in 12-36-Month Old Children from Low-income Families,” American Journal of Clinical Nutrition, 82(6):1269-75, December 2005.
Skalicky, A., A. Meyers, W. Adams, Z. Yang, J. Cook, and D. Frank. “Child Food Insecurity and Iron Deficiency Anemia in Low-Income Infants and Toddlers in the United States,” Maternal Child Health Journal, 10(2):177-85, March 2006.
Swann, C. “The Timing of Prenatal WIC Participation,” The B.E. Journal of Economic Analysis & Policy, 7(1), January 2007.
Whitaker, R., and S. Orzol. “Obesity Among US Urban Preschool Children: Relationships to Race, Ethnicity, and Socioeconomic Status,” The Archives of Pediatrics & Adolescent Medicine, 160(6):578-84, June 2006.
Whitaker, R., S. Phillips, and S. Orzol. “Food Insecurity and the Risks of Depression and Anxiety in Mothers and Behavior Problems in Their Preschool-Aged Children,” Pediatrics, 118(3):e859-868, September 2006.
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