WIC program
WIC began to promote and support breastfeeding women in the late 1980s, and in 1989 Congress mandated $8 million be used specifically for that purpose.
In December 2000, the White House issued an executive memorandum authorizing the WIC program to begin screening clients for childhood immunization status.
[5] Applicants to the WIC program must meet eligibility requirements in four areas: (1) categorical, (2) residential, (3) income, and (4) nutrition risk.
[6] Once applicants meet the eligibility requirements, they can expect to receive WIC assistance in the following four areas:[9] Nutrition education ranges various topics including healthy eating, appropriate infant feeding, and breastfeeding.
A study of birth outcomes showed benefit-to-cost ratios ranging from $1.77 to $3.13 in Medicaid costs saved for each $1 spent on WIC.
The food items provided by WIC are juice (single strength), milk, breakfast cereal, cheese, eggs, fruits and vegetables, whole wheat bread, whole grain items including brown rice and tortillas, canned fish (for exclusively breastfeeding mothers), legumes (dry/canned), and peanut butter.
The program also provides tofu, soy milk, and medical foods for children and women with various metabolic or other diseases.
Some organic forms of WIC-eligible foods (e.g., milk, eggs, cheese) meet the nutritional requirements set forth in WIC regulations and are therefore authorized.
[15] In many state programs, for a WIC certification and health screening process, the staff advises parents to bring their child's immunization records.
At the state level, the WIC agencies can choose to document immunization screening and referrals, along with many other optional activities.
A woman, infant or child must meet two standards to be eligible to receive WIC benefits: (1) nutritional risk and (2) income disparity.
Yet according to Peter Germanis and conservative AEI scholar Douglas J. Besharov in the SAGE Evaluations Review Journal, these two requirements often fall short in determining the real eligibility for WIC participants.
WIC's current definition of nutritional risk includes different medical conditions such as anemia and low or overweightness.
Their research concluded that because the judgment of nutritional risk is left up to the discretion of the doctor, many participants who only partly need WIC's assistance often take the spots of those with greater need.
While this definition seems straight forward, Besharov and Germanis describe many instances in which WIC participants with incomes above this level still received services.
[23] To combat this phenomenon, Gundersen suggests that if policymakers want to reach those most in need, they need to target this group of people who were once on WIC and left, not new recipients.
For instance, the nutritional risk criteria that had previously been instituted by the state cutoffs were standardized by the federal government in 1999.
[24] In 1989, the Child Nutrition and WIC Reauthorization Act increased the amount of eligible program participants by allowing groups such as Medicaid, Aid to Families with Dependent Children (AFDC), Temporary Assistance for Needy Families (TANF), and those qualified for food stamps automatically became eligible for WIC assistance.
Research has identified an increase in health benefits among WIC program participants that could offset the additional costs of Medicaid in the future.
Some scholars assert that the spending structure needs to be adjusted so a greater number of eligible individuals can receive WIC services.
Besharov and Germanis argue that a sustained effort to make the program more effective should begin with a policy debate about WIC's role and impacts.
In the article "WIC Reauthorization: Opportunities for improving the Nutritional Status of Women, Infants, and Children (2002), authors Fox, McManus, and Schmidt from the George Washington University, say local WIC agencies are required to make nutrition education available to participants at least twice in each six-month certification period.
Based on the data mentioned by Alison Jacknowitz from American University and Laura Tiehen from the U.S. Department of Agriculture in their article "Transitions into and out of the WIC Program: A Cause for Concern?
The program food package is designed to address the specific needs of low-income pregnant, breastfeeding, and postpartum non-breastfeeding women; infants; and children up to five years of age who are nutritionally at risk.
[28] Nationwide data showed that WIC participants had inadequate intake of vitamin E, magnesium, calcium, potassium, and fiber while using the original food packages.
[28] Despite the huge expenditures each month to supplement millions of diets in the country, the program was not delivering the necessary nutrients to this important population made up of women, infants, and children during the most critical time in their lives, drastically affecting future health.
This included prioritizing the targeted nutrient intake and offering recommendations for specific changes to the WIC food packages.
To do this, the committee was charged with making recommendations that were "culturally suitable, non-burdensome to administration, efficient for nationwide distribution and vendor checkout, and cost-neutral.
WIC has recently expanded this list to also include soy-based beverages, tofu, baby foods, whole-wheat bread, and a variety of fruits and vegetables.
The study revealed that WIC users who exclusively breastfed their children during the first six months of the child's life incurred a savings of $112 in Medicaid costs per infant.
