1. OSU-Tulsa WIC Program Yesenia Gomez NSCI 5373 December, 5 2002 CHILDHOOD NUTRITION

2. Topics Introduction to WIC WIC Eligibility Requirements WIC Food Package and Target Nutrients WIC Infant Formula Rebate System WIC Farmers’ Market Nutrition Program Cost of WIC Program Conclusions

3. Introduction to WIC Women Infants Children Program  Definitions  Background  Scope  Benefit //www.fns.usda.gov/wic/

4. Definition: The Special Supplemental Nutrition Program For Women, Infants and Children known as WIC program was created in 1972 by an amendment to the Child Nutrition Act of 1966 in response to growing evidence of poor nutrition and related health problems among low-income infants, children, and pregnant women. WIC Program Function in: – WIC provides cash grants to support program operations at 88 state-level WIC agencies, including those in all 50 States, American Samoa, the District of Columbia, Guam, Puerto Rico, the U.S. Virgin Islands, and 33 Indian tribal organizations.Introduction

5. Participation History - Nation: In 1974, the first year WIC was permanently authorized, 88,000 people participated. By 1980, participation was at 1.9 million; by 1990 it was 4.5 million; and by 2000 it was 7.2 million. In 2001, WIC served an average of 7.31 million participants per month. However, more than 7 million people get WIC benefits each month in the nation. Participation has increased gradually since the program began.Background

6. Background  Participation History - Oklahoma : WIC participation growth plot for Oklahoma from 1977 to 1997.  The participations raised from less than 10,000 to almost 40,000 in 5 years with growth rate of 6,000 participants/year (1977 – 1983).  After that, it dropped down and it remained almost constant during the years 1983 until 1989. A negative tendency is observed during 1990 – 1991.  However, after those years, Oklahoma’s WIC program came back with very strong growth rate of 10,000 participant/year.

7.  Participation History - Oklahoma: Recently, Oklahoma WIC Statistics by Carrie, C., 2002.  As of July 31, 2001, shows that 22,680 women, 23,833 infants and 42,026 children have participated with overall served around 88,539 participants.  A new computer system (OK-WIC) operational is implemented in 144 sites across the state.Background

8. Participation History - Tulsa:  In September 2002, the Oklahoma State WIC Program served 4,323 infants and 7,606 children in Tulsa county. WIC tracks health risks for specific age groups.  For infants and children in Tulsa county less than 24 months of age, 7.6% were at risk for weight/height less than or equal to the 10th percentile.  UNDERWEIGHT: For children age 2 to 5 years in Tulsa county, 5.3% were at risk for a BMI less than or equal to the 10th percentile.  OVERWEIGHT : For children ages 2 to 5 years in Tulsa county, 12.5% were at risk for a BMI greater than or equal to the 95th percentile Background

9. Scopes: The purpose of the program is to provide supplemental foods and nutrition education through payment of cash grants to state agencies, which administer the program through local agencies at no cost to eligible persons. The program is intended to serve as an adjunct to good health care during critical times of growth and development, also can help prevent medical and developmental problems. In addition, WIC was designed to supplement the Food Stamp Program and other programs that distribute foods to needy families. Introduction

10. Benefits: WIC program has been an important source of nutrition education, supplemental food, and health care referrals for low-income women during and after pregnancy and for infants and children up to age 5 years in the United States. Also WIC program decreases the incidence of iron deficiency anemia in children and contributed to reduce fetal deaths and infant mortality. Additionally, WIC help get children ready to start school: children who receive WIC benefits demonstrate improved intellectual development. Introduction Breastfeeding promotion and support are important components of the WIC program. WIC is effective in improving the health of pregnant women, new mothers, and their infants.

11. Topics Introduction to WIC WIC Eligibility Requirements WIC Food Package and Target Nutrients WIC Infant Formula Rebate System WIC Farmers’ Market Nutrition Program Cost of WIC Program Conclusions

12. Eligibility Criteria : To qualify for WIC, applicants must be either – pregnant woman, a non-breast-feeding women up to 6 months postpartum – breast-feeding woman up to 1 year postpartum – infants under 1 year of age – children up to the fifth birthday. The eligibility criteria for individuals include household income, state residency and individual’s nutritional risk status. To meet WIC Program income requirements, applicants must have family income at or below 185 percent of the U.S. poverty guidelines or participate in the Food Stamp, Medicaid, or Temporary Assistance for Needy Families (TANF) Programs. WIC Eligibility Requirements

14. Eligibility Criteria : In addition to the income criteria, WIC participants must meet nutritional risk standards. Two major types of nutritional risk are recognized for WIC eligibility: – Medically based risk such as anemia, underweight, maternal age, history of pregnancy complications, or poor pregnancy outcomes are designated as “high priority”. – Diet-based risk such as inadequate dietary pattern are rated as lower priority risk. – Nutritional risk is evaluated by a health professional such as a physician, nutritionist, or nurse based on Federal guidelines. At a minimum, the applicant’s height and weight must be measured and blood test taken to check for anemia. This health screening is free to program applicants. WIC Eligibility Requirements

15. Topics Introduction to WIC WIC Eligibility Requirements WIC Food Package and Target Nutrients WIC Infant Formula Rebate System WIC Farmers’ Market Nutrition Program Cost of WIC Program Conclusions

16. Food Package: Most WIC participants receive checks, vouchers, or electronic benefits transfer (EBT) cards each month that allow them to purchase a monthly food package designed to supplement their diets. WIC provides foods that are high in target nutrients such as protein, calcium, iron, and vitamins A and C. These nutrients are frequently lacking in the diets of the program’s low-income target groups, which may result in adverse health consequences. Dietary Products : WIC foods include iron-fortified infant formula and infant cereal, iron-fortified adult cereal, infant and adult 100% juices, vitamin C-rich fruit and vegetable juices, eggs, milk, cheese, peanut butter, dried beans, and peas. Tuna fish and carrots are additional to the enhanced food package for breast- feeding women whose infants are not receiving formula from WIC Food Package and Target Nutrients

17. Target Groups: There are seven WIC food packages designed for different target groups: Package I is for infants 0 to 3 months old Package II for infants 4 up to 12 months old Package III for women and children with special dietary needs Package IV for children 1-4 years old Package V for pregnant and breast-feeding women Package VI for postpartum women who are not breast-feeding, Package VII for breast-feeding women whose babies do not receive formula. Food Package and Target Nutrients

18. Topics Introduction to WIC WIC Eligibility Requirements WIC Food Package and Target Nutrients WIC Infant Formula Rebate System WIC Farmers’ Market Nutrition Program Cost of WIC Program Conclusions

19. Infant Formula: Mothers participating in WIC are strongly encouraged to breast-feed their infants if possible. However, state WIC Agencies will provide formula to mothers who choose to use it. WIC state agencies are required by law to have competitively-bid infant formula rebate contracts with infant formula manufacturers. This means a WIC state agency agrees to provide one brand of infant formula to its participants and in return receives money back, called a rebate, from the manufacturer for each can of infant formula that is purchased by WIC participants Cost-Effective Program : The WIC Program gets back over a billion dollars each year from infant formula manufacturers. From October 2000 to September 2001, infant formula manufacturers gave nearly $1.5 billion back to WIC State agencies and this money was used to serve about 2.1 million additional eligible women, infants and children. Infant Formula Rebate System

20. Topics Introduction to WIC WIC Eligibility Requirements WIC Food Package and Target Nutrients WIC Infant Formula Rebate System WIC Farmers’ Market Nutrition Program Cost of WIC Program Conclusions

21. FMNP: The Congress established the WIC FMNP in July 1992. This program provides additional coupons to WIC participants, which they can use to purchase fresh fruits and vegetables at participant farmers’ markets. Operated in 35 States, including the District of Columbia, Guam and 4 Indian Tribal Organizations Program Goals : 1. Improve the diet and health of WIC participants who are at nutritional risk 2. Supplement the income of small farmers. Farmers’ Market Nutrition Program

22. Topics Introduction to WIC WIC Eligibility Requirements WIC Food Package and Target Nutrients WIC Infant Formula Rebate System WIC Farmers’ Market Nutrition Program Cost of WIC Program Conclusions

23. Congress Grant : The number of women, infants, and children who can participate in WIC each year depends on the annual appropriation by Congress and the cost of operating the program Cost Comparison : WIC program cost $10.4 million in 1974; $727.7 million in 1980; $1.5 billion in 1985; $2.1 billion in 1990 and $3.9 billion in 1999. However, WIC accounts for almost 12 percent of total Federal Government expenditures for food and nutrition assistance. In the year 2002, Congress appropriated $4.387 billion for WIC and this funding includes $10 million for the WIC Farmers’ Market Nutrition Program Cost of WIC Program

25. Hispanic Participation : As can be seen from participation growth plot per states. Even though, there are not enough reports about different race participation in WIC program available. Larger Growth Rate of Participation are Present in States with High Population Density of Hispanic Communities as Comparing with Others States with lower Hispanic Ratio One Can Say that Hispanic Families has taking benefit of this successful program. From Personal Observation as WIC Volunteer Confirm High Participation of Hispanic Families in Tulsa, as well. Participation-Growth Analysis

26. Conclusions – The outcome of the studies performed by the FNS and non- government agencies conclude that WIC has become one of America’s most successful and cost-effective nutrition intervention programs. – Since its foundation, the WIC program has gained the position of becoming one of the most primary federally funded nutrition programs in the U.S. A collection of researched evidence, revised information, and up to date reports show the cost effectiveness of the WIC Program by protecting and improving the health/nutritional status of women, infants and children of low income means.Conclusions

27. Final Remarks – The final remarks of the importance of the WIC program is that alongside of providing health care and supplemental food for women, infants and children, it has also been an important source of education. – WIC has demonstrated the power of education and the information to reach and encourage low-income parents to participate in the program (as it is demonstrated by statistics). – The nutritionist role during this process is to inform and educate parents about WIC program and explain to them the importance of the health benefits that a good nutrition at early age can offer, beside of the economic reimbursement to the family, as well. Stimulating program for breastfeeding during pregnancy.Conclusions

28. – Blair B, Davidson D, Dembeck C, Robb K, Kauffman T. Bush’s Request-- Agency by Agency, Federal Times, 2002; 38: 10. – American Academy of Pediatrics. WIC Program. Pediatrics, Nov2001, Vol. 108 Issue 5, p1216, 2p – Bogo J. The Whole Package. The Environmental Magazine. 2000; 11: 22. – Carrie, Ceman: Oklahoma State Department of Health, WIC Program, personal communication, 2002. – Oliveira V, Gundersen C. WIC Increases the Nutrient Intake of Children. Food Review. 2001; 24: 27. – Henchy G, Weill J, Parker L. WIC in the States: Twenty-Five Years of Building a Healthier America. September 1, 1999. – Robertson RE. Food Assistance: WIC Faces Challenges in Providing Nutrition Services, FDCH Government Account Reports, 2001. – US General Accounting Office, “Early Intervention: Federal investments Like WIC Can Produce Savings,” Document HRD 92-18, Washington, D.C., April 1992.References

29. Questions?