Abstract
Background
The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is a federal nutrition assistance program aiming to address food insecurity and improve health. Participation varies across marginalized groups (eg, Black, Hispanic, low-income, rural), likely due to WIC access barriers and satisfaction, limiting WIC's impact on health disparities.
Objective
Assess WIC access and satisfaction across marginalized groups to understand determinants of WIC participation in Missouri, where food insecurity is high (11% overall, 12% Hispanic, 26% Black) and WIC participation low (41%).
Methods
This cross-sectional study used data from the Missouri WIC Experience Survey (April 2022–June 2022). Bivariate and multivariate logistic regression assessed access (eg, clinic wait times, clinic hours, clinic location) and satisfaction (eg, nutrition education, meeting dietary needs, shopping experience) across race/ethnicity, income, and urbanicity.
Results
The sample (n = 2232) consisted of 69% White, 16% Black, and 8% Hispanic WIC-eligible households. Most had monthly incomes of $4000 or less (69%) and 32% lived in rural areas. Black households had 75% higher odds of experiencing barriers compared to White households. Compared to urban households, rural households experienced 30% lower odds of being satisfied overall with WIC, but 75% higher odds of being satisfied with WIC meeting dietary needs. Hispanic households had 85% higher odds than White households of being satisfied with WIC.
Conclusions
Findings offer considerations for addressing WIC access and satisfaction. WIC design and implementation should focus on barriers to access for Black households and improving overall satisfaction with WIC among rural and low-income households.
Plain language title
Describing differences in WIC participation across racial, ethnic, rural, and low-income groups
Plain language summary
The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) supports families with low household incomes to purchase healthy food. WIC is not always easy to access, and families may not be satisfied with WIC benefits, leading to less participation in the program. Some groups such as Black, Hispanic, lower-income, and rural, may be more likely to experience barriers to WIC access and less satisfaction; however, less is known about these differences. We analyzed a survey of Missouri households who are eligible for WIC to understand their program experiences. Missouri is an important state to study because of the low levels of WIC participation. We asked about WIC access barriers such as clinic wait times, locations, and hours. We asked about satisfaction with using WIC such as finding WIC items in the store, WIC education, and WIC meeting dietary needs. Overall, 2232 people took the survey. Most were White (69%), but many were Black (16%) and Hispanic (8%). About 32% were rural and most (69%) made $4000 or less a month. Black households were more likely to face challenges accessing WIC services than White households. When using WIC, rural households were generally less satisfied than urban households but were more likely to feel like WIC met their dietary needs. Hispanic households were more satisfied with WIC overall, compared to White households. Differences in access and satisfaction with WIC are important to know how to improve WIC and make it better for everyone. If WIC is more accessible and people are satisfied, more people will benefit from WIC. Also, WIC may reduce food insecurity and improve health.
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