Evaluating the Special Supplemental Program for Women, Infants, and Children: An Examination of Participation and Programatic Effectiveness Among Children

The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) provides nutritious foods, nutrition education, and referrals for health and social services to low-income pregnant, postpartum, and breastfeeding women, and their infants and children under the age of 5. Numerous studies have examined various aspects of the WIC program, particularly prenatal participation and infant birth outcomes; however, very little research specifically examines WIC's largest participant group, children under the age of 5.The failure to study child WIC participants is problematic for several reasons. First, it is important to determine whether the program is reaching children most in need of benefits. In addition, the primary goal of WIC is to safeguard the health of low-income children: thus, an important measure of programmatic effectiveness is whether participation in WIC actually improves the health of the child participant group. This dissertation is composed of two studies designed to shed light on these understudied areas. Both studies rely on data from the 1999-2008 National Health and Nutrition Examination Survey (NHANES).The first study examines the influence of child, household, economic, and infant health variables on child WIC participation among 1 to 5-year-olds. Utilizing linear probability models and logistic regression, this study finds evidence that child WIC participants are more disadvantaged than eligible nonparticipants, providing further evidence of negative selection among child WIC participants. In addition, this study finds no association between measures of infant health status at birth and the likelihood of participating as a child. The results also indicate that participation in WIC declines as a children age, a finding consistent with other WIC research.The second study examines whether child participation in WIC is associated with improved health and well-being among children ages 2 through 4. This analysis examines the influence of WIC participation on seven outcome measures of child health and well-being: excellent/very good health, fair/poor health, overweight, at-risk overweight, normal weight, anemia, and whether the child is limited in physical activity. Using logistic regression analysis and propensity score matching, this study finds little evidence that child WIC participants perform better on measures of child health and well-being.