Abstract
WIC is designed to promote the health and nutrient consumption of pregnant (or postpartum) women, infants, and young children. Food, however, is often a communal commodity shared by all household members; thus, a family’s composition may impact the health benefits received by a WIC participant. Using data from the 2010 wave of the National Health Interview Survey, this study finds that an only child who participates in WIC receives a health benefit from their participation while the benefits received by children with siblings are dependent on the age, gender, and number of siblings with whom they share a residence.
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Notes
The focus of the present study is on WIC enrolled children (1 year of age or older) for a few reasons. First, they are the largest subscribers of WIC, often accounting for as many as 50 percent of all program participants. Second, other family members can readily consume the foods WIC provides to children, whose food packages contain juice, milk, breakfast cereal, cheese, eggs, whole wheat bread, legumes or peanut butter, and a voucher for fresh fruits and vegetables. The same cannot be said of the foods provided to infants, whose food packages consist of formula, baby food meats, and baby food vegetables. Finally, although the foods provided to pregnant or postpartum women can be shared with children in the household, the focus of this paper lies in understanding the role of siblings, thus excluding mothers from the analysis.
For the purposes of this study a child is considered an only child if they are the only individual in their household who is younger than the age of 18.
The HEI is an analytical tool designed by the USDA’s Center for Nutrition Policy and Promotion to measure compliance with dietary guidelines. The index assigns points based on a person’s reported daily consumption of 10 dietary components (grain, vegetables, fruits, milk, meat, fat, saturated fat, cholesterol, sodium, and variety) as well as an aggregate score. Each component’s score indicates the degree of compliance with a score of 10 indicating that the individual has consumed (at least) the daily-recommended value for that component, while a score of 0 indicates that an individual has not consumed any food belonging to that group. A HEI score of 100 would indicate that an individual has consumed at least the recommended daily values of all components.
As part of the supplemental survey of sample children a knowledgeable adult (often a parent or legal guardian) is asked whether the sample child’s health is better than, worse than, or about the same as it was twelve months ago.
Children born to women over the age of 40 were eliminated because the risk of complications during pregnancy and the likelihood of birth defects (which could both have a significant impact on a child’s health, separate from their income and program participation) increase sharply beyond this point.
A household’s PIR is the ratio of the midpoint of the family’s self-reported income bracket and the Census Bureau’s poverty threshold for the year in which the family was interviewed. For the purposes of this study a child was considered WIC eligible if their family’s PIR was 1.85 or below. This indicated that the household income was equal to or below 185 percent of the federal poverty line, which constituted the USDA’s income threshold for program eligibility.
Stratified estimation is preferred to pooled estimation with a control for the presence of a sibling as it is more flexible and does not restrict the coefficients for non-group dummy variables in the model to be the same for all groups.
It should be noted that the probability a child’s health improves or deteriorates is independent of the child’s current health level. That is, children in excellent, very good, and good health have roughly the same likelihood of seeing an increase or decrease in their health. Children in fair/poor health are less likely than the others to see an improvement in their health but are no more or less likely to see their health deteriorate than are other children.
For estimation purposes only, a household’s PIR is considered the midpoint of the PIR bracket the household is reported to belong to.
Alternative models controlling for additional child and sibling characteristics including the WIC participation status of preschool age siblings, the presence of disabled individuals in the household, and a child’s enrollment in a public health insurance program were also considered. The inclusion of these additional controls did not significantly affect the findings of this study and for brevity, the following discussion focuses on the more parsimonious estimation where siblings are categorized by age and gender only. Results from the expanded models are available upon request.
For brevity purposes, I only report and discuss the marginal effects for WIC participation and for siblings in WIC households, the variables of key interest. Marginal effects for other variables are available upon request.
For a detailed discussion of these methods as applied to WIC evaluation studies, see Colman et al. [2012].
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Acknowledgements
I am grateful to Nicole M. Coomer, Ardeshir Dalal, Carlos Liard-Muriente, Sharmistha Self, and two anonymous reviewers for their helpful comments and suggestions. All remaining errors are my own.
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Robinson, C. Family Composition and the Benefits of Participating in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). Eastern Econ J 42, 232–251 (2016). https://doi.org/10.1057/eej.2014.43
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DOI: https://doi.org/10.1057/eej.2014.43