Access to Healthy Foods Among WIC Families

UW Community Nutrition 531

January 7, 2011

Kari Fisher MPH, RD, CDNicole Flateboe MPH, RD, CD

Public Health-Seattle & King Co.

“WIC”

• The Special Supplemental Nutrition Program for Women, Infants and Children

• Federal Program– Also dependant upon State and local

government funding

• One of the most cost effective federal preventive health programs in existence

WIC Provides

• Health screening

• Nutrition and health education

• Breastfeeding promotion and support

• Referrals to health care and social service organizations

• Vouchers for nutritious foods

Who is Eligible?

• Low income (On Medicaid or 185% of FPL or less)

• Women who are pregnant, breastfeeding (up to 12 mo), post-partum women (up to 6 mo), Infants, and Children under age 5

• Have a medical or nutritional need

Washington State Income Guidelines through March 2011

Household or Gross Income** Gross Income** Family Size* Per Year Per Month

2 $26,955 $2,247

3 $33,874 $2,823

4 $40,793 $3,400

5 $47,712 $3,976* A household is defined as a group of related or non-related individuals, who usually, although not necessarily, are living together and share income. WIC includes unborn baby.

**Gross income is income before taxes and deductions.

Outcomes of WIC participation

• Longer pregnancies• Reduction in infant

mortality, low birth weight babies and premature births

• Greater likelihood of accessing prenatal care

• Increased nutrient density of children’s diet

• Reduced incidence of iron-deficiency anemia

• Increase in breastfeeding rates

• Improved childhood immunization rates and regular medical care

• Improved cognitive development

• Savings in health care costs

http://www.fns.usda.gov/wic/aboutwic/howwichelps.htm

A WIC appointment

• Eligibility review– Income – Health/Nutrition Assessment– Anthropometrics and assessment of growth– Screening for anemia

• Client-centered nutrition and health education

• Referrals to health care and social services

• Vouchers for nutritious foods “checks”

WIC Foods Support Good Nutrition

• Aligned with dietary recommendations for infants and the Dietary Guidelines for Americans

• Aim to reduce inadequate and excessive nutrient intakes in participants

• Take into account cultural food preferences

• Suitable for those who may have limited transportation, cooking and storage resources

WIC Approved Foods for Women and Children

• Fresh fruits and vegetables

• Whole wheat bread, brown rice, bulgur, oatmeal, soft corn tortillas

• Peanut butter• Dried beans and lentils• Cereal, iron fortified• Eggs

• Reduced-fat milk (Whole milk for children under 2 years)

• Cheese• Soy beverage• Tofu• 100% juice• Canned tuna or salmon

(Breastfeeding only)

WIC Approved Foods for Infants

• For the first 12 months:– Breastfeeding promoted as healthiest feeding

method– Iron fortified formula for non-breastfed infants

• 6-12 mo of age:– Jarred baby food vegetables and fruits– Jarred baby food meats (breastfed infants)– Iron/zinc fortified infant cereal

WIC in Washington State 2009

• 51% of all infants born participated in WIC

• 69% of WIC Families are employed

• 63% of WIC participants live at or below the poverty line

• WIC Food Dollars: $134 million

• Dollars directly to local farmers of fruits and vegetables: $796,000

• 63 community and public health agencies provide WIC, employing 1000 people

2009 Washington WIC Annual Report

WIC in King County

• 38,500 monthly caseload served by Public

Health - Seattle & King County WIC

Program

• WIC services provided at 24 hospital,

community clinic and public health sites

and other satellite sites

• 37% Infants born in KC on WIC

http://www.doh.wa.gov/cfh/wic/reports.htm

Nutrition 531 Access to Healthy Foods Among

WIC Families• Goal: Improve access to healthy foods in

WIC families in targeted areas of south King County.

• Objectives:

• Students will assess the ability of WIC families to access healthy foods.

• Students will develop recommendations for policy changes to improve food access for the WIC families.

What is CPPW grant?

• Public Health – Seattle & King County was awarded a federal stimulus money grant in 2010 for Obesity Prevention and Tobacco Cessation.

• The name of this grant is “Communities Putting Prevention to Work”—referred to as CPPW

Healthy Foods Here project

• This is one of the CPPW-funded projects with the goal of working with small grocery stores and convenience stores to sell fresh and healthy foods.

• This grant focuses on areas of the county with limited access to healthy foods in supermarkets (food deserts)

Healthy Foods Here cont.

• These areas of the county have higher rates of health disparities and poverty.

• Many of the supermarkets do not carry specific cultural foods representing the population who lives there.

• Individuals often prefer to shop at small grocery stores where the operators speak their language and carry familiar foods.

What Healthy Food Here is doing

• Providing store owners with training and technical assistance to carry healthier array of foods.

• Working to change the state regulations for stores to become WIC authorized vendors.

• Partnering with WIC Administration to gather information and educate staff in the WIC clinics in their catchment area.

WIC regulations

• Public comment is being gathered at this time.

• New recommendations will be adopted in Spring, 2011

• Healthy Foods Here is proposing policy changes to make it easier for small grocery stores to meet WIC authorized retail rules.

WIC Clinics in our focus area

High Point WIC—part of Neighborcare Health 6020 35th Avenue SW, Seattle, 98126

Highline WIC –next to Highline Hospital 13030 Military Rd. S, #108, Tukwila

White Center Public Health WIC 10821 8th Avenue SW, Seattle, 98146

High Point Neighbor Care WIC

• Located in the High Point neighborhood of West Seattle within a “food desert”

• 50% on Basic Food• Client’s Ethnic/Racial makeup: 45% Black or

African American; 21% Hispanic/Latino; 18% White; 16% American Indian or Alaska Native; 11% Multi-Race; 9% Asian; 2% Pacific Islander

• Language: English primarily, Spanish and Somali.

• 3 staff serve a WIC caseload of 825

Highline WIC

• Serves very diverse population that includes many new immigrants to US

• Located just east of Burien and north of SeaTac airport in Tukwila

• Multi-racial staff that speak Spanish, Somali, Hindi and Punjabi.

• Small clinic that serves a high volume of clients very efficiently.

• Community clinic site

Highline WIC demographics

• Caseload of 1450• 45% clients are on Basic Food• Ethnic/Racial make-up: 33% Black or

African-American; 31% Hispanic; 19% White; 9% Asian and 9% Multi-race.

• Languages: Many Spanish speaking, Somali, Russian and Burmese (new immigrant families)

White Center WIC

• Very diverse client population• WIC staff speaks English and several bi-

lingual Spanish speaking staff.• Located just south of City of Seattle limits

in White Center-Burien area• White Center Food Bank is located across

the parking lot from WIC clinic• Public Health WIC site

White Center WIC demographics

• Caseload of 2225

• 37% on Basic Food

• Client’s Ethnic/Racial Make-up: 41% Hispanic, 25% White, 16% Black or African American; 20% Multi-racial.

• Languages: Mainly Spanish speaking, also Vietnamese, Somali and Arabic.

What WIC Administration gets from this project:

• Improved knowledge of the shopping habits and access issues affecting our WIC clients

• Updated information about the degree of food insecurity affecting WIC clients

• Data to share with Healthy Foods Here project about WIC clients’ use of corner stores that could impact state policy.

Carrying out the Study

• Students will work with WIC staff at clinics to interview clients in a confidential and respectful manner.

• Interviews will be conducted in English only.

• Information will not have client identifying information associated with it.

• Students will sign confidentiality agreements at the clinic and agree to keep information private.

Any Questions?

?