The Impact of WIC on Birth Outcomes: New Evidence from South Carolina

Abstract

Objectives To investigate the impact of the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) on a variety of infant health outcomes using recent South Carolina Vital Statistics data (2004-2012). Methods To account for non-random WIC participation, the study relies on a maternal fixed effects estimation, due to the availability of unique maternally linked data. Results The results indicate that WIC participation is associated with an increase in birth weight and length of gestation, decrease in the probability of low birth weight, prematurity, and Neonatal Intensive Care Unit admission. Additionally, addressing gestational bias and accounting for the length of gestation, WIC participation is associated with a decrease in the probability of delivering a low weight infant and a small for gestational age infant among black mothers. Conclusions for Practice Accounting for non-random program participation, the study documents a large improvement in birth outcomes among infants of WIC participating mothers. Even in the context of somewhat restrictive gestation-adjusted specification, the positive impact of WIC remains within the subsample of black mothers.

Efficiency Versus Equity in the Provision of In-Kind Benefits: Evidence from Cost Containment in the California WIC Program

“…The WIC program is a pillar of the U.S. social safety net that targets the health and wellbeing of millions of poor pregnant women and young children. While a large literature examines the impacts of WIC on infant and child health and development (Currie, 2003;Bitler and Currie, 2005;Joyce et al, 2005;Lee and Mackey-Bilaver, 2007;Figlio et al, 2009;Foster et al, 2010;Hoynes et al, 2011;Marshall et al, 2013;Rossin-Slater, 2013;Edmunds et al, 2014;Currie and Rajani, 2015;Metallinos-Katsaras et al, 2015;Sonchak, 2016;Gregory et al, 2016;Jackson and Mayne, 2016;Fingar et al, 2017;Chorniy et al, 2018) much less is known about the costs and benefits associated with how the program is administered. While the complex rules about eligible products may encourage beneficiaries to make healthier food choices, they may also serve as a barrier to subgroups with high learning costs.…”

“…If, for example, they are used for outreach and educational interventions, then they may lead to increased program access (e.g., see Aizer, 2007 for evidence on the effects of such interventions in the case of Medicaid). These questions are particularly important in light of the evidence that WIC benefit receipt is associated with improved infant health (Bitler and Currie, 2005;Figlio et al, 2009;Rossin-Slater, 2013;Currie and Rajani, 2015;Sonchak, 2016;Fingar et al, 2017) and the growing literature on the lasting consequences of early life conditions (Almond et al, 2018;Almond and Currie, 2011;Barker, 1990). Increasing efficiency and equity in WIC would enable the program to play a bigger role in reducing disparities in early-life health and subsequent long-term and intergenerational health and human capital trajectories in the United States.…”

Does Prenatal WIC Participation Improve Child Outcomes?

“…Rossin-Slater (2013) finds that reductions in participation due to clinic closings reduced pregnancy weight gain, birth weight, and breastfeeding. Similarly, Sonchak (2016) finds that WIC participation among South Carolina (SC) mothers is associated with an increase in birth weight and length of gestation, decrease in the probability of low birth weight, prematurity, and Neonatal Intensive Care Unit admission.…”

The Impact of WIC on Infant Immunizations and Health Care Utilization

“…In a snapshot of participation from April 2012, 9.7 million women and children participated in WIC and 23 percent of participants were infants under the age of 1 year (USDA 2012). While the majority of extant research has focused on how program participation impacts infant health outcomes at birth (Brien and Swann 2001;Bitler and Currie, 2005;Joyce, Gibson, and Colman 2005;Joyce, Racine, and Yunzal-Butler 2008;Hoynes, Page, and Stevens 2011;Currie and Rajani 2015;Sonchak 2016), the impact of WIC on health care utilization and continuity of care has generally been overlooked.…”

“…Alternatively, if a mother chooses to participate in WIC because she is aware of her own poor health (that is not captured by observed covariates), the resulting negative selection will understate the benefits of WIC. To control for the possibility of selection bias, recent economic studies have relied on sibling fixed effects (Kowaleski-Jones and Duncan 2002;Foster et al, 2010;Currie and Rajani 2015;Sonchak 2016), propensity score matching (Foster et al, 2010), and ordinary least squares (OLS) with a rich set of control variables (Bitler and Currie 2005;Joyce, Gibson, and Colman 2005;Joyce, Racine, and Yunzal-Butler 2008). Despite methodological improvements, the debate over WIC's effectiveness has not yet been settled, with some studies reporting substantial health improvements for infants of WIC mothers, while other studies document only minimal health benefits (see Currie and Almond [2011] for an excellent overview of the WIC literature).…”