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Impact of the Revised Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) Food Package Policy on Fruit and Vegetable Prices

https://doi.org/10.1016/j.jand.2013.08.003Get rights and content

Abstract

Obesity is generally inversely related to income among women in the United States. Less access to healthy foods is one way lower income can influence dietary behaviors and body weight. Federal food assistance programs, such as the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), are an important source of healthy food for low-income populations. In 2009, as part of a nationwide policy revision, WIC added a fruit and vegetable (F/V) voucher to WIC food packages. This quasi-experimental study determined whether F/V prices at stores authorized to accept WIC (ie, WIC vendors) decreased after the policy revision in seven Illinois counties. It also examined cross-sectional F/V price variations by store type and neighborhood characteristics. Two pre-policy observations were conducted in 2008 and 2009; one post-policy observation was conducted in 2010. Small pre- to post-policy reductions in some F/V prices were found, particularly for canned fruit and frozen vegetables at small stores. Compared with chain supermarkets, mass merchandise stores had lower prices for fresh F/V and frozen F/V and small stores and non-chain supermarkets had higher canned and frozen F/V prices, but lower fresh F/V prices. Limited price differences were found across neighborhoods, although canned vegetables were more expensive in neighborhoods with higher concentrations of either Hispanics or blacks and fresh F/V prices were lower in neighborhoods with more Hispanics. Results suggest the WIC policy revision contributed to modest reductions in F/V prices. WIC participants’ purchasing power can differ depending on the type and neighborhood of the WIC vendor used.

Section snippets

Sample and Design

This study involved 3 years of data (2008-2010) from all WIC vendors in seven northern Illinois counties (DeKalb, DuPage, Kane, Lee, Ogle, Winnebago, west suburban Cook).19 Although located in Cook County, the city of Chicago was not included because most WIC participants in Chicago are served by WIC food-distribution centers. These counties were chosen based on proximity to the research team, as well as contiguity and demographic diversity (race/ethnicity, socioeconomics, urbanicity). Under

Results

A total of 329 vendors were observed in 2008, 346 in 2009, and 364 in 2010. Across the 3 years, 27% were chain supermarkets, 8% were mass merchandise stores, 13% were non-chain supermarkets, 16% were small stores, and 37% were pharmacies.

Discussion

Implemented in 2009, the WIC policy revision is one of the most significant efforts to modify the nutrition guidelines in a federal food and nutrition assistance program. These revisions provide an important opportunity to evaluate how revised policies in food and nutrition assistance impact food prices and dietary choices. WIC and authorized vendors serve approximately 8.9 million infants, children, and pregnant/postpartum women each month with estimated expenditures of $6.8 billion annually.26

Conclusions

In the United States, body weight is inversely related to income among women, with differences in association strength sometimes observed by race/ethnicity.36, 37, 38 Ensuring availability and economic accessibility of F/V is essential to promote positive health outcomes among low-income populations. Although a larger subsidy and greater retail stocking requirements could yield more substantial environmental change,19 this study suggests that the cost-neutral WIC initiative might have reduced

Acknowledgements

The authors thank Penny Roth, Steven Strode, and James Armbruster at the Illinois Department of Human Services, Bureau of Family Nutrition for their contributions to this study. We also thank Sumithra Murthy and Susan Hobson for excellent assistance with data collection and Barth Riley, PhD, for statistical support.

S. N. Zenk is an associate professor, Department of Health Systems Science, University of Illinois at Chicago, Chicago, IL.

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    • Cited by (0)

    S. N. Zenk is an associate professor, Department of Health Systems Science, University of Illinois at Chicago, Chicago, IL.

    L. M. Powell is a professor, Health Policy and Administration Division, University of Illinois at Chicago, Chicago, IL.

    A. M. Odoms-Young is an assistant professor, Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, IL.

    R. Krauss is a graduate student, Department of Economics, University of Illinois at Chicago, Chicago, IL.

    M. L. Fitzgibbon is a professor, Department of Medicine, University of Illinois at Chicago, Chicago, IL.

    R. T. Campbell is a professor emeritus, Epidemiology and Biostatistics Division, University of Illinois at Chicago, Chicago, IL.

    D. Block is an associate professor, Department of Geography, Sociology, History, African-American Studies, and Anthropology, Chicago State University, Chicago, IL.

    STATEMENT OF POTENTIAL CONFLICT OF INTEREST No potential conflict of interest was reported by the authors.

    FUNDING/SUPPORT Supported by the USDA Economic Research Service RIDGE program and the Robert Wood Johnson Foundation Health Eating Research Program (#65852). S. N. Zenk’s time for manuscript development was supported by the Robert Wood Johnson Foundation Nurse Faculty Scholar Program (#68033). M. L. Fitzgibbon's time for manuscript development was supported by the National Institutes of Health (P60ND003424 and P50CA106743).

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