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ICYMI... Higher breastfeeding rates among WIC participants would yield health-related cost savings

Tuesday, September 10, 2019

USDA’s Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) encourages and supports breastfeeding among postpartum women participating in the program. Studies have found that breastfeeding confers a number of health benefits to both infant and mother. The American Academy of Pediatrics recommends exclusive breastfeeding for about 6 months, followed by continued breastfeeding until at least 12 months of age as complementary foods are introduced. A recent ERS study estimated the potential cost savings to WIC households and/or their private and government health insurance providers if 90 percent of WIC infants in 2016 had been breastfed for 12 months (first 6 months exclusively). Cost savings were calculated based on estimated reductions in nine pediatric and five maternal diseases. ERS researchers found the estimated cost savings would total $9.1 billion. Three-quarters of the savings, $6.9 billion, is derived from reductions in early deaths of mothers and infants. Medical costs, including physician fees and hospital costs, account for $1.5 billion of the savings, and nonmedical costs, such as lost wages from missed work days due to maternal illness or caring for a sick infant, account for another $0.6 billion. The data for this chart appear in “Economic Implications of Increased Breastfeeding Rates in WIC” from ERS’s Amber Waves magazine, February 2019. This Chart of Note was originally published March 15, 2019.

WIC participation continues to fall

Friday, May 24, 2019

USDA’s Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) provides supplemental food, nutrition education, and health care referrals to low-income pregnant, breastfeeding, and postpartum women, as well as infants and children up to age 5 who are at nutritional risk. An average 6.9 million people per month participated in the program in fiscal 2018, a 6-percent decrease from 2017. This marked the largest single-year decrease in the program’s history. For the 8th consecutive fiscal year, participation for each of the three major WIC-participant groups—women, infants, and children—fell by 4–6 percent. Improving economic conditions in recent years have likely played a role in the participation decline. Because applicants must have incomes at or below 185 percent of poverty or participate in certain other assistance programs to be eligible, the number of people eligible for WIC is closely linked to the health of the U.S. economy. Falling WIC caseloads may also reflect the decline in the number of U.S. births. During 2008–17, the number of births fell by an average of 1.4 percent per year (except in 2014, when the number of births rose by 1.4 percent). This chart appears in the ERS report, The Food Assistance Landscape: FY 2018 Annual Report, April 2019.

Higher breastfeeding rates among WIC participants would yield health-related cost savings

Friday, March 15, 2019

USDA’s Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) encourages and supports breastfeeding among postpartum women participating in the program. Studies have found that breastfeeding confers a number of health benefits to both infant and mother. The American Academy of Pediatrics recommends exclusive breastfeeding for about 6 months, followed by continued breastfeeding until at least 12 months of age as complementary foods are introduced. A recent ERS study estimated the potential cost savings to WIC households and/or their private and government health insurance providers if 90 percent of WIC infants in 2016 had been breastfed for 12 months (first 6 months exclusively). Cost savings were calculated based on estimated reductions in nine pediatric and five maternal diseases. ERS researchers found the estimated cost savings would total $9.1 billion. Three-quarters of the savings, $6.9 billion, is derived from reductions in early deaths of mothers and infants. Medical costs, including physician fees and hospital costs, account for $1.5 billion of the savings, and nonmedical costs, such as lost wages from missed work days due to maternal illness or caring for a sick infant, account for another $0.6 billion. The data for this chart appear in “Economic Implications of Increased Breastfeeding Rates in WIC” from ERS’s Amber Waves magazine, February 2019.

Increased breastfeeding rates among WIC infants would raise program costs

Friday, February 15, 2019

Breastfeeding promotion and support is a priority in USDA’s Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). Although breastfeeding rates among infants participating in WIC have been increasing in recent decades, they remain below those of other infants. At the request of the U.S. Senate Committee on Appropriations, ERS examined the economic impacts of breastfeeding on the WIC program. ERS researchers estimated the economic costs and benefits if breastfeeding rates for WIC infants were more aligned with medically recommended levels i.e., if 90 percent of infants participating in WIC in 2016 had been exclusively breastfed for their first 6 months, followed by another 6 months with complementary foods—but no infant formula. Results from the analysis indicate that the number of mothers who participated in WIC that year would have increased by 646,000 per month, an 8-percent increase in the monthly number of total participants. This increase is the result of breastfeeding mothers being able to participate in WIC for 12 months postpartum versus 6 months for nonbreastfeeding mothers. Although infants’ food package costs would have decreased by $546.7 million that year, mothers’ food package costs would have increased by $512.9 million, and nutrition services and administrative costs would have increased by another $286.2 million. The net effect would have been an increase of $252.4 million—a 4-percent increase in total 2016 program costs. This chart appears in the ERS report, The Economic Impacts of Breastfeeding: A Focus on USDA’s Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), released on February 14, 2019.

Prices of reduced-fat milk in WIC transactions vary by store type

Tuesday, August 7, 2018

USDA’s Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) provides benefits for specific types and quantities of foods to low-income pregnant, post-partum, and breastfeeding women; infants; and children up to age 5. Many State WIC agencies authorize a variety of large and small stores to redeem WIC benefits, in part to ensure geographic access for WIC participants. A recent ERS study examined prices paid in WIC transactions in four States for reduced-fat milk, one of the most widely redeemed foods in the program. Findings from the two States with substantial numbers of both small and large WIC-authorized stores show that reduced-fat milk WIC prices varied substantially across store types in counter intuitive ways. After controlling for store size and rurality, chain supermarkets/grocery stores in both States had significantly lower reduced-fat milk prices than supercenters (e.g., Target or Walmart; 35 to 79 cents per gallon lower) which are often known for low prices. While small and nontraditional food stores tended to have higher prices for reduced-fat milk, reduced-fat milk prices were lower in WIC-authorized pharmacies and discount stores in the Midwest State. Reduced-fat milk prices at small and nontraditional food stores versus supercenters ranged widely from 23 cents less to 63 cents more. The data for this chart are from the ERS report Price Variability Across Food Product and Vendor Type in Food Benefit Redemptions under the Special Supplemental Nutrition Program for Women, Infant, and Children (WIC), released July 31, 2018.

Decline in WIC participation persists

Friday, March 16, 2018

USDA’s Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) provides supplemental food, nutrition education, and health care referrals to low-income, nutritionally at-risk pregnant, breastfeeding, and postpartum women as well as infants and children up to age 5. In fiscal 2017, the program served an average of 7.3 million people per month, down 21 percent from its peak in fiscal 2010. For the 7th consecutive year, participation for all three major groups fell. The number of women, infants, and children participating in WIC each fell by 5-6 percent. Improving economic conditions in recent years have likely played a role in the participation decline. Since applicants must have incomes at or below 185 percent of poverty or participate in certain other assistance programs to be eligible, the number of people eligible for WIC is closely linked to the health of the U.S. economy. Falling WIC caseloads may also reflect the decline in the number of U.S. births. Since 2007, the number of births have fallen each year except in 2014. This chart appears in the ERS report, The Food Assistance Landscape: FY 2017 Annual Report, released on March 15, 2018.

WIC participation continues to fall

Wednesday, June 14, 2017

USDA’s Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) provides supplemental food, nutrition education, and health care referrals to low-income, nutritionally at-risk pregnant, breastfeeding, and postpartum women as well as infants and children up to age 5. In fiscal 2016, the program served an average of 7.7 million people per month, down 16 percent from its peak in fiscal 2010. For the 6th consecutive year, participation for all three major groups fell. The number of women and children receiving WIC assistance each fell by 4 percent in fiscal 2016, and the number of infants dropped by 3 percent. Improving economic conditions in recent years have likely played a role in the participation decline. Since applicants must have incomes at or below 185 percent of poverty or participate in certain other assistance programs to be eligible, the number of people eligible for WIC is closely linked to the health of the U.S. economy. Falling WIC caseloads may also reflect the decline in the number of U.S. births. During 2008-15, the number of births fell each year except in 2014. This chart appears in "WIC Participation Continues to Decline" in ERS’s Amber Waves magazine, June 2017.

Redemption rates of WIC benefits at large stores differs across States

Wednesday, August 10, 2016

In fiscal 2015, 8 million women, infants, and children under age 5 participated in USDA’s Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). Participants in 48 States and the District of Columbia received paper vouchers or electronic benefit cards redeemable at authorized retail stores for a set of nutrient-rich supplemental foods. WIC participants in Mississippi pick up their WIC foods at distribution centers, and prior to 2016, Vermont participants had their WIC foods delivered to their homes. Using two USDA administrative data sources, a recent ERS report found that over three-fourths of the WIC benefits redeemed in stores in fiscal 2012 were redeemed at large stores (supercenters, supermarkets, and large grocery stores), ranging from 50 percent in California to 99 percent in Nevada. Large stores accounted for 91 percent or more of WIC retail redemptions in 17 States and 81-90 percent in 13 States. Other types of stores, such as medium and small grocery stores and WIC-only stores, account for a sizable share of WIC redemptions in some States. This chart appears in “States Differ in the Distribution of WIC Benefits Across Types of Retail Food Stores” in the August 2016 issue of ERS’s Amber Waves magazine.

Just over two-thirds of WIC participants in 2014 had incomes below poverty

Wednesday, April 6, 2016

USDA’s Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) provides supplemental food, nutrition education, and health referrals to low-income, nutritionally at-risk pregnant, breastfeeding and postpartum women, infants, and children younger than 5. In fiscal 2015, an average of about 8 million people per month participated in the program. Income eligibility for USDA’s WIC program is capped at 185 percent of the Federal poverty level. Among those participating in WIC in April 2014, 67.4 percent had incomes at or below poverty continuing the trend of increasing share of WIC participants with incomes at or below poverty which began in 2000. Slightly more than 1 percent of those participating in WIC in April 2014 had incomes greater than 185 percent of the Federal poverty level—similar to the shares since 2004. These individuals likely represent applicants who, because of their participation in Medicaid, automatically met income eligibility for WIC. In some States, the Medicaid income cutoff is higher than 185 percent of the Federal poverty level. This chart appears in the WIC Program topic page on the ERS website, updated March 16, 2016.

The WIC brand of infant formula varies by State

Tuesday, September 22, 2015

USDA’s Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) provides participating infants with free infant formula. WIC is the major purchaser of infant formula in the United States; over half of all formula is purchased with WIC benefits. To reduce costs, WIC State agencies (except Mississippi and Vermont, which use a competitive solicitation process) are required to have competitively bid rebate contracts with formula manufacturers. Contracts are awarded to the manufacturer offering the lowest net price for formula (wholesale price minus the rebate). The winning manufacturer gets an exclusive contract—typically lasting about 4 years—to provide its infant formula to WIC participants in the State. In some instances, WIC State agencies have formed multi-State alliances and jointly request rebate bids. Since the mid-1990s, only three formula manufacturers—Abbott, Gerber, and Mead Johnson—have bid on WIC contracts. For contracts in effect in March 2015, Abbott was the WIC brand in 23 States and the District of Columbia, Gerber in 9 States, and Mead Johnson in 18 States. This chart updates information in the ERS report, Manufacturers’ Bids for WIC Infant Formula Rebate Contracts, 2003-2013, EIB-142, July 2015.

WIC households favor supercenters for their primary grocery shopping

Tuesday, August 11, 2015

Data from a new USDA-funded survey, National Household Food Acquisition and Purchase Survey (FoodAPS), show that households that participate in USDA’s Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) are more likely to use supercenters for their primary food shopping than non-WIC comparison households (non-participating households that contain either a pregnant woman or a child under the age of 5). Over half of WIC households (52 percent) used a supercenter for their main food shopping, compared with 45 percent of non-WIC comparison households with incomes below 185 percent of the poverty threshold and 41 percent of higher-income non-WIC comparison households. Because WIC households are larger and more likely to contain multiple young children compared with non-WIC comparison households, WIC households may be more enticed to shop at supercenters in order to purchase larger-sized products or take advantage of one-stop shopping. This chart appears in “Most U.S. Households Do Their Main Grocery Shopping at Supermarkets and Supercenters Regardless of Income” in the August 2015 issue of ERS’s Amber Waves magazine.

Participation in USDA's WIC program fell for the fourth consecutive year in 2014

Tuesday, June 23, 2015

USDA’s Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) provides supplemental food, nutrition education, and health care referrals to low-income, nutritionally at-risk pregnant, breastfeeding, and postpartum women as well as infants and children up to age 5. In fiscal 2014, an average 8.3 million people per month participated in the program, 5 percent fewer than the previous year. This was the largest 1-year decrease since the program’s inception in 1974. Since peaking in fiscal 2010, the number of participants has decreased by almost 10 percent. Falling WIC caseloads reflect the continued decline in the number of U.S. births, which began in 2008. In 2013 (latest data available), 3.9 million babies were born in the United States, down from 4.3 million in 2007. Fewer births reduce the potential pool of WIC-eligible participants. Improving economic conditions in recent years may have also played a role in the decline in participation. This chart appears in “WIC Experienced Largest Decrease in Participation in Program’s History in 2014” in the June 2015 issue of ERS’s Amber Waves magazine.

Effects of the WIC program extend beyond its participants

Monday, April 13, 2015

Each month, USDA’s Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) provides supplemental food, health care referrals, and nutrition education to over 8 million low-income, nutritionally at-risk women, infants, and preschool children. In 2012, just over half of all infants in the United States, and over a quarter of all pregnant and postpartum women and children younger than 5, participated in the program, representing a potentially lucrative market for manufacturers of some WIC-approved foods, such as cereals. WIC requires that all breakfast cereals provided through the program be fortified with iron and contain no more than 6 grams of sugars per dry ounce. In response to these requirements, some cereal manufacturers formulated (or reformulated) their products to meet WIC standards. Because these products can also be consumed by non-WIC individuals, WIC may impact the diet quality of all children and adults who eat WIC-approved breakfast cereals, not just participants. This chart is from “Painting a More Complete Picture of WIC: How WIC Impacts Nonparticipants” in the April 2015 issue of ERS’s Amber Waves magazine.

U.S. food shoppers do not usually shop at the closest grocery store

Tuesday, March 31, 2015

A new survey funded by USDA, the National Household Food Acquisition and Purchase Survey (or FoodAPS), asked the main food shopper of the household where they did most of their food shopping. Researchers compared the distance to this store to the distance to the nearest supermarket or supercenter authorized to accept benefits from USDA’s Supplemental Nutrition Assistance Program (SNAP-SM/SC). Researchers found that on average, all households—those receiving food assistance and those not—bypass the SNAP-SM/SC closest to their home to shop at another store, which may or may not be SNAP authorized, for their main grocery purchases. The average SNAP participant lived 1.96 miles from the nearest SNAP-SM/SC, but traveled 3.36 miles to their primary store for food shopping. WIC-participating households were 1.92 miles from the nearest SNAP-SM/SC, but traveled 3.15 miles to do their main grocery shopping. Non-poor households traveled 3.98 miles, while the closest SNAP-SM/SC was 2.21 miles from their home. Store proximity may be important, but price, quality, and selection also affect where households shop. In addition, households may food shop on their way home from work or other activities. The statistics for this chart are from the ERS report, Where Do Americans Usually Shop for Food and How Do They Travel to Get There?, released on March 23, 2015.

Southern States generally have a higher share of infants participating in WIC

Tuesday, March 10, 2015

USDA’s Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) provides supplemental food, nutrition education, and referrals to health care and other social services to eligible low-income women, infants, and preschool children. In fiscal 2014, WIC served an average of 8.3 million people each month, including almost 2 million infants. State level data from fiscal 2012 reveal that on average, about 51 percent of all infants in the United States participated in the program. The share of infants that participated in the program varied by State, ranging from a low of 30 percent in Utah to a high of 67 percent in Mississippi. In six States (Mississippi, Arkansas, Kentucky, Louisiana, South Carolina, and Alabama)—all located in the southeastern United States—over 60 percent of all infants participated in WIC. Economic conditions impact both the percent of infants eligible to participate and the percent of eligible infants enrolled in the program. Participants in WIC must meet maximum income guidelines. A State with a more robust economy is more likely to have fewer residents who qualify for WIC. The statistics for this map can be found in the ERS report, The WIC Program: Background, Trends, and Economic Issues, 2015 Edition, January 2015.

Share of WIC participants with incomes at or below poverty has increased since 2000

Friday, January 30, 2015

Income eligibility for USDA’s WIC program is capped at 185 percent of the Federal poverty level. Applicants who demonstrate current eligibility for Medicaid automatically meet income eligibility for WIC and do not have to document their incomes when they apply for WIC. With a large and increasing share of WIC applicants reporting participation in Medicaid at the time of WIC certification (73 percent in 2012, up from 66 percent in 2010), there has been concern that if States continue to raise their Medicaid income cutoffs to greater than 185 percent of the Federal poverty level this might result in WIC serving a larger share of participants with incomes above the intended cap. However, that has not happened. The share of WIC participants with incomes at or below poverty has been steadily increasing since 2000. The share of WIC participants with incomes at or below 50 percent of the poverty line has increased from 26.5 percent to 33.4 percent in 2012, and the share with incomes between 51-100 percent has grown from 29.1 percent to 33.2 percent in 2012. A version of this chart appears in the ERS report, The WIC Program: Background, Tends, and Economic Issues, 2015 Edition, released January 27, 2015.

Prices for WIC foods in California are higher at smaller stores

Wednesday, October 1, 2014

In fiscal 2013, USDA’s Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) served an average of 8.7 million low-income participants per month, with expenditures totaling $6.4 billion. Containing program costs is a continual issue because WIC is funded annually by Congressional appropriations, making the program’s capacity largely dependent on funding levels and costs per participant. In turn, costs per participant depend in part on the prices charged for the WIC foods by WIC-authorized retailers. States are required to authorize an appropriate number and distribution of retailers to ensure adequate participant access to supplemental foods. A recent study found that smaller retailers in California charge higher prices than larger retailers for comparable WIC foods. However, prices did not decrease steadily with increases in store size. Stores with three or four check out registers had lower prices than did the smallest stores, and prices dropped again for stores with five or six registers, but prices were comparable among all stores with at least five registers. This chart is from “WIC Foods Cost More in Smaller Stores” in the September 2014 issue of ERS’s Amber Waves magazine.

Children 1-4 years old account for just over half of WIC participants

Monday, August 25, 2014

The Special Supplemental Nutrition Program for Women, Infants, and Children, commonly known as the WIC program, provides low-income women, infants, and children younger than 5 who are at nutritional risk, with specific types of supplemental foods, along with nutrition education and health care referrals. As USDA’s third-largest food and nutrition assistance program, WIC served 8.7 million participants per month in fiscal 2013, and Federal expenditures for the program were nearly $6.5 billion. In April 2012, 53 percent of WIC participants were children ages 1-4 years, a small increase from their 50-percent share in the early 1990s. Women and infants each made up a little less than a quarter of WIC participants. This chart appears in the WIC Program topic page on ERS’s website, updated July 10, 2014.

Infant formula costs decreased in 20 of 22 WIC contracts awarded after 2008

Wednesday, April 30, 2014

The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is USDA’s third largest food and nutrition assistance program, with fiscal year 2013 expenditures totaling $6.4 billion. To reduce costs, WIC State agencies enter into cost-containment contracts with infant formula manufacturers. Typically, a manufacturer gives the State agency a rebate for each can of formula purchased through the program, in exchange for the exclusive right to have its formula provided to WIC participants in the State. Contracts are awarded to the manufacturer offering the lowest net price (the manufacturer’s wholesale price minus the rebate). A recent ERS study found that among the 46 WIC State agencies that awarded new rebate contracts after December 2008, nearly all paid lower real net prices under the new contracts. Real net prices decreased by an average 43 percent—or 23 cents per 26 reconstituted fluid ounces—resulting in total annual savings of $107 million (holding retail markups constant). This chart appears in “Infant Formula Costs to the WIC Program Fall” in ERS’s March 2014 Amber Waves magazine.

Nutrition programs projected to account for 80 percent of outlays under the Agricultural Act of 2014

Wednesday, March 12, 2014

The new U.S. farm bill, the Agricultural Act of 2014, was signed on February 7, 2014 and will remain in force through 2018. The 2014 Act makes major changes in commodity programs, adds new crop insurance options, streamlines conservation programs, modifies provisions of the Supplemental Nutrition Assistance Program (SNAP), and expands programs for specialty crops, organic farmers, bioenergy, rural development, and beginning farmers and ranchers. The Congressional Budget Office (CBO) projects that 80 percent of outlays under the 2014 Farm Act will fund nutrition programs, 8 percent will fund crop insurance programs, 6 percent will fund conservation programs, 5 percent will fund commodity programs, and the remaining 1 percent will fund all other programs, including trade, credit, rural development, research and extension, forestry, energy, horticulture, and miscellaneous programs. Find this chart and additional information on the new U.S. farm bill on the Farm Bill Resources pages.

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