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COMPLETED MAR 1 5 l99& n reo Srotes Aporrmel'lr or Ag• cult .. re Food ono Consumer SPrvrce Olfi::e of Analysis and Evaluation Study of WIC Participant and Program Characteristics 1994 STUDY OF WIC PARTICIPANT AND PROGRAM CHARACTERISTICS 1994 Prepared for Office of Analyses and Evaluation Food and C0l'.Sumer Service U.S. Depanment of Agriculture 3101 Park Center Drive Alexandria, Virginia 22302 December 1995 Bonnie Randall Lyria Boast Laurin Holst With the assistance of Frederick deFriesse Liya IsaJcov Tracy Olcott Douglas Taylor FNS 53-3198-9-002 Prepared by Abt Associates Inc. 55 Wheeler Street Cambridge, Massachusetts 02138 ACKNOWLEDGEMENTS The 1994 study of WIC pantctpant and program characteristics. like irs predecessors in 1990 and 1992, must be dedicated to our friends and colleagues in State WIC agencies. They provtde all of the data presented in this repon and its appendices. We gratefully and humbly acknowledge their cooperauon and conunend the diligence of the WIC Program m creating and maintairung vaable. practical client infonnation systems. Denise Thomas, the project officer at the Food and Consumer Service (FCS), has been unstinting in providing suppon and guidanc-: and has maintained her sense of humor for the past eighteen months. Others at FCS who have given generously of their time and knowledge include: Julie Kresge, Laurie Hickerson, and Matthew McKeam. At Abt Associates, Nancy Burstein and Michael Puma provided technical guidance and useful commento-ry; Eileen McEnaney ably and cheerfully assisted in repon production. • I Aclcnowltdrtmtnts 1 J I The 1994 Study EXECUTIVE SUMMARY The Spectal Supplemental Nutnuon Program for Women. Infants. and Children (WIC) is administered by the Food and Consumer Serv1ce CFCS) of the US Department of Agriculture (USDA). The WIC Program provides a combination of direct nutritional supplementation. nutrition educauon and counse!ing. and increased access to health care and social service providers for pregnant. breastfeeding, and postpartum women: infants; and children up to the age of five years. WIC seeks to improve fetal development and reduce the incidence of low binhweight, short gestation. and anemia through intervention during the prenatal period. Infants and children who are at nutritional or health risk receive food supplements. nutrition education. and access to health care services to maintain and improve their health and development. To receive WIC benefits, an individual must be categorically eligible; that is. the person must be a pregnanl. breastfeeding, or postpartum woman; an infant up to the age of one year: or a child aged one through four years. In addition. each applicant must be found to be income eligible and at nutritional risk. Eligible applicants receive supplemental food usually in the fonn of vouchers or checks which allow them to obtain specific types of food (milk, juice. cereal. for example) from participating retail grocers. The WIC Program was established in 1972 by an amendment to the Child Nutrition Act of 1966. WIC has greatly expanded since its inception. and. m April 1994, WIC served almost seven million participants at an annual cost of over three billion dollars. Public Laws 99-500 and 99-591, enacted in 1986, require FCS to submit bienmal repons to the Congress on current participant and program characteristics in the WIC Program. This legislation specifies that each biennial report must include· • Infonnation on the income and nutritional nsk characteristics of WlC participants. • Data on WIC program participants for m1grant fann worker families. • Other infonnatlon on WIC pantctpauon that 1s deemed appropnate by the Secretary of Agnculture. This publication is the founh repon which has been prepared to meet the legislative mandate to provide infonnation on WIC panicipants and programs to the Congress. The 1994 study of WIC program and participant charactenstics CPC94), like the 1992 study (PC92), is substantially different from earlier effons to collect data on WIC participants. PC94 employs the prototype reponing system which was developed by FCS for the 1992 study and which routinizes the collection of panicipant information from State WIC agencies. Earlier FCS studies of the WIC Program-in 1984 (PC84), 1988 (PC88), and 1990 CPC90)-were based on PC94 Encutivt Summary ,;, nationally representative samples of WIC pan1c1pants and programs. PC94. like PC92, contains information on a near-census of WIC pan1cipants m Apnl I 994 Participant Records. The current system for reponmg pan1c1pant data 1s based on the automated transfer of an agreed-upon set of data elements. State WIC agencies download routinely collected information which is on their existing automated client and management information systems. State and local WIC staff use these data to cenify applicant eligibility for WIC benefits and to 1ssue food vouchers and checks. This Minimum Data Set (MDS), which consists of eighteen items, was developed by FCS working with the Information Committee of the National Association of WIC Directors (NAWD). For the month of April 1994, each State WIC agency submitted MDS data on either a representative sample or a census of its WIC panicipants. In Apnl of 1994, there were eighty-four State WJC agencies: the fifty States. the District of Columbia. Guam. Pueno Rico. and the American Virgin Islands. along wnh th1ny Indian Tribal Organizations (ITOs). All eighty-four WIC agencres prov1ded data for PC94. Two of the eighry-four submitting agencies chose to repon on representative samples rather than censuses of their WIC participants. These States mclude Connecticut and Montana and account for about 1.3 percent of PC94's participant records. These data are weighted so that the total numbers of WJC panrcipants reponed here correspond to the total US WJC population m April 1994. The State-maintained automated information systems from which PC94 data are drawn do not always contain complete information on every individual enrolled in the WIC Program. Unreponed PC94 data may be unavailable for a variety of reasons which may indicate that participants in any of the not-reponed categories may be different from those individuals with data reponed. Assumpdol"l'i regarding missing data vary by the nature of the variable and by the category ol WJC participant. To account for these anomalies. a uniform strategy has been adopted for preparing all tables m this repon. Data not reponed are included m the calculation of percentage distributions for each characteristic. While mcludmg missing data in the denominators for all calculations tends to place estimates for each characteristic at a lower bound, th1s approach has allowed consistent presentation of tabulations throughout the repon. Funher. it assures that all information needed to calculate upper-bound estimates is readily available m every table. Caution should be used in companng results across groups; m1ssmg data must always be considered m gaugmg differences between. among, or across groups or categones of WIC pan1cipants. A second note of caution must be sounded here. Because of data quahty 1ssues in one large State, it is likely that the PC94 estimate of number of one-year-old WIC enrollees is 0.008 percent high. As a result. the PC94 estimate of number of WIC infants is about 1.0 percent low. PC94 Encu1111e Sumnuuy 1v The 1994 WIC Program Participant Characteristics in 1994 Summary of State Programs. The 1994 study. like earlier studies. mcluded a survey of State WTC agencies which obtamed infonnauon on WIC program characteristics. This survey was conducted by mail. with telephone followup. Data were collected on State WIC operaung policies and procedures for mcome detennination. food package tailoring, food instrument Issuance. and average monthly food package costs by participant category. All of the eighty-four State WIC agencies operating in April 1994 completed the survey questionnaire. During the two-year period between April 1992 and Apnl 1994, little change has occurred in WIC program operations and procedures. In 1994, WIC services were delivered in the fifty States. the District of Columbia. Pueno Rico, Guam. and the American Virgin Islands as well as by thiny Indian Tribal Organizations. These eighty-four State WIC agencies operated 2,129 local WIC agencies where staff delivered WIC serv1ces at about ten thousand serv1ce sites. Just about half (49 percent) of all WIC participants receive services in mne States~alifomia. Aorida. Georgia. Illinois. Michigan. New York. Pennsylvama. Ohio, and Texas. In fact. more than one-quarter (28.3 percent) of WIC participants can be found in three states~alifomia. New York, and Texas. This proponion has grown from 2.5.3 percent in 1992. In April 1994, 6,907,848 women, infants. and children were enrolled in the WIC Program-a 20 percent increase over WIC enrollment reponed in 1992. A caution must be raised with regard to comparing PC92 and PC94 with their near censuses of WIC enrollees to findings from earlier studies. Previous proJects have generally reponed program participation as measured by food instrument Issuance. PC92 and PC94 provide infonnation on all individuals listed as WIC Program enrollees on management and client infonnation systems maintained by State WIC agencies. It is likely that, in most States. food instruments were not issued to small percentages of these enrollees. Some of the increase in WIC participation from 1990 to 1994 can be attributed to this difference in measurement. Some of the 1992-to- 1994 growth is the result of targeung cenain States to receive increased funding in order to serve larger proponions of eligible populations. Half (.50.2 percent) of WlC participants are children. infants account for 26.8 percent and women 23.0 percent. This d1stnbution contams a slightly higher propon10n of children than seen in 1990 and 1992 and a somewhat lower proponion of infants (30.1 in 1992 and 29.8 in 1990). This shift may reflect declining US binhrates. Women were funher divided into pregnant (11.9 percent of all participants). breastfeeding (4.0 percent of all partiCipants), and postpanum (7.1 percent of all panicipants). The percentage of postpartum participants increased by 2 percentage points from PC92. while the percentage of pregnant WIC panicipants decreased by 1.6 percentage points. See Exhibit E. I. PC94 E.rtcutivt Sumnuuy v Exhibit E.1 Distribution of Individuals Enrolled in the WIC Program April1994 Poatpllrtum Women Pregnant Women Children N•U07,141 Most (82 percent) of the pregnant women pan.cipating m WIC are between the ages of 18 and 34 as are high proponions of breastfeeding (83.7 percent) and postpartum (83.0 percent) "omen. Only I 0 3 percent of women WIC clients are aged seventeen or younger. Over three-quarters (84 percent) of all infant WIC participants were cen1fied for WIC benefits during their first three months of hfe. Child participation decreases as age mcreases-most (40 percent) ch1ld participants are one year of age. It is imponant to reiterate here that the findings reponed in this volume must be interpreted through the lens of unreponed data. For example. with regard to age. information to calculate this variable was not reponed for 1.5 percent of women. 3.0 percent of infants, and 2.5 percent of children. PC94 ExtcUIIIIt Summary 111 About the same propomons of pregnant WIC participants enrolled m the program during their first (38.9 percent) and second (40.1 percent) tnmesters. These figures represent a 5.2 percentage point mcrease m first tnmester enrollment smce 1992 and a 1.5 percentage pomt decrease m second tnmester enrollment. Data needed to calculate trimester were not reponed for 10.3 percent of pregnant WIC participants. In 1992. the not-reponed percentage was 8.8. Race and Ethnicity. In the 1994 study, as in previous studies. whites made up the largest percentage of WIC participants ( 42.7 percent), followed by Hispan1cs (26.1 percent), blacks (25.4 percent), Asian or Pacific Islanders (2.6 percent). and American Indian or Alaskan Natives ( 1.7 percent). Race/ethnicity data were reponed for 98.4 percent of WIC panicipants. This distribution indicates small increases, since PC92, in the percentages of Hispanic and Asian or Pacific Islanders with corresponding decreases among black and white enrollees. Household Size. The mean household size of WIC participants m April 1994 was 4.0. a slight increase from the 3.8 average reponed in I 992. The percent of pregnant women certified as one-person households was 17.8 percent-about the same as reported in PC92. OveraJI, information on household size was reponed for 98.9 percent of WIC participants. Income. Among WIC participants reporting some income. the average annualized income of families/econom1c units of persons enrolled m the WIC Program m April 1994 was $9,684, an increase l)f $393 since 1992. This increase in current dollars is probably a decrease in real dollars, that is, the higher average most likely reflects inflation rather than increased income. Across participant categories, breastfeeding women reponed the highest average income at S 1 I .032; postpartum women exhibited the lowest average income at $9.197. lllese findings replicate PC92 results. As in I 988. 1990. and 1992, black participants displayed the lowest average income-$7 ,281 for families or economic umts. a decrease from $7.329 reported for PC92. As they did in the 1992 study. Asian or Pacific Islander participants had the highest average annualized mcome at $11,667. Findings about income must be interpreted with caution given the high proportion of unreported information. For PC94. income cannot be calculated for 16.4 percent of WIC participants-virtually the same proportion ( 16.7 percent) of unreported income data as in PC92. ParticipatioP in Other Programs. WIC legislation allows mcome ehg1biluy requirements to be met by participation m means-tested programs such as the Medica1d, Food Stamp, and Aid to Families wuh Dependent Children (AFOC) Pro gran ~s. In 1994, about two-thirds of WIC participants received benefits from at least one other public assistance: program. With regard to participation m each program, 53 percent of WIC clients rece1ved Medicaid benefits; 37 percent participated in the Food Stamp Program: <md 27 percent of WIC participants reponed receiving AFDC benefits. Less than one-quarter (22.9 percent) participated in all three programs, receiving Medicaid. food stamp, and AFDC benefits. Such data were not reponed for 7.8 percent of 1994 WIC reczpients. PC94 EztcuJivt SumtNJry vii These estimates of reported part1cipauon m other programs may well represent a lower bound. At certification. staff in local WJC agenc1es prov1de infonnauon on other programs so that some WTC clients apply for these benefits after they are certified to receive WTC benefits and this mfonnauon on program part1c1pauon is recorded. Poverty Status. Compared with the general US population. the WJC population is distinctly poor, with two-thirds of WJC partiCipants at or below the poverty line. The sharp contrast between WTC clients and the general population can be seen in Exhibit E.2 which compares the poverty status of WTC paruc1pants reporting income to the general US population-three-quarters of WJC enrollees reporting income are at or below the poverty line. More detailed figures appear in Chapter Four of this report. Nutritional Risk. For PC94, States could report up to three nutrnional nsks for each participant. For women, inadequate or mappropnate nutnent Intake. general obstetncal risks. hemogloLin or hematocnt measurements below State cntena. and high weight for height were the predominant risks reported. Children also showed inappropriate or inadequate nutrient mtake and low blood measures as their most frequently recorded risks. Just over two-thirds of WIC anfants were recorded at risk due to the WJC-eligibility of the1r mothers or because the1r mothers were at risk during pregnancy. At least one nutritional risk was reported for 98.9 percent of WTC enrollees m April 1994. Migrant Status. Of parucular interest to the Congress is the participation of migrant farrnworkers in the WJC Program. Exhibit E.3 shows m1grant partit:ipation across the States. In April 1994, there were 48,141 migrant WIC participJnts identified on State WTC enrollment files. Migrant WIC participants make up less than I percent of the population receiving WIC services. Nearly half of these parttcipants were enrolled in the WJC Program in Florida and Texas Migrant women enrollees an WIC tend to' be older than the general WIC population: this population also reports lower incomes. Average income an the national WIC population is 20.6 percent higher than incomes reported by m1grant farrnworker WIC participants. For PC94, State WIC agenc1es reported anfonnation on migrant status for 99 0 percent of US WIC part1c1pants. PC94 Eztcutivt Summary 11ii Exhibit E.2 Comparison of Poverty Levels of WIC Participants to Persons in the US Population 0 ! Q. ().50 51-100 101-150 151·115 fillet 115 Perc.nt of PO¥efty PC94 Ezccu/111e SumiNJry ix Exhibit E.3 Distribution of Migrant Farmworker WIC Participants by State Apri11994 Note Puerto Rico -1.4% Peroenteges ere based on total migrant WIC pertldplltlon. Stmu with lett !hen \ percent of the tolal W1C migrant population .,. not lhown. PCU Encutivt 511"'"""1 z CONTENTS Acknowledgements Executive Summary iii The 1994 Study . . . . . . . . . . . . . . . . . . . . . . . . . . . . . iii The 19Q4 WIC Program . . . . . . . . . . . . . . . . . . . . . . . v Panicipant Characteristics in 1994 . . . . . . . . . . . . . . . . . v Contents xi Exhibits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xiii Chapter One Chapter Two Chapter Three Chapter Four Chapter Five Chapter Six Chapter Seven Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Program Operations . . . . . . . . . . . . . . . . . . . . . . . . . . . . Panicipant Benefits . . . . . . . . . . . . . . . . . . . . . . . . . . . . Eligibility for WIC Benefits . . . . . . . . . . . . . . . . . . . . . . . Program Participation . . . . . . . . . . . . . . . . . . . . . . . . . . . Previous Studies of WIC Participant and Program Characteristics . . . . . . . . . . . . . . . . . . . . . . . The 1994 Study of WIC Panicipant and Program Characteristics . . . . . . . . . . . . . . . . . . . . . . . . PC94 Sununary of State Programs . . . . . . . . . . . . . . . . ... Organization of This Report . . . . . . . . . . . . . . . . . . . . . . . Overview of WIC Participation and Food Package Costs ... Food Packages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Demographics of WIC Participants ............. . .. . Income of WIC Participants ..................... . Inc11me and Poverty . . . . . . . . . . . . . . . . . . . . . . . . . . . . Poverty Status . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Nutritional Risk Characteristics Nutritional Risk Criteria . . . . . . . . . . . . . . . . . . . . . . . . . Nutritional Risks in PC94 . . . . . . . . . . . . . . . . . . . . . . .. Nutrition and Poverty Status . . . . . . . . . . . . . . . . . . . . . . . Anthropometric Values . . . . . . . . . . . . . . . . . . . . . . . . . . Blood Measures . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. Priority Levels . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Characteristio of Migrant Fannworker WIC Participants 1 1 5 6 7 9 10 14 14 15 15 27 33 37 42 49 49 54 78 86 94 103 109 Comtnls xi Appendix A Appendix B Appendix C Appendix D Appendix E Appendix F Appendix G CONTENTS (continued) Summary of State Programs Food Packages and Instrument Issuance State-by-State Tables Means-Tested Programs. for Detennining WJC Income Eligibility Income Documentation and Verification State-by-State Tables Dietary Intake Policies and Methods Documentation of Nutritional Risk Criteria State-by-State Tables Nutritional Ri~k Eligibility Criteria State-by-State Tables Distribution of Migrant WlC Panic1pants by State Supplemental Data Set Definitions State-by-State Tables Conltntl rii Exhibu E. I Exh1bu E 2 Exhabu E.3 Exhibit 1.1 Exhibu 1.1 Exhibu 1.3 Exh1bu 2.1 ExhabJt 2.:! Exhibit 2.3 Exhibit 2.4 Exhibu 2.5 Exhibit 3.1 Exh1bu 3.2 Exh1b1t 3.3 Exh1b1t 3 4 fxhibu 3.5 EXIDBITS Distnbuuon of Individuals Enrolled m the WIC Program April 1994 . . . . . . . . . . . . . . . . . . . . . . . ....... . Companson of Poverty Levels of WlC Pamc1pams to Persons in the US Population . . . . . . . . . . . . . ...... . Distribution of Migrant Fannworker WIC Participants by State April1994 . . . . . . . . . . . . . . . . . . . . . . . . . . . ... Distribution of Local WlC Agencies and WIC Participants by State .................................... . WlC Priorities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Minimum Data Set Definitions Distribution of WIC Participants by PartiCipant Category in 1994 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Food Package Adjustment and Tailoring Pracuces Used by States . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. Food Package Tailoring Pracuces and Use of Standard Food Instruments . . . . . . . . . . . . . . . . . . . . ... Frequency of WIC Food Instrument Issuance Among State WIC Agenc1es . . . . . . . . . . . . . . . . . . . . . . . . . . . . Estimated Average Cost of Food Packages by Participant Category. Region. and State ............... . Distribution of Age of WlC Participants at Certification by WlC Participant Category 1990. 1992, 1994 ... Distnbution of Pregnant Women WlC PartiCipants by Trimester of Enrollment 1992 and 1994 .......... . Distribution of Racial and Ethnic Characteristics of WlC Participants by Participant Category . . . . . . . . . . . . . . . . . .. Distnbution of Racial and Ethnic Characteristics of WIC Women. Infants, and Children 1990, 1992, 1994 ......... . Distribution of Racial and Ethnic Characteristics of WIC Participants by Region . . . . . . . . . . . . . . . . . . . . . . . . . . . VI IX X 2 8 11 16 18 19 20 21 28 29 29 30 31 hibits nii Exhibit 4.1 Exh1bit 4.2 Exhibit 4.3 Exhibit 4.4 Exhibit 4.5 Exhibit 4.6 Exhibit 4 7 Exhibit 4 . ~ Exhibit 4.9 Exhibit 4.10 Exhibit 5.1 Exhibit 5.2 Exhibit 5.3 Exhibit 5.4 Exhibit 5.5 EXJUBITS (Continued) Means-Tested Programs Used to Detemune WIC Income Eligibility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Income Documentation and Verification Policy Number and Percent of WIC Panicipants with Reponed Participation m Other Programs . . . . . . . . . . . . . . . . . . . . . Distribution of the Size of Families or Economic Units of WIC Participants by Panicipant Category . . _ . . . . . . . . . . . . Mean and Median Annualized Family or Economic Unit Income of WIC Participants by Panicipant Category . . . . . . . Average Annualized Family or Economic Unit Income of WIC Participams by Panicipant Category and Racial or Ethnic Characteristics . . . . . . . . . . . . . . Distribution of Percent of Poveny Level of WIC Panicipams by Participant Category . . . . . . . . . . . . . . . . . . . . . . . . . . Distribution of Percent of Poveny Level of WIC Participants by Participant Category and Racial or Ethnic Characteristics Distribution of Percent of Poveny Level at Cenification for WIC Panicipants Reponing No Other Benefit Receipt Comparison of Poveny Levels of WIC Panicipams to Persons in the US Population in 1994 . . . . . . . . . . . . . . . . . . . . . Broad Categories of Nutritional Risk Criteria Developed by the National Association of WIC Directors ............. . State Policies for Obtaining Dietary Intake Information Dietary Intake Methods Routmely Used by States State Documentation of Nutrnional R1sk Critena . . . . . . . . . . . Distribution of Number of Nutritional Risk Factors for WIC Participants Reponed at Cenificauon 1990. 1992, 1994 ..... . 34 35 36 38 39 40 43 44 47 48 50 51 51 52 53 Exhibits .ri" Exhibit 5.6 Exhibit 5.7 Exhibit 5.8 Exhibit 5.9 Exhibit 5.10 Exhibit 5. 11 Exhibit 5.12 Exhibit 5.13 Exhibit 5. 14 Exhibit 5.15 Exhibit 5.16 Exhibit 5.17 Exhibit 5.18 EXIUBITS (Continued) Number and Percent of Women WIC Pan1cipants by Panic1pam Category, Age at Cenification. and Type of Nutritional Risk Reponed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55 Number and Percent of Infant and Child WIC Panicipants by Age at Cenification. and Type of Nutritional Risk Reponed . . . . 56 Number and Percent of WIC Panicipants with Specific Nutritional Risks Reponed at Cenification . . . . . . . . . . . . . . . 57 Number and Percent of Women WIC Panicipants by Panicipant Category with Specific Nutritional Risks Reponed . . . . . . . . . . 58 Number and Percent of Infant WIC Panic1pants with Specific Nutritional Risks Reponed by Age at Cen1ficauon . . . . . . . . . . 59 Number and Percent of Child WIC Pan1cipants with Spec1fic Nutruional Risks Reponed by Age at Cenificauon . . . . . . . . . . 60 Number and Percent of Amencan Indian and Alaskan Native \VIC Panicipants with Spec1f1c Nutritional Risks Reponed by Panicipant Category . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61 Number and Percent of Asian or Pacific Islander WIC Panicipants with Specific Nutritional Risks Reponed by Panicipant Category . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63 Number and Percent of Black (non-Hispanic) WIC Panicipants with Specific Nutritional Risks Reponed by Panicipant Category . . . . . . . . . . . . . . . . . . . . . . . . . . . 65 Number and Percent of Hispanic WIC Panicipants with Specific Nutntional Risks Reponed by Panic1pant Category . . . . 67 Number and Percent of White (non-Hispanic) WIC Panicipants with Specific Nutritional Risks Reponed by Panicipant Category . . . . . . . . . . . . . . . . . . . . . . . . . . . 69 Nutritional Risks Reponed in at least 15 Percent of WIC Panicipants 1990, 1992, 1994 . . . . . . . . . . . . . . . . . . 71 Nutritional Risks Reponed in at least 15 Percent of Amencan Indian and Alaskan Native WIC Pan1cipants by Panicipant Category . . . . . . . . . . . . . . . . . . . . . . . . . . . . 72 Exhibit 5. 19 Exhibit 5.20 Exhibit 5.21 Exhibit 5.22 Exhibit 5.23 Exhibit 5.24 Exhibit 5.25 Exhibit 5.26 Exhibit 5.27 Exhibit 5.28 Exhibit 5.29 Exhibit 5.30 EXIDBITS (Continued) Nutritional Risks Reponed in at Least 15 Percent of Asian and Pacific Islander WIC Participants by Participant Category Nutritional Risks Reponed in at Least 15 Percent of Black (non-HispaniC) WIC Participants by Participant Category Nutritional Risks Reponed in at Least 15 Percent of Hispamc WIC Participants by Participant Category . . . . . . . . . . . . . . . Nutritional Risks Reponed in at Least 15 Percent of White (non-Hispanic) WIC Participants by Participant Category Nutruional Risks Reponed in at Least 15 Percent of Pregnant WIC Pan1cipants by Age at Certification . . . . . . . . . . . . . Number and Percent of Women WlC Participants with Spec1fic Nutritional Risks Reponed At Certification bv Percent of Poveny ................................... . Number and Percent of Infant WIC Panicipants with Specific Nutritional Risks Reponed At Certification by Percent of Poveny . . . . . . . . . . . . . . . . . . . . .............. . Number and Percent of Child WIC Panic1pants with Spec1fic Nutritional Risks Reponed At Cenificauon by Percent of Poveny . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... Number and Percent of One-Year-Old Child WIC Participants with Specific Nutritional Risks Reported At Certification by Percent of Poveny . . . . . . . . . . . . . . Number and Percent of Two-Year-Old Child WIC Participants with Specific Nutritional Risks Reponed At Cen1ficauon by Percent of Poveny . . . . . . . . . . . . . . . . . . . . 73 74 75 76 77 79 80 81 82 83 Number and Percent of Three-Year-Old Child WIC Participants with Specific Nutritional Risks Reponed At Cenificauon by Percent of Poverty . . . . . . . . . . . . . . . . . . 84 Number and Percent of Four-Year-Old Child WIC Panic1pants with Specific Nutritional Risks Reponed At Cenificauon hy Percent of Poveny . . . . . . . . . . . . . . . . . . . . . . . . . 85 Ezhiblls xvi Exhibu 5031 Exhibit 5o32 Exhibit 5033 Exhibit 50 34 Exhibit 5035 Exhibit 5036 Exhibit 5037 Exhibit 5o38 Exhibit 50 39 Exhibit 5040 Exhibu 5 41 Exhibit 5042 Exhibit 5043 Exhibit 5044 EXIDBITS (Continued) Distribution of Infant WIC Partacipants Accordang to Selected Anthropometric Measures: 1990. 1992. 1994 Distribution of Infant WIC Partacapants by Racaal or Ethnic Characteristics According to Selected Anthropometric Measures 0 0 0 0 0 0 0 0 0 0 0 • 0 0 0 0 0 0 0 0 0 0 0 0 .. 0 0 0 0 0 0 0 0 0 Distribution of Child WIC Participants by Age According to Selected Anthropometric Measures: 1990. 1992. l994 0 0 0 0 0 0 0 Distribution of Child WIC Participants by Age· and Racial or Ethnic Characteristics According to Selected Anthropometric Measures 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Number and Percent of Infant WIC Participants at Risk According to Several Anthropometric Criteraa Number and Percent of Child WIC Participants at Risk According to Several Anthropometric Criteria Nwnber and Percent of Breastfeeding and Postpartum Women WIC Panicipants at Risk According to Several 87 88 89 90 91 92 Anthropometric Criteria o o • 0 o 0 o o 0 o o 0 0 0 0 0 0 0 0 . 0 0 0 0 0 0 93 State 1994 Nutritional Risk Eligibility Criteria for Hemoglobin and Hematocrit Levels Compared with 1989 CDC Standards for Anemia 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 95 Hematologic Criteria Commonly Used for Determaning WIC Eligibility 0 0 0 0 . . 0 . • 0 o 0 o 0 0 o o 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 96 Availability of Hematological Data for WlC Participanrs Percenr of WIC Participants by Partacipant Category wuh Specific Types of Hematological Measures 0 0 0 0 0 0 0 0 0 0 • 0 97 Number and Percent of Women WIC Participants Falling Below Several Hematologic Standards 0 0 • 0 0 0 0 0 0 0 0 0 0 98 Number and Pt:rcent of Child WIC farticipanrs Falling Below Several Hematologic Standards 0 0 0 o o 0 • 0 0 0 0 0 0 0 0 0 0 99 Number and Percent of Anemic Women WIC Partacipants by Participant Category and Racial or Ethmc Charactemtics 0 0 0 0 0 10 I Number and Percent of Anemic Child WIC Participants by Age at Time of Blood Measurement and Racial or Ethnic Characteristics 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 • • • • . 0 0 0 0 0 0 102 Ezhibits ZVIi Exhibit 6.1 Exhibit 6.2 Exhibit 6.3 Exhibit 6.4 Exhibit 7.1 Exhibit 7.2 Exhibit 7.3 Exhibit 7.4 Exhibit 7.5 Exhibit 7 6 Exhibit 7.7 Exhibit 7.8 Exh1bit 7 9 EXIUBITS (Continued) WIC Priorities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 104 Priority of All WIC Participants by Pan1c1pant Category . . . . . 105 Priority of Infant WIC Panicipants by Age at Certification . . . 106 Priority of Child WIC Participants by Age at Certificauon . . . . . I 07 Distribution of Migrant Fannworker WIC Participants by State. April 1994 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 110 Distribution of Migrant Fannworker WlC Participants by WIC Panicipant Category and Age at Certification . . . . . . . . . . . . . 111 Mean and Median Annualized Family or Economic Unit Income of Migrant Farmworke.r WlC Participants by Participant Category . . . . . . . . . . . . . . . . . . . . . . . . . 112 Distribution of Percent of Poverty Level of Migrant Fannworker WIC Panicipant~ by Participant Category . . . . . . . . . . . . . . . 113 Nutritional Risks Reported in at Least 15 Percent of Migrant Farmworker WIC Participants by Participant Category . . . . . . . 115 Number and Percent of Migrant Farmworker WIC Participants with Specific Nutritional Risks Reponed by Participant Category . . . . . . . . . . . . . . . . . . . . . . . . . . I 16 Nwnber and Percent of Anemic Migrant Fannworker WIC Participants by Participant Category . . . . . . . . . . . . . . . . . 117 Distribution of Infant and Child Migrant Fannworker WIC Participants According to Selected Anthropometric Measures 118 Prionty of Migrant Farmworker WIC Participants by Participant Category . . . . . . . . . . . . . . . . . . . . . . . . . . 119 Ezhibils xviii Program Operations 1. INTRODUCTION The Special Supplemental Nutrition Program for Women. Infants. and Children (WIC) was created in 1972 and is admmistered by the Food and Consumer Service (FCS) of the US Department of Agnculture (USDA). WIC was established to counteract the negative effects Clf poverty on prenatal and pediatric health and provtdes a combination of direct nutntional supplementation. nutriuon education and counseling, and increased access to health care and social servtce providers for pregnant. breastfeeding, and postpanum women; infants: and children up to the age of five years. By intervening during the critical prenatal period. WIC seeks to improve fetal development and reduce the incidence of low birthweight, shon gestation. and anemta. Infants and children who are at nutritional or health risk can receive foe d supplements. nutrition education. and access to health care to maintain and improve their health and development. The WIC Program was established in 1972 by an amendment to the Child Nutrition Act of 1966. WIC has vastly expanded since ns inception. and. in April 1994. WIC served almost seven million panicipants at an annual cost of more than three billion dollars. Legislation (Public Laws 99-500 and 99-591), enacted in 1986. requires FCS to submit biennial repons to the Congress on current panicipant and program characteristics in the WIC Program. This legislation specifies that each bienmal repon must include: • Information on the income and nutritional risk characteristics of WIC panicipants. • Data on WIC program panicipation for migrant farm worker families. • Other information on WIC panicipauon that IS deemed appropriate by the Secretary of Agnculture. This repon is the founh publicauon prepared to meet the 1986 legtslauve mandate. WIC services are delivered in each of the fifty States. the Distnct of Columbia. Pueno Rico. Guam. and the American Virgin Islands. Additionally. in 1994. thiny Indian tribal organizauons (ITOs) served as State WlC agencies. Over 2.000 local agencies (defined as the organizations one level below State WIC agencies) provide servtces to pantcipants at an estimated 10.000 serv1ce sHes Exhibit 1.1 presents information on the number of local service delivery agenc1es operated by the eighty-four State WIC agencies. At the federal level. FCS and its seven regional offices provide cash grants to State WIC agencies for program administration and operations: issue regulations: and monitor compliance with these regulations. State WIC agencies set nutritional risk eligibility standards. allocate funds to local WIC sponsoring agencies. monitor compliarce with FCS and State regulations. and prov1de Chapllr Ont: Introduction to PC94 I Exhibit 1.1 Distribution of Local WIC Agencies and WIC Participants by State State Nonheast Connecticut Maine Massachusetts New Hampshire New York Rhode Island Vermont Indian Township (MEl Pleasant Po1nt (ME) Seneca Nat1on (NY) Mid-At111ntic Delaware Distnct of Columbia Maryland New Jersey Pennsy1van1a Puerto Rico Virginia Virgin Islands West Virgm1a Southe11st Alabama Flonda Georg1a Kentucky MISSISSIPPI North Carolina South Carolina Tennessee Eastern Band-Cherokee (NCI MissiSSIPPI Choctaw Seminole Tribe (Fll Note Number of local Agencies 21 11 37 9 93 14 12 1 1 1 17 7 18 20 25 7 35 1 8 67 48 21 53 23 85 15 14 1 1 Percent of All local Percent of US Agencies WIC Participants 0 .99 0.95 0.52 0 .42 1.74 1.84 0 .42 0.29 4 .37 7.2'2 0 .66 0 .29 0 .56 0 .22 0.05 o.oo· 0.05 o.oo· 0.05 o.oo· 0.80 0 .22 0 .33 0.31 0.85 1.23 0.94 2.02 1.17 4 .08 0 .33 2.70 1.64 2.09 0.05 0 .09 0.38 0.74 3.15 1.72 2.25 5.10 0.99 3.C3 2.49 1. 7'3 1.08 1.61 3.99 2.57 0.70 i.85 0.66 1.86 0.05 0.01 0 .05 0 .01 0 .05 o.oo· The est1mate of local WIC agenc1es 1s denved from State enrollment f1les conta1n1ng 1dent1f1ers for local agenc1es charged With adm1n1stenng WIC serv1ces. •1nd1cates agenc1es serv.ng less than 0 .01 percent of US WIC. Ch11pltr Ont: Introduction to PC94 2 Exhibit 1 . 1 (continued, Distribution of local WIC Agencies and WIC Participants by State State Mldw•st IllinOIS Indiana Michigan Minnesota Ohio Wisconsm . Southwest Arkansas Lou1s1ana New Mex1co Oklahoma Texas ACL INMI Cherokee Nat1on lOKI Chickasaw Nat1on lOKI Choctaw Nation lOKI Citizen-Potawatoml (OKI Eight Northern Pueblos INMI Five Sandoval Pueblos INMI lTC - Oklahoma Otoe·Missouna lOKI Pueblo of Isleta INMI Pueblo of San Felipe INMI Pueblo of Zufi1 INMI Santo Dommgo INMI WCO lOKI Note Number of local Agenciea 87 50 52 62 76 63 76 116 104 20 76 1 1 1 1 1 1 1 1 1 1 1 Percent of All local Percent of US Agencies WIC Participants 4 .09 3.57 2.35 2.25 2.44 3.31 2.91 1.45 3.57 3.66 2.96 1.57 3.57 1.23 5.45 1.99 4 .88 0.96 0.94 1.02 3.57 8.81 0 .05 0 .01 0.05 0.10 0.05 0.03 0 .05 0 .04 0.05 0.02 0 .05 0 .01 0 .05 0.01 0.05 0 .00 0 .05 0.01 0.05 0.01 0 .05 o.oo• 0.05 0 .01 0.05 0.01 0 .05 0.03 The estimate of local WIC agenc1es IS denved from State enrollment f1les cont111ntng 1dent1f1ers for local agenc1es charged w1th adm1n1stenng WIC servtces. "lnd1cates agenc1es serv1ng less than 0 01 percent of US WIC. Cll11pltr Ont: Introduction to PC94 J Exhibit 1.1 {continued) Distribution of Local WIC Agencies and WIC Participants by State State Mount•in Pl•ln.s Colorado Iowa Kansas Missouri Montana Nebraska North Dakota South Dakota Utah Wyommg Cheyenne River Sioux ISO) NIITDC (NEl Rosebud Sioux ISDl Shoshone-Arapahoe (WY) Standing Rock Sioux (NO) Three Affiliated INO) Ute Mountain Ute (COl We.stern Alaska Arizona Califorma Guam Haw au Idaho Nevada Oregon Washmgton ITC - Anzona ITC-Nevada NavaJO Nation IAZ) Tot•! Note Numb11 of Local Agencies 40 19 31 108 62 15 28 61 19 17 1 1 1 1 1 14 18 80 1 14 9 5 35 62 3 1 17 2,129 Percent of All Local Agenc••• 1.88 0.89 1.46 5.07 2.91 0.70 1.32 2.87 0 .89 0 .80 0.05 0.05 0.05 0 .05 0 .05 0.05 0 .05 0.66 0.85 3.76 0.05 0 .66 0 .42 0.23 1.64 2.91 0.14 0.05 0.80 100.0 Percent of US WIC Participants 1.03 0 .88 0.86 2.10 0.31 0.51 0 .24 0.29 0.94 0.16 0 .01 0.01 0.02 0.01 0.02 0 .01 o.oo· 0.25 1.33 12.19 0.08 0.36 0.48 0 .38 1.11 1.57 0 .13 0.01 0.28 100.0 The estimate of local WIC agenc1es IS denved from State enrollment f1les conta1mng 1dent1f1ers for local agenc1es charged w1th adm1mstenng WIC serv1ces. "lnd1cates agenc1es servmg less than 0 .01 percent of US WIC. Clulpttr Ont: lntrod~.Ktion to PC94 4 Participant BenejiJs technical assastance to local WIC agency staff. LocaJ WIC servace provaders are often city or county health departments. but WIC sponsors aJso include hospuals. maternal and child health programs. and commuruty acuon agencies. The funds received by locaJ WIC agencies are used to provide federally specafied supplemental foods to WJC panacipants and to pay administrative costs. ancludmg the costs of cenifying applicants as eligible and counseling WJC panacapants on nutritional issues. In recent years. State agencies have negotiated rebates provided by manufacturers of infant formula. It is estimated that 40 percent of all infanz formula sold in the US is purchased with WIC dollars. These rebates are used by State and local WIC agencies to provide WIC services to larger numbers of eligible individuals. WJC seeks to improve the health of program panicipants during pregnancy and the postpanum period. infancy. and early childhood by providing nutmious food and nutrition educauon as adjuncts to good health care. The benefits provaded by WIC are briefly described below. • Food Packages. f ood, food vouchers. or food checks are distributed to panicipants to provide specific nutrients known to be lacking in the dietS of target populations. FCS regulations specafy WIC food packages that are designed for different categories of panicipants, including an enhanced package for women to encourage them to breastfeed their infants. These packages contain foods that are good sources of the nutrients most likely to be lacking in the WIC population's diet-protein. iron. calcium. and vitamins A and C. The food packages are grounded in the developmental needs of infants as well as in pediatric recommendations on infant feeding . Food packages incorporate the recommended eating patterns for preschool children and the special additional nutritional requirements of pregnant and breastfeeding women. Most States operate retail food delivery systems where WIC clientS receive food instrumentS to purchase their supplemental foods at panacipaung local grocery stores. These checks or vouchers are "food-specific." in that they can be used only for food prescrabed by health or nutriuon professionals at local WIC agencaes. These food items are specified on eo ~ h WIC food mstrument. In a few geographic areas. iood as delivered to panicipant homes. or panicipants pick up food at specified distribuuon points. A small number of States operate both retail and direct delivery systems. Several States are assessang the feasibility of electronic issuance of WIC benefits. Wyoming is demonstrating a joint CltGpttr Ont: Introduction to PC94 5 Eligibility for WIC Btntftts WJC-food stamp benefit delivery system usmg a card contammg a nucrochip. • Nutrition Education and Counseling. Nutrition education plays a crucial role in the WJC Program and is viewed as an essenual benefit directed toward achieving positive changes in panicipant knowledge, attitude, and behav1or about food consumption. FCS regulations require WJC service agencies to offer to panicipants at least two nutrition education sessions during each- usually s1x-momh-cenifir.ation period. Panicipants may be counseled in one-on-one seumgs. may attend group classes. or may view films. slide-tape presentations, or videos on a variety of health and nutrition-related top1cs. • Access to Health Can and Social Services. Each WJC agency is charged with asststing WJC pantcipants to obtain and use preventive health care servtces. Through either the provision of on-site health services or referral to other agenctes, the WJC Program serves as a link between the pantcipant and an appropriate health-care provtder or system. Since 1984, most local WJC agencies have referred clients to a vanety of social services. Coordination between WTC and soctal service programs has increased since WJC regulations created adjunctive eligibility for WTC benefits based on eligibility for other programs. During 1994. many local WIC agencies provided infonnauon on other socaal services such as the Food Stamp Program. Medicaid, Aid to Families wnh Dependent Children Program CAFDC), substance abuse counseling and treatment. and other programs providmg services needed by WJC clients. T'.e degree to which local WJC agenctes acuvely facilitate such access varies with the type of local sponsonng agency and the nature of the servtce sne at which WIC benefits are delivered. Eligibility for receipt of WJC benefits is based on four factors: categoncal eligibility; res1dence within the State agency service area: income eligibility; and nutritional risk. First. a pan1cipant must be a member of cenam categoncally eligible groups: women during pregnancy and up to the first stx weeks after delivery; women up to one year postpanum if breastfeedmg or up to six months postpanum if not breast feeding; infants up to one year old: and children aged one through four years. Second. an applicant must document res1dence in the geographic area served by the State WIC agency. Chqttr Ont: Introduction to PC94 6 Program ParticipaJion Third. a panicipant must be income-eligible. The mcome limit for eligibility ts set by each State agency. However. th1s mcome hrnit may not exceed 185 percent or be less than 100 percent of the Office of Management and Budget (OMB) poverty income guidelines. which are based on household size. As of February 1994, at the 185-percent threshold, a person from a family of four with an annual household income of $27,380 or less would be mcome-eligible for WIC benefits. All States now set WIC income eligibility at 185 percent of poveny. States are also permitted to establish standards and procedures for verification and documentation required to validate income. Some States require income be documented with paysrubs. Others allow applicants to self-declare income. FCS regulations allow a WJC service provider to conclude that a panicipant is adjunctively income-eligible for WJC benefits through documentation of his/her panicipation in another means-tested program such as Medicaid. AFDC. or food stamps. Fmally, each WIC panicipant must be determmed to be at nutntional risk based on a m~ical and/or nutritional assessment by a competent professional authority such as a physician. nutritionist, nurse, or other health professional. At a minimum. height (or length) and weight are measured and, with the exception of infants under six months, a hematological test (generally a hematocrit) ts administered to assess nutritional status. Federal program regulations allow State and local agencies to develop appropriate screening systems to assess nutritional risk. According to program regulations, risk can be indicated by such factors as abnonnal weight gain during pregnancy, a history of high-risk pregnancies, low birth weight, stunted growth. low weight, obesity, anemia. or an inadequate dietary pattern. Because no single national set of nutritional criteria exists. WIC eligibility can vary with location. The WIC Program must operate within annual funding levels established by the Congress. The number of panicipants served each year depends on total funds available as well as on allocation of these funds by FCS to mdividual States. For each local agency, a maximum case load is determined based on the agency· s funding level and predicted case load turnover. When a local WIC agency reaches this maximum panicipation level wuhin ava1lable funding, a system of priorities is followed in allocating caseload "slots" to eligible applicants. Some agencies maintain waiting lists of eligible applicants and. as WIC opemngs become available. fill them from their waiting lists. To ass1st State and local WIC providers wuh servtce provision. FCS has defined seven priority levels, based on applicant categoncal status and type of nutnuonal risk condition. In general the purpose of the extsting priority system is to give precedence to medically cased nutrmonal nsks over risks based oniy on inadequate diet. Priorities are presented in Exhibit 1.2. Chaptlr Ont: /ntroducnon to PC94 7 Exhibit 1.2 WIC Priorities Priority II Ill IV v VI VII Description Pregnant and breastfeed1ng women and mfants, at nutr1t1onal nsk as demonstrated by anthropometric or hematological assessment or by other documented nutr~tionally·related medical cond1t1on. Infants up to six months of age of mothers who participated m WIC during pregnancy, or who would have been ehgible to part1c1pate under Prionty I documented med1cal condition. This pnonty may also be ass1gned to a breastfeed1ng motr r of an mfant who 1s class1f1ed as Pr~onty II. Children at nutnt1onal nsk, as demonstrated by anthropometnc or hematological assessment of other documented med1cal cond1t1on. At State optiOn, thiS pnorlty can also Include h1gh·r~ s k postpartum women. Pregnant and breastfeed1"9 women and Infants, at nutrtt1onal nsk ac demonstrated by Inadequate d1etary pattem. At State option, this pnonty can also 1nclude h1gh·r1sk postpartum women. Children at nutnt1onal r~sk due to Inadequate dietary pattern. At State opt1on. th1s pnonty can also 1nclude h1gh·nsk postpartum women. Postpartum women, not brentfeed1ng, at nutritional nsk on e1ther medical or dietary cntena-unless ass1gned to h1gher pnortt1es at State discretion. Previously certified partiCipants hkely to regress 1n nutrtt1onal status without contmuat1on of supplemental foods. ChqtiT Ont: Introduction to PC94 8 Prtvious Studits of WJC Participant and Program Characttristics FCS has completc::J our prev1ou~ studies of WIC panacapam and program characteristics. Ir 984 (PC 88 (PC88), and 1990 (PC90). FCS and Its contractors conduc ·J stud• u nationally representative samples of WIC panicipants. Data re obt lhrough rnatl surveys of State and local WIC agencies: record abstr 1on t local WIC servtce sues: and. in PC88. imerv1ews with panicipants and followup data collection on food instrwnem pickup. PC84. conducted for FCS by Ebon Research Systems. collected data from twenty-eight State agenc1es. 204 local agencies. 356 service sites. and 6.444 panicipant records. Major findings addressed: • The distribution of panicipants by panicipant category. by priority. and by income. • The nutritional risks of WIC panicipants. • State and local WIC agency coordination wnh health and social service programs. • The methods. frequency. and types of nutntion educauon provided to WIC panicipants. PC88, the second study of WIC panicipant and program characteristics. was conducted by Research Triangle Institute. For this srudy. staff in State and local WIC agencies collected data and imerviewed a nationally representative sample of approximately 7,000 WIC clients. A six-month followup data collection effon detennined the rate of actual pickup of WIC food instruments. State WIC agencies were surveyed to gather infonnation on WIC Program operations. PC88 reponed on: • The distribution of panicipants by panicipant category. by priority. by panicipation in other programs. and by family income. • The nutritional nsks of WIC pan1cipants. • State and local policies and agency coordination with health and social serv1ce programs. • Food package prescriptions. PC90 served as a transnional study which built on the PC84 and PC88 research des1gns while mmunizing sample stze to conserve research expenditures. A goal for PC90. and all future studtes of WIC panicipant charactenstics. is limiting burden on State WIC agencies to encourage continuing biennial pamcipation tn the WIC reponing system created for the 1992 study of WIC panicipant and program characteristics (PC92). For PC90. field researchers from Abt Associates abstracted data from a nationally representative sample of 2,343 Chapttr Ont: introduction to PC94 9 Tht 1994 Study of WJC Participant and Program CIUJracttristics panicipam records. All State WIC agenc1es were surveyed to obtam mformauon on WIC Program operations. The methodology used for PC94 was first developed for the 1992 study. The 1992 study of WIC participant and program characteristics (PC92) was substantially different from earlier studies with regard to collecting data on WlC participation. FCS developed a prototype reponing system which allows the acquisition of all participation data through the automated transfer of an agreedupon set of data elements. State WIC agencies download. to diskettes or magnetic tapes, routinely collected information which is on their existing automated client and management information systems. State and local WIC staff obtain these data to cenify applicant eligibility for WIC benefits. to guide nutrition education. and to issue food instruments. This Minimum Data Set (MDS) was developed by FCS working with the Information Committee of the National Association of WIC Directors (NAWD). The MOS. which consists of eighteen items, appears in Exhibit 1.3. For the reference month of April 1994. each State WIC agency submitted MDS data on either a representative sample or a census of its WIC pamcipants. The final PC94 dataset encompasses information on all individuals enrolled in the WIC Program as of the reference month. Many studies of the WIC Program have reponed participation measured by the numbers of individuals who were issued food instruments during designated time periods. PC94 repons on enrollment which is defined as individuals cenified to receive WIC benefits for specific time periods, including individuals who did not claim or use the food instruments issued during those time periods. State WIC agencies estimate that, each month, at least 90 percent of wtC enrollees pick up their food instruments. In April of 1994, there were eighty-four State WIC agencies: the fifty States. the District of Columbia. Guam. Pueno Rico, and the American Virgin Islands. along with thiny Indian Tribal Organizations (ITOs) . PC94 data were submitted by 100 percent of State WIC agenctes. PC94 describes slightly more than 6.9 million panicipants cenified as eligible for WIC benefits in Apnl 1994 Two of the e1ghty-four submittmg agencies chose to repon on representative samples rather than censuses of the1r WIC panicipams. These States mclude Connecticut and Montana and account for about 1.3 percent of PC94 's pamc1pant records. These data are weighted so that the total numbers of WIC panicipams reponed here correspond to the total US WIC population in April 1994. The State-maintained automated informauon systems which are the sources of data for PC94 do not always contam complete mfonnauon on every individual enrolled in the WIC Program. Note that all of the tables in this publicauon include columns or rows labeled not reported. The figures presented in these columns and rows indicate the numbers and percentages of WIC panicipants for whom States could not provide information on specific items. Chapttr Ont: Introduction to PC94 10 Exhibit 1.3 Minimum Data Set Definitions For btenrual repons on WIC panicipant and program charactensucs. the tenn pantctpant means a person cenified as enrolled in the WIC Program. The data items should reflect the participant's status oo each item at the time of the most recent WIC Program certification for the reference month of April 1994. However. as a convenience to State Agencies that do not maintain historical files and that update the information in their automated systems during cenification periods. current information that was on the file for each panicipant in April 1994 was accepted. 1. State Agency ID A unique identifier that pennits linkage to the WIC State Agency where the panicipant was enrolled. 2. Local Agency ID A unique identifier that pennits linkage to the local agency where the panicipant was centfied as eligible for WIC benefits. Service Site ID A unique identifier that pennits linkage to the service site where cenified. Either Local Agency 10 or Service Site 10 will be reponed according to the level that the State Agency feels appropriate. 3. Case ID A unique record number for each panicipant which maintains individual confidentiality at the national level. 4 . Date of Birth Month. day, and year of panicipant's binh. 5. Race/Ethnlcity The classification of the panicipant into one of the five (5) racial/ethnic categories: white: black; Hispanic: American Indian or Alaskan Native; or Asian or Pacific Islander. The ethnic categories. white and black. include only those persons who are not of Hispamc origin. 6a. Certification Category The category-~me of five (5) possible categories under which a person is cenified as eligible for WIC benefits: pregnant woman: breastfeeding woman: postparrum woman. not breastfeeding; infant (under 12 months): or child (12-59 months). 6b·c. Expected Date of Delivery or Weeks Gestation For pregnant women. the projected date of delivery or the number of weeks since the last menstrual penod as detennined at WlC Program centfication. These data items are used to detennine whether a pregnant woman is in the first. second. or third trimester of pregnancy. 7. Date of Certification The date the person was declared eligible for the most current WIC Program cenification. Month. day and year are provided. 8. Sex For tnfants and children. male or female . Cltapttr Ont: Introduction to PC94 I I Exhibit 1.3 (continued) Minimum Data Set Definitions 9 . Priority level Participant priority level for WIC Program cenification at the time of the most current WIC Program cenificauon date. 10a·c. Participation in AFDC, Medicaid, Food Stamps The panicipant's reponed panicipation m each of these programs at the time of the most current WIC Program cenification. 11 . Migrant Status Panicipant migrant status according to the federal WIC Program definition of a migrant farmworker. 12. Number in Family or Economic Unit The number of persons in the family or economic unit on which WIC income eligibility was based. A self-declared number in the family or economic unit may be reponed for panicipants whose income was not required to be detemuned as pan of the WIC cenification process. These panicipants include adjunctively income-eligible panicipants (due to AFDC, Food Stamp program. or Medicaid participation) and those participants deemed income eligible under opuonal procedures available to the State Agency in Federal WIC Regulations. Section 246. 7(c)(2)(vii) and (viii) (i.e., means tested programs identified by the State for automatic WIC Program income eligibility.) 13a-c. Family or Economic Unit Income l. For persons for whom income is determined during the cenification process, the income amount that was determined to qualify them for the WIC Program. 2. For descriptive purposes only, for panicipants whose income was not required to be determined as pan of the WIC Program cenification process, the selfreponed income at time of cenification. If updated since cenification, the current self-reponed amount. These panicipants include adjunctively incomeeligible panicipants and those persons deemed eligible under optional procedures available to the State Agency in Federal WIC Regulations, Section 246. 7(c)(2)(vii) and (viii). 14a-c. Nutritional Risks Present at Certification The three highest priority nutntional risks present at the current WIC Program cenification. 15a·b. Hemoglobin. Hematocrit or EP Value That value for the measure of iron status that applies to the current WIC Program cenification. It is assumed that the measure was collected wuhin 60 days of the cenification date. 16a·b. Weight The panicipant's weight measured according to the CDC nutntion surveillance program standards tnearest one-quaner ('A) pound). 17a·b. Height The panicipant's height (or length) measured according to the CDC nutrition surveillance program standards [nearest one-eighth (1/a) inch]. 18. Date of Height and Weight Measure The date of the height and weight measures that were used during the current WIC Program cenification period as of April 1994. Ch~~pttr On1: Introduction to PC94 12 States were generally able to provide infonnauon on every MDS it..:m for each pan1cipant. However. PC94 contains data on panicipauon mother programs for only about 92 percent of the panicipants m the database: data on income were submitted for 86 percent of the 6.9 million WIC pan1cipants. Five StatesAlabama. Illinois. Indiana. New York. Pueno Rico. South Dakota. and TeMessee-reponed data on income for less than 70 percent of their WIC panicipants. lnfonnation on blood measurements may be absent from the database for reasons which may be related to the category to which a WIC panicipant is assigned. For instance. WIC regulations permit clinics to dispense with blood tests for infants under six months of age, as well as for children who are found to be within normal ranges at their most recent cenifications. Unreponed PC94 data may be unavailable for a variety of reasons which may indicate that panicipants in any of the not-reponed categories may be different from those individuals with data reponed. As noted above. assumptions regarding missing data vary by the nature of the variable and by the category of the WIC panicipant. To account for these anomalies. a uniform strategy has been adopted for preparing all tables in this repon. Data not reponed are included in the calculation of percentage distnbutions for each characteristic. While including missing data in the denominators for all calculations tends to place estimates for each characteristic at a lower bound. this approach has allowed consistent presentation of tabulations throughout the repon. Further. u assures that all information needed to calculate upper-bound estimates is readily available in every table. Caution should be used in comparing results across groups; missing data must always be considered in gauging differences between, among. or across groups or categories of WIC panicipants. A second note of caution must be sounded here. Because of data quality issues in one large State. it is likely that the PC94 estimate of number of one-year-old WIC enrollees is 0.008 percent high. As a result. the PC94 esurnate of number of WIC infants is about 1.0 percent low. The specifications for the 1994 study of WIC pan1c1pant and program characteristics included a nineteen-Item Supplemental Data Set (SDS). Included in this dataset are such items as binhweight. birth length, source of prenatal care. and duration of breastfeeding. About 60 percent of the eighty-four reponmg State WIC agencies provided some SDS data. representing a two-thirds increase since 1992. However, no State WIC agency provided information on every SDS item for every panicipant. The most frequently reponed SDS item was food package code. submitted by fony-four States. Thiny-mne State WIC programs submitted information on breastfeeding status. and thiny-three States reponed duration of breastfeeding. The limited amount and incompleteness of SDS data preclude computation of nauonal estimates. The final appendix to this repon presents a series of tables reponing State-level data for those States submitting SDS information. A complete list of SDS items is also included in that appendix. Chapttr Ont: Introduction to PC94 I J PC94 SumnuJry of Stale Programs Organization of This Repon The 1994 study. like earlier studies. mcluded a survey of State WIC agenc1es to obtain infonnauon on WIC program charactenstics. For PC94. each State WIC agency was mailed a computer-generated paper copy of its responses to the PC92 Summary of State Programs (SSP). State respondems were asked to confinn or revise their 1992 responses. A copy of the Summary of State Programs (SSP) appears in Appendix A. Data were collected on: • Operating policies and procedures of State WIC agencies with regard to income detennination. food package tailoring, and food instrument issuance. • Average monthly food package costs by pamcipant category. • Nutritional risk criteria established by State WIC agencies including standards for hemoglobin and hematocrit values as well as methods for obtaimng dietary intake infonnation. • Lists of local WIC agencies or service sites operated by each State WIC agency. All of the eighty-four State WIC agencies operating in April 1994 completed questionnaires. Each of the eighty-four reponing agencies provided infonnauon on every item in the questionnaire. Chapters Two through Seven contain tabular presentations which display PC94 data on WIC panicipants and programs. Tables are accompanied by limited text which is provided only to explain WIC procedures or to distinguish changes. since 1984, in the characteristics of WIC programs and panicipants. Because PC94 is a near census of WIC panicip~nr~. standard errors are not needed to interpret findings presemed here. Cha wo presents infonnation on overall panicipation in the WIC Program as we,J mfonnauon on WJC food packages and their costs. In Chapter Three. demographic data on WIC panicipams are reponed. Chapter Four offers infonnation on State procedures for detenmning income eligibility along with panicipation data on receipt of benefits from programs other than WIC; household size: average annual income; and percent of poveny of WJC households. Chapters Five and Six prov1de infonnauon on nutritional risk and WIC pnorny groups. Finally, Chapter Seven contains infonnation on migrant WIC pan1cipants. Data are reponed on age. income. nutritional risk, and priority. Note that every table in this publication includes a column or row labeled nor reported. The figures presented in these columns and rows indicate the number or percent of WIC panicipams for whom States provided no informauon for specific items. ChGpttr Ont: Introduction 10 PC94 14 Food Packtzgts 2. OVERVIEW OF WIC PARTICIPATION AND FOOD PACKAGE COSTS During April 1994, there were 6,907,848 individuals enrolled in the WIC Program. {See Exhibit 2 .1.) This figure is 20 percent higher than the 1992 enrollment level. Some of the growth between 1992 and 1994 can be aunbuted to the fact that. during this time period. the Food and Consumer Service (FCS) provided larger appropriations to States in the Western region. These targetedgrowth ~ tates include Arizona. California, Florida, Nevada, and Texas. Additionally, States continued to negotiate rebate contracts wnh infant formula. and, in some cases, cereal manufacturers. Savings accrued from these rebates enabled local WIC service providers to offer WIC benefits to previously unserved eligible individuals. The proponions of enrollment by WIC panicipant category show some change in 1994. Since 1992, the proponion of pregnant women has declined from 13.6 percent to 12.0 percent. The proponion of infant enrollees has gone from 30.1 percent in 1992 to 26.9 percent in 1994, while children now account for 50.2 percent-up from 47.5 percent in 1992. These changes may reflect a declining national birthrate (from 16.3 births per thousand women in 1991 to 15.9 in 1992)1 • They may be the result of income shifts (categorical eligibility), changes in the numbers of eligibles who apply. or application of the priority system or increased funding which allows States and their local agencies to serve applicants with lower priorities, especially children. For PC94, it must also be noted that. because of poor quality data in one large State. the estimate of number of WIC infants is about 1.0 percent low. It may be that some proponion of this apparent decline in WJC infant enrollment can be attributed to erroneous data from this one State. The proponion of bre~tfeeding women rose slightly between 1992 and 1994 from 3.6 percent to 4.0 percent. There was a substantial increase in proponions and numbers of posrpanum women receiving WIC benefits-two full percentage points or 191,500 more women. It may be that the additional funds in the States targeted for growth permitted WIC to expand its caseload to serve more non-breastfeeding postpartum women. Panicipation in the categories of posrpanurn women and children has increased by 2.0 and 2. 7 percentage points. respectively. Seven maximum food packages are defined by federal WIC regulations: two for infants which are age-dependent: one for children or women with special dietary needs; one for children aged one through four years: one for pregnant and breastfeeding women; one for non-bre;tStfeeding postpanum women: and an enhanced package for breastfeeding wor,ten. State and local agencies may tailor food packages to achieve admimstrati te efficiencies or to meet the nutritional needs of individual WJC clients. t'.dministrauve adjustments to WIC food packages include specifying package stze. brand. or form. Nutritional tailormg often focuses on specifying a form of infant formula or changing food types to 1 Data reported in Cu"~nt Population Surveys, 1991 and 1992. US Bureau of the Ccn:us birthrates for 1993 and 1994 are not yet ava1lable. Chapttr 'J'Wo: Ovtmtw of PC94 WIC Partie~palion and Food Pack.agt Costs IS Exhibit 2.1 Distribution of WIC Participants by Participant Category in 1994 Participant Category Number of Percent of Participants Category Women 1,590,762 n/a Pregnant women 823.604 51.8% Breastfeeding women 275,158 17.3 Postpartum women 491 ,998 31.0 lnf•nts 1,852.455 n/a Children 3.464,631 n/a US WIC 6,907,848 NA 1nd1cates not applicable. Distribution of WIC Participants by Participant Category 1990, 1992, 1994 Percent of WIC Participants 23. 1 o/o 12.0 4 .0 7.2 26.9 50.2 Percent of Total WIC Participants Participant Category 1990 1992 1994 Women 23.9% 22.4% 23.1% Pregnant women 13.5 13.6 12.0 Breastfeed~ng women 10.41 3.6 4 .0 Postpartum women 5.2 7.2 lnf•nts 29.8 30.1 26.9 ChHdren 46.3 47.5 50.2 USWIC 4,538,112 5,754,003 6,907,849 Note • In 1990. breastfeed1ng and postpartum women were comb1ned 1nto one reponmg category because of the small sample of pan1c1pants 1n the 1990 study. Chapter Two: Ovtmtw of PC94 WIC Participa.tr.on and Food Pac/uJgt Costs 16 address the nutruional risks of spec1fic of pan1cipams. Exhibits 2.2 and 2.3 prov1de information on food package tailoring pracuces reponed by States. Most WIC pan1cipants rece1ve food Instruments (enher vouchers or checks for use in retail grocery stores) wh1ch contam 1nformauon on type and amount of food and may include infonnauon on maximwn allow4lble cost A food instrument is designated a voucher or check to indicate the State's redempuon process. States detemune the frequency of issuance for these food instruments. which are generally produced on automated information systems at standard intervals. In most States. WJC panicipants pick up food instruments at local WIC service sites. Information on State issuance appears in Exhibit 2.-t. State policies and procedures have remained stable since 1988. The trend to bimonthly issuance continues. Less frequent issuance is seen. by many States. as administratively efficient as well as less burdensome for WIC recipients. State-by-State information for Exhibits 2.1 through 2.4 appears in Appendix B of this repon. Finally. State-reponed informauon on costs of food packages for April 1994 1s presented in Exhibit 2.5. These estimated average costs wtre calculated usmg the State cost data weighted by enrollment data at the panicipant category level . Thiny-five (or 42 percent) of the eighty-four reponing agencies submitted estimated rather than actual food package costs. The highest average cost appears in the Western region with the lowest average food package cost occurring in the Southeast. Chapttr Two: Omvitw of PC94 W/C ParticipDIIon and Food Paclulgt Costs 17 Exhibit 2.2 Food Package Adjustment and Tailoring Practices Used by States State Agenctes AdjustmentfT alloring Practices Number Percent Only use muimum e/loweble f«i.,.l foud package 3 3.6% Adjustment for edmlnlstretlv• efficiency 80 95.2 Brands of food are designated or disallowed 61 72.6 Size of food container rs desrgnated 64 76.2 Specrfrc form of food lwrthin a food group) is specified 57 67.9 Certatn food types lfrom a food category) are eliminated 31 36.9 Other methods lsuch as addrng spec1al foods) 21 25.0 Teiloring for pefticipant nutrition•! ntHKb 81 96.4 Type of m1lk IS spec1fied Ito reduce fat, lactose, or calorresl 62 73.8 Type of cheese 1s spec1fied Ito reduce fat) 24 28.6 Type of cereal 11 spec1fied Ito reduce sucrose) 8 9.5 Spec1f1c forms of formula are specified lready-to-feed or powdered formula) 74 88.1 Amounts of certa1n food types are reduced Ito reduce calorres or nutrrent 43 51.2 intake for we1ght control) Amounts of certain food types are reduced Ito meet age-related needs) 53 63.1 Quantity of eggs rs reduced Ito reduce cholesterol) 19 22.6 A spec1f1c form of food 1s specrf1ed for the conven1ence of the partiCipant 67 79.8 !powdered m1lk, JUICe concentrate) Other methods lsuch as substrtut1ons for food allerg1esl 24 28.6 Tote/ reporting Stet• WIC egencies 84 100.0 Not•• Responses are not mutually exclusrve. so percentages do not sum to 100 percent. Percentages rn thrs table are based on the number 1841 of reponrng State WIC agencres. WIC food rnstruments hst specrfrc foods up to maxtmum amounts for each month as defmed 1n federal WIC regulatrons Ch~~pttr TWo: Ovtrvitw of PC94 WIC Partrciplllron and Food Paclutgt Costs 18 Exhibit 2.3 Food Package Tailoring Practices and Use of Standard Food Instruments .......................... ~ ........................... .... Stet• Agencies Standardized Instruments and Tailoring Number Percent Standard food packages are available for 38 45.2% specific categories of participants Standard food instruments can be selected 8 9.5 or combined to create food packages for participants Standard food instruments can be tailored 23 27.4 by marking choices or amounts of food types directly on each food enstrument Standard food packages or food 10 11 .9 instruments are not used. Each food package prescription IS individualized Other methods of food ta1lorang 5 6.0 Total reporteng State WIC agenc1es 84 100.0 Notes WIC food mstruments hst spec1f1c foods up to maximum amounts for each month as defined m federal WIC regulations. For more mformat1on on other methods of food ta1lonng, see Table 2.3A in AppendiX B. Chapttr Two: Ovrrvrtw of PC94 W/C PanrctptiiJon and Food PacluJgt Costs 19 Exhibit 2.4 Frequency of WIC Food Instrument Issuance Among State WIC Agencies Issuance Pattern St•nd•rd frequency of food Instrument lssu•nce Yes No Total reporting State WIC agencies lssu•nce frequencies• Every month Every two months Every three months Other V•rl•tlon •llowed In the frequency of food instrument lssuflnce• Certarn participant categones must ptck up food instruments more often Certatn high-risk participants must pick up food instruments more often Congested local agencies issue food instruments less frequently Local agencies may choose the frequency wtth which they issue food mstruments All food instrum11trts issued with s•me frequency Note a State Agencies Number 77 7 84 61 45 8 7 48 11 34 10 24 19 37 Percent 91 .7% 8.3 100.0 72.6 53.6 9.5 8.3 57.1 13.1 40.5 11 .9 28.6 22.6 44.1 WIC food Instruments list spec1f1c foods up to max1mum amounts for each month as def1ned 1n federal WIC regulat1ons. • Responses w1th1n thiS set of categones are not mutually exclus1ve. so percentages do not sum to 100 percent Percentages are based on the number (841 of repon1ng State WIC agenc1es. • Other Includes: Pan1c1pants 1n remote areas who travel every other month to p1ck up food Instruments; some local agenc1es ma11 food tnstruments; some local agenc1es allow pan1c1pants to choose the frequency of 1ssuance. Chapter J'wo: Overview of I'C94 W/C l'artie~palion and Food l'adctlfe Costs 20 EAielbll 2 .G Estimated Average Cost of Food Package• by Participant Category, Region, and State Outt.ye In Doleft for Aptl 1114 Computed Averege for Computed Averege for RegioniState AI: ,egniN'It lre11tfeedlng ,Oitpertum Allnf11nt1 Allnfenll Totel AI WIC 'ertldp11nt1 AI WIC ,..udpente Women Women Women Women lef~~NMet•• After Met•• CMdren ... Of ........ Afler Rebete Norlh•••t Mean 38 .47 40 64 45.23 36.08 74 85 38.89 38.39 43 08 34 20 Medran 35 88 34.44 48.58 31U7 68.88 21 .58 34.77 40.73 31 .12 Standard de111atron 7 81 11.33 9.39 9 .90 27.01 35.48 8.99 6.50 8 55 Connectrcut 49.47 65.84 57.54 39.42 87.57 43. 14 27.88 44.59 35 21 Marne 31 .39 32.87 37.01 28.18 83.84 20.97 30.70 38.23 28.68 Mass achusella 31.12 34.44 38.25 22.89 67.69 21.49 30.40 39.02 28.52 New Hampshire 30.28" 32.56" JUSt" 26.22" 65.88" 21 .58" 30.95" 38.46" 28.74. New York 34 85 NA NA NA 72.04 23.68 31 .32 42.10 30.19 Rhode Island 36.88 26.57 54.41 53.80 53.08 4.03 44.14 44.99 32.04 Vermont 45.82" 48.53" 48.58" 39.40° 67.79" 18.18" 38.21" 39 38" 36. 13. lndran T ownshrp I MEl 39. 13 63.63" 52.37 39.17 44.25 NA 39.13 NA NA Pleasant Pornt IMEI NA 30.60 38 60 35.25 100.00 90.00 44.20 NA NA Seneca Natron (NV) 48.30" 60.73" 50.73" 43.44• 138.153" 107.02" 48.87" 67.89 54 . 0~ Mid Alfantic Mean 35 63 39.98 35.28 26.38 86.62 31 .44 34.43 43.68 31 .60 Medran 34.72 35.16 38.34 25.10 70.82 23.12 33.62 42.61 29.53 Standard de11ratron 7 51 18 85 5 42 5.84 13.08 25.59 7.30 8.77 8.78 Delaware NA 34.95 38.42 27.58 69.57 25 09 32.93 43 72 29 53 Orstrict ol Columb11 37.71" 80.21" 32.41" 18.28" 70.18" 18.42" 35.84" 48.01" 30.48" Maryland 36.21 38.98 42.90 29.25 I 76.86 22 84 34.20 44 25 28 13 New Jersey 29.70 30.98 31 .41 24.75 73.49 24.79 29.35 40.74 28 28 Pennsyl11ania 33.22 35.36 39.02 22.72 71 .07 17.13 33.52 41 .48 29 96 Puerto Rrco 48.39 NA NA NA NA 98.94 48.24 62.57 54 31 Vrrgrma 42.51 39 80 35.73 35.90 40 94 30.12 42.47 42 51 31 21 Vrrgrn Islands 24.11 25.74 25.42 21 .17 48.85 23.12 23.66 28 95 23 80 West Vrrgrnra 33.20 33.80 36.95 25.45 74.23 22.51 29.75 40 89 28 76 • hllmiltd average monthly cost NA ond<ueu thai da11 • •• not a va1l1ble Cllapttr 1Wo: OlltrvtiW of I'CH W/C rarticlpe/IH Mil Fooll fod:llfl C:1111J ll •• Exhibit 2.5 (continued I Estimated Average Cost of ~ood Packages by Participant Category, Region, end State Outteyeln Dolert fot Apdi11!J4 Computed Averege for Computed Average for Region/Stele AI Pregnent lreeatfeedlng Poatpertum AI lnlent1 Allnlenta To tel AI WIC Pertlclpenta AI WIC Plrtlci$1enta Women Women Women Women lefote Rebete1 After Rebetea Chlchn lef:He Rebete After Rebelo~ Southe•st Mean 3S 44 37.25 38 87 26.60 67.86 20.18 34 06 40 49 29 08 Med1an 33.81 33.30 34.18 27.02 7L80 21 .88 31 .89 41 .92 29 09 Standard dev11t1on 9 47 9.22 10.42 4 79 18.99 9.06 8.99 9 93 3 03 Alabama 34 27 NA NA NA 75.03 26 31 31.38 45 OS 30 66 Florida 33.15 39.71 32.75 23.46 76.84 19.93 32.00 44 75 29.26 Georgia 34 06 33.30 33.37 25.97 78.23 18.79 29.25 41 .21 29 02 Kentucky 29.11 32.68 34.70 28.07 82.08 7.38 37.70 41 .92 29 77 MISSISSippi 27 17. 29.09' 32.94. 19.48. 21.88' 21 .88. 22.53' 23 86 23 86 North Carolina 28 54 31.21 34.18 21.14 70.37 22 03 27.80 40 02 26 35 South Carohn1 31.22. 31.67' 31 .10' 31 87' 71 .75' 31 .47' 29 18' 42.99' 28 68" Tennessee 36.24 38.28 38 26 30 16 70.46 5.67 36 44 44 91 29 09 Eastern Band Cherokee INCI 40 83' 39.80' 50.66' 32.04' 82 16' 30.14' 39.01. 36 75' 35 04' MISSISSIPPI Choctaw NA NA NA NA NA NA NA 24 32' NA Sem1nole Trtbe IFLI S9 84 59.61 81 83 NA 71 a4 NA 55 34 59 61 NA Midwest Mean 35.88 37 26 38 99 28 59 84.61 25 93 31 57 42 15 29 14 Medtan 36.03 37.57 39 45 28 44 88 36 22 60 33 45 41 92 28 92 Standarti dev11110n 1 76 1.70 3.23 2 90 3.78 10 59 3 32 3 84 3 02 llhno1s 37 57 37 57 37 57 29 83 87.43 27 79 34 30 46 50 33 41 lnd1ana NA 35.12' 35.12' 28.44. 78. 71' 15.77' 30.32' 38 99 25 98 M1ch1gan 36.03' 39.07' 41.32. 28.33' 82.99' 22.60' 33 50' 46 so· 31 30' Mtnnl'!sota NA 38.61 41 .96 24 21 87.54 43 21 26 29 37 09 26.33 Oh1o NA NA NA NA NA NA NA 41 86' 27 39 ' W1scons1n 34 05 35 94 NA 32 16 86.36 20 27 33 45 41 98 30.45 • hlomeltd evetege monthly cost NA ondtcllu lhll dill 111 no1 ' ""llblt Cltapttr Two: O~t~ltllll of~ WIC l'anidpell., .,.~ Foqd PocltDft Costs 11 Exhibit 2 .5 (continuedt Estimated Average Cost of Food Packages by Participant Category, Region, end State Outley• In Dobfs fOf Aptl 1194 Computed Averege for Computed Averege for Region/Stele AU Pregnent Bre111feedlng Poatpertum Alllnfenta AI lnfenta To tel AI WIC Pettlclpenta AI WIC Pertlcipenta Women Women Women Women lefote Rebetea After Rebet .. Chlkken llelore Rebete After Rebete Southwest Mean 34 93 36.03 39 94 30 70 72 49 45.07 34 44 43 60 30 43 Medtan 35 72 38 .52 40 98 31 85 74 09 47 35 35.23 43 12 30 54 Standard devtalton 1 1 ~ 8 .38 9 60 6 32 14.37 17.66 6 45 7 81 11 37 Arkansas NA NA NA NA NA NA NA NA NA Loutstana 39.oo• 41.00• 41 .00 . 35 oo• 74.60° 12 oo• 34 oo• 47 88 ' 30 51 " New Mexico 35.59 NA NA NA 64.44 19.50 35.59 41 56 30 54 Oklahoma 27.69• 28.17 ' 30.25. 24.47" 79.19· 23.92' 29.12' 43 t 2 • 20 39' Texas NA 30.69' NA 23.17. 71 09 ' NA 28 41' 38 65 25 54 ACL WIC INMI 46 09' 43.76' 57 52' 36.98' 44 75 ' NA 40 68' 46 so· NA Cherokee Natton lOKI 16 99 18.01 18 .01 14 53 78.29 42 29 16 46 26 26 20 76 Chtckasaw Nalton lOKI 35 72' NA NA NA 73 14' 46 67' 34 54' 44 eo· 37 87" Choctaw Natton lOKI 39 06 ' 39 06 ' 40.60' 37 52 . 103 4 3 ' 69 71. 34 86' NA NA Ctltzen Potawaton,• lOKI 38 17 ' 38 62 " 44 16. 31 75 • 75 75' 47 65' 41 09 ' 44 92' 40 24 . Etght Northern Pueblos (NM) 32 75 54 59 44 67 NA 16 11 44 62 41 48 50 61 19 II Ftve Sandoval Pueblos (NM) 31 16 30 07 32 00 31 43 85 10 69 60 30 10 41 74 38 64 lTC Oklahoma 30 21 31 89 31 86 26.88 68 67 47 35 29 35 42 17 39 01 010e Mtssourta lOKI NA 38 63 ' 40 98' 33 22' 83 04 ' 54 95 ' 43 53' 45 16. 39 95. Pueblo of Isleta (NMI 38 52 ' 38 72' 40 96' 35 87' 65.30' NA 38 61 ' 34 01 " NA Pueblo of San Feltpe INMI NA 38.42 44 78 31 85 43.21 NA 35 71 38 75 NA Pueblo ol Zum INMI 44 78 . 43 78" 51 12. 36 42' 86.54. 59 sa· 39 22' 55 81. 45 82 . Santo Oom111go INMI 3 1 00' 30.00. 34 oo · 28 oo· 5B.oo· NA 31 oo· 35 85 NA WCD lOKI 37 17 31.13 46.97 33 41 73 68 48 08 36 25 44 78 38 58 • htonoated ave••ll• monthly cost Nl\ ondoc•tu th•t data lrt not ••••table Chqpttr Two: Ovtrvrtw of PCU WIC Pafticiptlliott 111td Fqod Padatt Com 1J Exhibit 2.5 (continued) Estimated Average Cost of Food Packages by P.IJrticipant Category. Region, and State Outleya In Oofle,. fOf Aptt 1994 Computed Average for Computed Average for Region/State An Pregnant Breastfeedlng Poltpertum AU Infants AI Infants Total AI WIC Pertlclpent1 A" WIC Participanll Women Women Women Women Before Rebetee After Rebates Chldren llelore Rebate After Rebete Mount•in Pl•ins Mean 38 84 41 41 44 05 33 64 71 11 35 40 36 17 41 97 34 31 Medran 37 68 39 75 44 63 33 55 73 74 26 29 35 69 42 26 33 31 Standard :1evtatron 5 20 6 04 6 .35 6 97 18 88 15 28 5 60 6 51 7 26 Colorado 36 34 . NA NA NA 74 07 ' 16 10 ' 35 69 ' 39 59 ' 29 19 . Iowa 30.7 ' . 34.31 • 33.91 • 24.05 ' 71 17. NA 31 11. 39 02' NA Kansas 33 87 36 63 39.01 27 73 73.74 NA 32 20 42 26 NA MtSSOUrt 36.80" NA NA NA 78 27" 23 98' 35 30 ' 46 01 ' 32 96 ' Mon tana 45 33' 45 .64' 45 64 ' 38.07' 66 73 ' 21 39 ' 42 76' 48 52" 38 46' Nebraska 30 23 31 39 35 63 25 52 67 36 16 13 30 15 38 54 26 71 North Dakota 38 18' 38 44' 50 68' 31 69' 76 76" 26 29' 31 69" 33 17' 23 78' South Dakota 45 45 ' 46 35 ' 50 87' 39 12" 95 47" 47 76 ' 41 82 ' 54 73. 45 18 . Utah 37 68 ' 46 84. 39 12. 23 12. 28 45 " 6 45 . 30 08 ' 31 63 ' 26 29 ' Wyomrng 36 52" 43 84 . 49 63 ' 35 40' 69.50" 24 16. 38 22 ' 36 98' 28 76 ' Cheyenne Rtver Sroux ISDI 42 43 39 75 45 68 43 80 69 35 45 91 45 79 49 92 45 20 NIITDC INFI 38 23' 39 70' 44 63' 30.37 ' 77 26' 60 26' 37 11 . 45.81' 28 81' Rosebud Stoux ISDI 49 61 . 52 oo• 52 oo· 40 oo• 104 oo· 68 96 . 44 oo· 42 92. :3741' Shoshone Arapahoe IWVI 41 62 49 51 53 26 37.70 89 12 57 35 28 60 35 87 33 31 Standrng Rock Stoux INDI 37 13 39 75 40 55 31 .09 81 88 57.00 35 70 42 95 39 17 Three Afftltated INDI 43 34 43 34 43 34 43 34 43 34 24 00 43 34 49 93 45 59 llte Mountatn Ute ICOI 36 67 33 60 36 75 NA 42.40 35 29 31 41 35 57 33 78 E \ tom• ted 1verage monthly co" NA tndoclln that dill ate not avaollble Chapttr Two: O•tnltw of PC94 WIC P~mcipdllott and Food Paclcqgt CoJil U Exhibit 2.5 (contlnuedt Estimated Average Cost of Food Packages by Participant Category. Region. and State Outl1yt In Ool1rt fOf Apdl 1994 Computed Averege for Computed Average for Regton/Stlte All Pregn1nt Brentfeedlng Postpenum AU Intents Alllnfents Tot•l A• WIC Plnlclpents All WIC Panlctpents Woman Wom1n Women Women l1f0fl R1b1te1 After Reb1111 Children Before Reb111 After Reb1te West em Mean 51 92 43 95 48 47 36 10 77 34 38 31 39 70 52 68 43 34 Med•an 42 00 45 03 46 97 37 25 79.71 25 52 40 32 51 09 43 92 Standard devtatton 36 44 12 72 15 00 10 42 JO 22 27 5(1 13 00 14 43 13 67 Alaska 42 oo• 45.03. 46 75 " 37 25 • 98.28 . NA 50 91" 47 28" 41 24 . Ar~zona 36 31 " 38 71. 38 71. 31 .52" 80.31 " 35 55" 36 57 " 45 go· 33 9J• Cdhlornta 42 82 44.43 53 93 37 04 70 28 20.58 34 29 49 41 34 57 Guam 22.00" 20.00" 28.00 " 17.00 " 29.00" 2o.oo · 20.00" 53.66 " 53.66. lfawau NA NA NA NA NA NA NA 59 16 46 58 Idaho 44 sa· 46 97 . 46 97 " 38 12" 84.80" 157.28 . 44 07" 52 76" 46.40" Nl'vada 33 30" 35 67 " 36 n · 28 16" 62.21" 22 28 " 26 40" 37 sa· 26 94 . Orf'gon 34 so · NA NA NA 40 so• s oo· 29 70" 34 oo· 26 30" Washmgton 68 21" 67 51" 01 so · 55 63" 79 11 . 25 52 " 64 36" 70 83" 53 71 " lTC Artzona NA NA NA NA NA NA NA 40 25 32 38 lTC Nevada NA 45 73 " 52 15" 39 as • 91 98" 70 07" 45.73. 55 oa· 50 70" Navato Nation IAZI 143 24 . 51.4 7 . 51 47" 40 30" 13680" as so· 44 97 " 85 91. 73 64 . fst•mated everege monthly cost NA mel•ce tes thet date ••• not evittleble Chapttr 1Wo. Oltn lt lf' of PC94 W/C Pomclpdliop ond Food Pad:agt Costs 2S BLANK PAGE 3. DEMOGRAPIUCS OF WIC PARTICIPANTS Demographic nems m the Minimum Data Set are age. mmester of enrollment durmg pregnancy. and racetethrucny of WTC enrollees m Apral 1994 These data are displayed m Exhibns 3 1 through 3 5 For both PC92 and PC94. States reponed age data on 98.5 percent of women enrolled in the WIC Program. Between 1992 and 1994. there were v1nually no changes an the age distribution of WTC women. Across all categoraes of women. most are young-82 percent are between the ages of eighteen and thiny-four However, m 1994, as in 1992, only 12 percent of pregnant women are under the age of eighteen. The clustenng of infants m the zero-to-three-month-old category has increased considerably since 1992; nearly 85 percent of all WIC infants fall into that age group at time of cenification. In 1992. slightly more than threequaners of infants were zero-to-three months in age at ume of cenificauon. Many WTC agencies have Initiated outreach programs to encourage early enrollment of infants which may account for this increase. The age distribuuor' of children. on the other hand. has shifted slightly to the older ages. wnh hagher percentages of children aged three years or older at then most recent cenaficatlons. Data to calculate trimester of enrollment were reponed for 89.7 percent of pregnant WTC enrollees. Because such data were not reponed for a large proponion of pregnant WTC clients, findings on trimester of enrollment must be viewed with caution. Approxunately equal numbers of pregnant WIC panicipants enrolled in the program during their first and second trimesters. wnh 38.9 percent in the first trimester and 40.1 percent in the second. Between 1992 and 1994. enrollment in the first tnmester increased by five percentage points. while late (third-trimester) enrollment decreased by 5.2 percentage pomts. This change is a significant one for WTC. These figures may indicate that WTC's outreach to pregnant women and promotion of early prenatal enrollment are successful effons. Slight differences may be seen an the ethmc compos1taon of the WJC program since 1992; percentages of Asian and Hispanac WTC enrollees have risen. whale percentages of black and white (non-HispaniC) enrollees have decreased. Hispanac enrollment mcreased by rhree percentage pomts across the nauon (from 1.3 million to 1.8 million), w1th larger mcreases m the Mid-Atlanuc and Southwest regions. This substantial mcrease may reflect WIC outreach to nonEnglish- speaking populations. II may also reflect nauonal trends. The Bureau of the Census estimates that the Hispanac populauon res1dent m the US has mcreased from 9.5 percent of the population an 1992 to 9. 9 percent of the population in 1994, so the number of Hispanic residents rose from 24 2 mallion m 1992 to 25.9 million m i994. Asian enrollment has risen by one percentage pomt. This increase occurred evenly across the seven FCS reg1ons. With the exception of the Western reg1on. where Asian enrollment increased by two percentage points. Chapttr Thrtt: Dtmo8raph1cs of PC9.t WIC Parne~panrs 17 Exhibit 3.1 Distribution of Age of WIC Participants at Certification by WIC Participant Category 1990. 1992. 1994 Participant Category and Age et Certification l'regn•nt wom•n Under 1 5 years• 15 - 17 years 18- 34 years 35 or more years Age not reported' BrHitf•edlng wom•n Under 15 years• 15 - 17 years 18 - 34 years 35 or more years Age not reported' Postp•rtum wom•n Under 15 years• 15 • 17 years 18 - 34 years 35 or more years Age not reported' Tot•J wo,., Under 1 5 years• 15 - 17 years 18 - 34 years 35 or more years Age not reported' /nf•m•' 0 · 3 months 4 - 5 months 6- 8 months 9- 11 months Age not reported' Chlldrtm0 1 year 2 years 3 years 4 years Age not reported' US WIC Note a • Not a reportmg category m 1990 1990 611.483 11 .7% 85.0 3.2 470,256D 1,081 , 739 9.2% 86.8 4.0 1,352.876 78.6% 7.4 9.2 4.7 2,103.497 41.3% 26.7 20.6 10.4 4,538,1 12 1992 Percent by participant category 781 ,029 1.0% 10.9 82.7 4.5 0.9 207,58G 0.2% 3.6 85.0 9.4 1.8 300.498 0.8% 11 .0 81 .5 4.3 2.3 1.289. 11 5 0.9% 9.7 82.8 5.2 1.4 1,732,077 76.2% 5.2 8.4 4.8 5.4 2.732.810 43.9% 24.2 18.5 11.5 1.8 5,754,003 1994 823,604 1.0% 1 1 .2 81 .7 5.0 1.0 275.158 0.2% 4.0 83.7 9.6 2.5 491 ,998 0.7% 9.6 83.0 5.1 1.6 1,590.762 0.8% 9.5 82.5 5.8 1.5 1,852.455 84.2% 3.1 7.2 2.6 3.0 3,464,631 40.0% 24.6 19.9 12.7 2.9 6,907.848 • In 1990. breutfeedtng and postpartum women were combtned mto one reporttng category ' An 1nfant •s deftned as a partlctpant who, at cert1ftcat1on, IS under one year of age and who would be class1fled as a ch1ld at the age of 366 days • About 12.8 pet cent ol one-year-old ch1ldren are eleven·month·old Infants who have been recert1f1ed as chtldren About 0 1 percent ol WIC PlrtiCipants who are class1fted as 1nfants are partiCipants who are older than 366 days Cltt111ttr Thrtt: Dtmorn~phtcs of I'C94 WIC l'tuflapants 18 Exhibit 3.2 Distribution of Pregnant Women WIC Participants by Trimester of Enrollment 1992 and 1994 1992 Trimester of Enrollment Number Percent Ftrc;t lrtmester 263,050 33 7% Second trimester 324,571 41.6 Thtrd tnmes ter 124,311 15.9 Trtmester not reported 69,095 8.8 Total pregnant women 781 ,029 100.0 Exhibit 3 .3 Distribution of Racial and Ethnic Characteristics of WIC Participant• by Participant Category Racial or Ethnic Cheracteristlcs Amerecan lnd1an or Alaskan Nat1ve As 1an or Pacific Islander Black (non·H1s pan1c) H1s pan1c Wh11e (non H1s panicl Race or ethnicit'f not reported Total US WIC Pregnant Women 15% 2.6 23.9 27.7 43.8 0 .6 100.0 823,604 Breastfeedlng Postpartum Women Wo~n Total Women Percent by participant category 20% 1 1% 15% 2.7 3.0 2.7 13.4 25.0 22 4 36.1 24.0 28.0 43.9 46.2 44 5 1.9 0 .7 09 100.0 100.0 1000 275.158 491 ,998 1,590, 762 Infanta 1 5% 2.8 26.3 27 9 40.8 08 100.0 1,852,455 Cllapttr Thrtt · Dfmofraplticr of rC9-I K'IC rarriCipanu 29 1994 Number 320.085 330.020 88.370 85. 128 823.604 Children 19% 2.4 26 3 24 2 42.8 2.3 100.0 3.464.631 Percent 38 9% 40.1 10 7 10 3 100 0 Total WIC Participants 17% 2.6 25 4 26.1 42.7 1.6 100.0 6.907.848 Exhibit 3.4 Distribution of Racial and Ethnic Characteristics of WIC Women, Infants, and Children• 1990, 1992, 1994 Women lnflnta Children Racial or Ethnic Characteristic 1990 1992 1994 1990 1992 1994 1990 1992 Percent by pertlclpent cet1gory Arncr~can lnd1an or 05% 1 7% 1.5% 08% 1.4% 15% 1 2% 2 1% Alaskan Nat1ve As1an or Pac1l1c 1 5 1 9 2 7 09 2 3 2 8 08 1 7 lsl.mdcr Black (non I llspan1ct 25 7 24 2 22 4 26 8 28 2 26 3 29 1 29 2 H1span1c 24 3 26 1 28 0 25 6 26 4 2 7 9 15 8 19 4 While lnon H1span1cl 47 1 45 1 4 4 5 45 4 40 5 40 8 51 7 46 4 Other' OJ t./A NIA 00 NIA N/A 1 1 N/A Rar P or etlmu.1ty not N/A 1 2 09 NIA I 1 08 N/A 1 I reported' US WIC 1,08 1,739 1,289. 115 1,590, 762 1,352,876 1, 732.077 1,852,455 2 , 103 497 2,732,8 10 Notes • In 1990 rac1al and ethn1c charac t e r~s t lcS wero reported lor the COIIftguous States b Not a rrportmg cateqorv 1n 1992 and 1994 ' Not a rcport1ng catrgorv 1n 1990 ( hapttr Thrtt: Otmorrapltics of PC94 W/C Participants JO Total WIC 1994 1990 1992 1994 19% 09% 1 8% 1 7% 2 4 1 0 1 9 }. (j 26 J 2 7 (j 17B l'.J 1 24 2 20 8 23 0 26 1 4 2 8 48 7 44 3 42 1 NIA 06 N/A N/A 2 3 N/A 1 1 IL 3, 464,631 4538112 5. 754,003 6 ,901 fJ-18 Exhibit 3 .5 Distribution of Racial and Ethnic Characte;istics of WIC Participants by Region Region Northeast Mtd Atlantic Southeast Mtdwest Southwest Mountatn Platns Western US WIC American Indian or Asian or Pacific: Alaskan Native Islander 0 .4 3.8 0.2 1.4 0 .5 0 .9 0 .7 2.1 2.6 09 4.3 1 5 3.9 68 1. 7 2 6 116,916 179,574 Black lnon-Hiapanlct 25 5 28.8 43.2 29.6 22.2 12.8 7.6 25 4 1, 754,201 Race or White Ethnlclty Hispanic lnon·Hispanfct Not Reported Percent by region 27.9 40.4 1.9 29.8 39.7 0 .2 6.6 48 8 0 .0 8.9 58.1 0 .5 44.2 30.0 0 1 9.9 71 .2 0 2 50 5 24.5 67 26.1 42.7 1.6 1,802,449 2,946,565 108,140 Chapttr 171rtt: Dtmorrapllln of I"CH WIC Pame~pa"ts Jl Total WIC 780,779 931 ,463 1.348,329 1,091 , 716 987,720 511 ,977 1. 255,861 100 0 6,907.848 Black enrollment decreased bv nearlv two percemage pomts beaween 1992 and 1994 This decrease was seen urulateraJlv across all reg1ons Although this population showed a propomonate decrease. numbers of black fnon-H1spamc1 WtC panac1pams mcrea..sed shghtly from I 6 rrulhon an 1992 to 1 7 m1lhon an 1994 White enrollment decreased by slightly more than one percentage po1m. w 1th the largest dechnes occurnng an the Mld·Atlanuc. Mountam Plains. and We!tem reg1ons. Actual numbers of white enrollees rose from :! .5 mall ion an 1992 to :!. 9 m11lion m 1994 Whale Amerrcan lndaan or Alaskan Nauve pan1c1pauon shov.;s VIrtually no change at the national level. there were shght decreases-of about one percentage pomt an both the Moumam Plains and Western reg1ons. ln actual nwnbers. Natave Arnencan/Aiask.an Nauve enrollment remamed about the same an the Mountaan Plaans between 1992 and 1994 Paralleling the considerable 1992-to-1994 growth an WlC in the Western reg1on. WlC enrollees an th1s rac1al/ethmc group ancreased. an actual nwnbers. from 42.692 an 1992 to 48.978 an 1994-a 15 percent mcrease. Clt~~pttr Thr11: IHMttfrophiCI of PC94 WIC P~lf'MIIJ 32 4. INCOME OF WIC PARTICIPANTS Federal regulations requ1re categoracally ehgible WIC applicants to meet mcome eligibility standards set by State WJC agenc1es Income hmits set by the States may not exceed 185 percent or be less than 100 percent of the Office ot Management and Budget (OMB) poveny mcome gu1delines. which are based on household size. As of February 1994. at the 185-percent threshold. a person from a family of four w1th an annual household income of S27 .380 or less IS income-eligible for the WJC Program. In 1990. State WJC agencies were required to establish procedures for determining an applicant adjunctively income eligible for WJC benefits if the individual could document panicipation in such means-tested programs as the Aid to Families with Dependent Children tAFDC), Food Stamp, or Medicaid Programs. As of April 1994, a vast majority of State WIC agencies were implementing such procedures. WJC regulations also allow States to extend automatic WIC income eligibility to individuals who pantcipate m other Stateselected. means-tested programs which apply income eligibility guadelines that are in congruence with State regulations on WlC income. Exhibit 4.1 dasplays information reponed by States on their use of means-tested programs to determine WIC income eligibility. As reponed m PC92, a substantial majomy of States apply AFDC. food stamp, and Medicaid panicipauon to deterrrune WIC income eligibility. In addition. the percentages of states using panicipation m Supplemental Security Income, Free or Reduced-Price National School Lunch Program. or other means-tested programs to establish adjunctive eligibility have increased steadily since 1990. States are also permitted to establish requirements for documenting and verifying income. Such documentation can range from a paysrub to self-declaration State-reponed information on income documentation appears in Exhibit 4.2. More than one-third of State WJC agencies requare WJC apphcants to document income. Another third allow applicants to self-<ieclare mcome. In sixteen of the remammg twenty-four agencaes. documentation of income may be requared by local WIC agencies. State-level tables containing information on means-tested programs and mcome documentation appear in Appendix C. The reponed 1994 pan1cipauon of WJC clients m other programs appears m Exhiblt4.3. States reponed program panacipauon mformauon for 92.2 percent of WJC enrollees. In 1994, two-thuds of WJC recapients. for whom other program participation is reponed. were receavmg benefits from at least one other public assistance program at ume of WIC cen1ficat1on. A majoraty (53 percent) ofWIC clients receaved Med1caad benefits; 37 percent ofWIC chents panac1pated in the Food Stamp Program: and 27 percent reponed rece1vmg AFDC benefits Almost one-quaner (22.9 percent) partiCipated mall three programs. receivmg AFDC. food stamps. and Medicaid benefits. These estimates represent a lower bound of program participation because the data are recorded at ume of cenificauon. Staff in local WlC service Sites refer WJC enrollees to other programs. and this participation is not captured an the estimates presented here Chopllr Four: /tfcomt of PC94 WIC Parnc1ptum JJ Exhibit 4.1 Means-Tested Programs Used to Determine WIC Income Eligibility Program Adjunctive Income eligibility AFDC or ADC Food Stamp Program Medicaid Autom11tlc Income eligibility Supplemental Sccur~ty Income Free or Reduced Pr~ce NSLP meals Other programs No programs Total rcportmg State WIC agencies Notes • In I 994. other programs Included Extended Med1ca1d Healthy Start Head Sta11 Maryland Weatheuzallon Program Maryland Phermecy Ass1stance Program Low Income tlorne Energy Ass1stance Agencies Reporting In 1990 Agencies Reporting In 1992 Number Percent 55 72.4% 44 57.9 61 80.3 17 22.4 15 19.7 14 18.4 7 9.2 76 100 General Pubhc Ass1stance Program Mich1gan Care Number 72 72 76 20 16 14 2 83 Food Aed1Str1but1on Program on lnd11n Reservations Refugee Resettlement Progrem Child Summer food Program Percent 86.7% 86.7 91 .6 24.1 19.3 16.9 2.4 100 Agencies Reporting In 1994 Number Percent 73 86.9% 74 88.1 77 91 7 22 26.2 21 25.0 18• 21.4 2 24 84 100 Alter June I , I 990 federal WIC regulations allowed partiCipation 1n the AFOC. Food Slimp, or Med1ca1d Programs to 1nd1cate ad1unctlve 1ncome ehg1b1hty lor the WIC program Responses are not mutually exclus1ve so percentages add to more than 100 percent Percentages are based on r.umbers of reportrng egenc~es Cltapttr Four. lncqtret of PC94 WIC Parne~pattiJ J./ Exhibit 4.2 Income Documentation and Verification Policy State Agencies Documentation Verification end Requirements Nl~muet Percent Income documentation requ~red 32 38.1% Applicant self-declares mcome for econom1c unit 28 33.3 In some cases local agenc1es have d1scret1on w1th regard 16 19.0 to mcome documentation Income documentatiOn preferred m all cases but not e 9.5 reqUired Total reportmg State WIC agenc1es 84 100.0 Chapttr Four· lnt:omt of PC94 W/C Panwptvm JS Exhibit 4 .3 Number and Percent of WIC Participants with Reported Participation in Other Programs at Certification Reported receiving benefits trona ... Number Percent of All WIC A1d to Fam1hes w1th Oedendent Ch1ldren IAFOCI. Food 1,579,145 22.9% Stamp, and Med1ca1 Programs AFOC and Food Stamp Programs 85,245 1.2 AFOC and Med1ca1d Programs 175.948 2.5 Food Stamp and Med1ca1d Programs 627.177 9 .1 AFOC only 37,660 0.5 Food Stamp Program only 251 ,180 3.6 Med1ca1d Program only 1,303.825 18.9 Do not partiCipate tn other programs 2.309.740 33.4 No parttctpatton reported 537.929 7.8 US WIC 6,907.848 100.0 Note a Not reponed md1cates the number and percentage of partiCipants for whom no data regard1ng partiCipation 1n Med1ca1d, AFDC, and Food Stamps are reponed Most lndtan Tnbal Organ1zat1ons liTO) pan1c1pate 1n the Food 01strlbut10n on lnd11n ReservatiOns IFDPIRI Program Although PC94 data spec1f1cat1ons permitted lnd1an WIC programs to repon FOPIR partiCIPation. only three of 30 ITOs chose to repon these data Of the 60.5 percent, 28,570 1nd1v1duals for whom these data were reponed , onlv 4 3 percent pan1c1pate 1n the FOPIR program Chapttr Four: Jncomt of PC94 WIC PMtmptl.lltr 36 /ncomt and Povtrry For the 1994 WIC pantc1pant md program charactensucs study. State agenctes were asked to repon for each person enrolled m WIC dunng April 1994· s1ze of fam1ly or econonuc unn: mcome of family or economic urut: and mcome penod. In many States. rouune collection of such mfonnauon 1s a relauvelv 1 ecem under&dbn~ .)U that .)vme or all of the~e d3t3 art- .,,., r~poned fnr ~pnl 1994 for about 13.8 percent of the almost seven rrullion WIC pan1cipantS States w1th income informauon rrussmg for over 30 percent of the1r WIC pan1c1pants mclude: Alabama. lllinots. Indiana. New York. Pueno Rtco. South Dakota. and TeMessee. For some panicipantS. States reponed "actual" income-that IS. the figures provided by WJC applicantS. For some applicants detenmned adjunctively mcome eligible. States mdicated income ranges. Both types of data have been combined to compute average annualized mcome and to caJculate percent of poveny. MidpomtS of income ranges were used m these computations. Footnotes on tables md1cate that. m some States. md1v1duals were reponed to have zero mcomes. While ava1lable mcome data from aJI States have been included m thi!l anaJysis. these zeroes have been excluded because. m fony-two of eighty-four reponmg agenctes. zero does not indicate that the participant has no income. In some States. zero 1s used to indicate missing data. Most of the individuals have income. but no descnptive information was collected. Exhibns 4 5 through 4.9 present data on the income and poveny status of WIC pan1c1pants during 1994 The mean and median mcomes of WJC enrollees rematn at low levels. Average family (economic urut) stze slightly increased from 3.8 persons in 1992 to 4 .0 persons in 1994 <Exhibit 4.4). Most of this mcrease occurred in unns of six or more persons. The number of WlC pan1cipants reponmg m this category increased by 29.4 percent smce 1992. Across panic1pant categones. the largest mcrease m household s1ze occurred for breastfeedmg women. resulting m an average household s1ze of 4 6 persons. Approxunately 2.0 percent of infants and children and 4.2 percent of postpanum women are classified as residing m oneperson households These categones include children placed in foster care and mothers who nuscarry or whose Infants are placed m foster care Exhibits 4.5 and 4 6 present mean and med1an incomes by participant and ethmc categories. Data to calculate mean and median income were not reponed for 16.4 percent of WIC enrollees. For the 83.6 percent of WIC enrollees with income data. average farnily/econorruc unit income across all categones was $9,684 m April 1994, a 4 0 percent mcrease from 1992. Median mcome m 1994 shows a 2 7 percent mcrease over 1992. Income d1stnbuuons by pamc1pam and ethn1c categones have changed little smce 1992. The htghest average mcome conunues to be reponed for breastfeedmg women. the lowest was reponed for pregnant women-the category contammg the youngest adult WIC pamc1pants Across ethnic categones. Astan or Pac1fic Islanders reponed the htghest mcomes. while black panic1pants reponed the lowest. Th~e findings are consistent wnh income data collected by the US Bureau of the Census. Ch11pttr Four: lncomr of PC94 W/C PamapGIIts 17 Exhibit 4 .4 Distribution of the Size of Families or Economic Units of WIC Participants by Participant Category Site of Family Pregnant ar .. stfeeding Total or Economic Unit Women Women Postpertum Women Women Infanta Children Total WIC Percent of totel women Percent by category I !l!U 199" ,qq2 1!)94 1 'l'J2 1!J!J4 1992 1994 1992 1994 1992 1994 1992 1994 1 person' 17 3% 17 8% 0 .9% 0.0% 25% 42% 11 .2% 10.5% 2.0% 1 7% 23% 22% 42% 40% 2 persons 26 7 26 5 15 1 15.6 17.7 19.5 22 8 22 5 16.4 16 J 119 119 15 7 15 5 J persons 24 9 25 0 26.1 27.1 29 0 29.4 26.0 26 7 29 2 29 7 24 6 24 J 26 J 26 J 4 persons 15 2 15 I 21 9 22.1 23 7 22 6 18.2 18.6 24 I 24 6 27 J 27.0 24 J 24 4 5 persons 7 7 7 7 14.2 13 6 1 J 5 12.2 10 1 10 1 1 J 9 14 1 17 J 16 8 14 7 14 5 6 or more " 7 69 13 4 16.5 119 10 9 90 98 12 2 12 I 14 9 16 5 12 8 13 8 persons Srze not reported 1 5 0 7 8 5 49 1 8 08 2 7 1 5 2 3 I I 1 7 09 2 1 1 1 US WIC 781 ,029 823.604 207,587 275. 158 300.499 491 .998 1,289.115 1.590. 762 1. 732.077 1.852.455 2.732 811 3 ,464 631 5. 754 003 6,907 848 Mt!ln 30 30 39 4 .6 3 8 3 7 3 J 3 5 38 3 8 40 4 4 3 8 40 Notes Calculations rn thrs table are based on all families or economtc unrts reportrng size Unrts reporting zero members are rncluded tn the srze not reported category • Mothers who mrscarrv. mothers of rnfants assrgned to foster c are, and mfants and chtldren assrgned to foster care mav be reported as berng rn one person economrc unrts Cltapltr Four: lncomt of PC94 WIC Porticipanu J6 Exhibit 4.5 Mean and Median Annualized Family or Economic Unit Income of WIC Participants by Participant Category Pregnant Breeatfeedlng Postpartum Total Total Women Women Women Women Intents Children WIC Average (meanl tncome $9,017 $11,032 $9,197 $9,423 $9,315 $9,988 $9,684 Medtan income $7,800 $9,638 $7,752 $8,040 $7,800 $8,248 $8,008 Percent with income reported 82.2% 83 4% 84.8% 83.2% 80.7% 85 3% 83 6% Percet .t wtth income reported as zero• 3 8 2.8 2.4 3.2 3.3 2.0 2 6 Percent wtfh income not reportedb 13.9 13.8 12.8 13.5 15 9 12 7 13.8 US WIC 823.605 276,159 491,999 1,590, 762 18,524,553 3,464,632 6.907,849 Notes State and local WIC agenctes may colftct data on weekly, monthly, or annueltncomes. For repor1tng and analysts, annualized tnc'lmes h1ve been computed Also not~ that tncome calculattons mclude only those parttctpants for whom State WIC lgenctes reported data on mcome, tncome pertod, and s1ze of economtc urut In 1994, a State WIC agency could report actual mcome for a parllctpent or could report an tncome range Both types of d1ta ate tncluded tn the calculat1ons of mean and med11n mcomes • Zero mcomes are e11cluded from mean and medtan tncome calcul1t1ons. In 42 of 84 reporting 1genctes. zero may be used to tndtcate mtsstng tnforrna11011 so that PC!N cannot dtsttngutsh between households for whom States dtd not report income and households for whom St1tes reported zero income When ent11es of zero are mcluded, the average mcome across all WIC partiCipants ts t9,362 b Not reported tndtcates the percentage of parttctpants by part1ctpant category for whom no data on tncome , tncome pertod, or Slle of econom1c un1t are reported Cltapttr Four: '""'"'' of PCH WIC PDrtlcipDnls J9 Exhibit 4.6 Average Annualized Family or Economic Unit Income of WIC Participants by Participant Category and Racial or Ethnic Characteristics Reciel or Ethnic Characttrlatic Pregnant Women Breaatfeedlng Women Postpartum Women Total Total Women Infanta Children P ertJcipan t s Amerlc•n lndl•n Of Af•d•n N1ti11• Average tmeanl1ncome $9,426 110,383 19, 101 $9,680 $9,619 $10,300 $10,007 Med1an mcome $7,800 18,964 17,452 $7,800 17,800 $8,628 $8,326 PPrr.ent with Income reported 86 6% 89 6% 87 0% 86.9% 87.3% 91 2% 89.4% Percent with income reported as zero• 36 1 7 2.2 2 8 2 2 1 2 1 7 Percent w1th income not reported~ 10.7 8 .7 10.8 10 3 10 5 7 7 8 8 Number of WIC Part1c1pants 12.045 5 ,501 6,655 23.201 27,071 66,645 116,916 Asi•n Of P•ciflc /sf•nder Average (meanl income $10,731 112,117 111 ,478 $11 ,230 $11 ,300 $1 2, 105 $11 ,667 Med111n 1ncome $9,828 110,992 110,164 S10, 164 110,164 $10,548 t10,308 Percent w1th mcome reported 84 0% 85 0% 90 1% 86 2% 85 2% 89 2% 87 3% Percent w1th mcome reported as zero• 27 30 2 3 26 2 2 1 3 1 9 Percent w1th Income not reported~ 13 3 12 0 76 ttl 12 6 95 10 8 Number of WIC PartiCipants 21 ,156 7,378 14,681 43,215 62,570 83,789 179,574 Bl•ck (non Hisp•nic} Average (mean) mcome $7,014 t8,943 $6,862 $7. 168 $6,852 $7,537 $7,281 Med1an 1ncome $5 ,400 17,200 S6,400 $5,400 $5,200 $5,676 $5,400 Percent w1th mcome report11d 79 5% 80 7% 83 9% 81 2% 77 4% 84 9% 82 0% Percent with Income reported as zero• 4 1 2 3 2 1 3 2 J 8 :l O 2 8 Percent w1th 1ncome not reported~ 16 4 17 1 14 0 15 6 18 8 13 1 15 2 Number of WIC PartiCipants 197.006 36,838 122,948 356,791 486,394 911 ,017 1,754,202 Hispanic Average (meanlmcome $9,269 $9,703 19,476 $9,423 19,316 $9,459 $9,411 Med1an mcome $8,496 18.964 18,544 t8,640 t8 ,400 $8,320 $8,400 Percent w1th income reported 79 6% 82 4% 84 5% 81 5% 78 5% 83 7% 81 7% Percent w1th mcome reported as zero• 50 4 8 40 4 7 4 7 36 4 2 Percent w1th mcome not reported~ 15 4 12 8 1 1 6 13 8 16 7 12 7 14 1 Number of WIC Part1crpants 228,286 99.209 1 17,855 445,350 517,398 839,702 1,802,450 (/ropttr Four llfcomt of I'C94 KIC l'omcrpantJ 40 Exhibit 4.6 (continuedt Average Annualized family or Economic Unit Income of WIC Participants by Participant Category and Racial or Ethnic Characteristics Pregnent Breeatfeeding Poatpel1um Total Reciel or Ethnic Cherecteriatlc Women Women Women Total Women lnfenta Children Pertlctpenta White (non H!Jpenk} Avertge lmeanltncome $9, 768 t1 2.613 t10. 135 $10,379 $10,613 $11 ,548 $11 ,04 1 Med1an 1ncome $8,820 112,000 t8,962 t9,288 t9,600 t10.200 $9,804 Percent wtth tncorne reported 85 4% 87 4% 85 9% 85 9% 84 1" 900% 87 5% P"'rcent wtth 1ncome reported 11 zero• 30 1 8 1 8 24 2 2 1 2 1 7 Percent w1th 1ncome not reported' 11 5 110 12.3 11 7 13 7 89 10 8 Number of WIC Parllctpants 360,454 120,931 227,295 708,680 764,892 1,482,994 2,946,566 Ethnlcity not reported Average (meenl income t9,870 f10,931 t9,618 $10,042 t1 0.089 $10,589 $ 10,293 Mc.d1an tncome $8,112 t9,800 t7,920 t8,424 $8,292 $8,736 $8,508 Pe cent wnh income reported 60 1% 19 8% 29 9% 36 4% 64 0% 12 9% 22 6% Percent wtth 1ncome reported es zero• 4 4 08 1 6 23 40 06 1 2 Perce'lt w1th Income not reported' 35 4 79 3 68.5 61.3 32 0 86 5 76 2 Numb[ r ol WIC PllltCiplnls 4,658 6,301 3,566 13,525 14,130 80,485 108, 141 Note a State 11nd local WIC egeoctes may collect dete on weekly, monthly, or 1nnuellncomu For 11ponitlg 1nd eol lylls, a nnueltzed tncomes h1v1 b11n computed Also note thet tncome celculaltons 1nclvd1 only those pertic1peots lor whom S1111 WIC 1g1nctes raporled d1t1 on mcome mcome pe11od end Sill of economtc un1t In 1994, 1 Stele WIC egency could repo1t ectuel lncome lor 1 pertlclpent or could rapon en 1ocom1 renge Both types ol date 111 Included 1n the cek:ul1110ns of mean end med110 lnton.es 'Ze10 mc:omes 111 uc:luded from mun end medien 1ncom1 c:elc:ulatloos In 42 of 84raportlng eg1ncte1, 1110 may b1 used to •nd1clle m1s51ng 1nlorm11ton so th1t PC94 c:1nnot d1sttogutsh between houuholds lor whom Stetes d1d not 11port lncom1 1nd houuholds lor whom Slltll fiPortld 1110 Income. When entr1es ol 1110 111 1nclud1d, the I YIItge tncome 1crou 111 WIC pertiCIPints 1s t9,J62 • Not repo11ed 1nd1CIIIS the pe~c:eoteg1 ol perllclpeots by PIIIICiplnl c1tegory lor whom no dele oo Income, lncom1 pe11od. or 1111 ol t c:ooom1c un1t 111 tepotted Clcopttr Four: l~ttomr of PC94 WIC Portwponts 41 Povtrry Status In Exhibits 4. 7 and 4.8. information 1s presented on percent of poveny level by pan1c1pant category and by race/ethrucuy Agatn. across all categones. there has been httle chal'ge smce 1992. w1th almost three-quaners of WIC pan1c1pants reponmg mcomes at or below 130 percent of poveny. while close to two-thirds of WIC panicipantS reponed mcomes at or below the poveny line Withan categones. the percentage of women pan1c1pan1S below the poveny hne has increased since 1992 by three percentage pomts: Infants display a two percentage point increase. Again. n 1s imponant to note that these findmgs apply to only the 83.6 percent of Apnl 1994 WIC enrollees for whom mcome data were reponed. Exhibit 4. 9 presents the distribution of percent of poveny for those pamcipants who repon no panicipauon in the AFDC. Food Stamp. and Med1ca1d Programs. This group accountS for one-third of the WIC populauon. There are some differences between this group and the WIC population receiving other benefits Just under one-half (46.6 percent) of these mdiv1duals are under the poveny lme as compared with two-thirds of the WIC population reponmg pan1c1pat1on m public a1d programs. The poveny of WIC panicipaniS can be seen m the mformauon displayed an Exhibit 4.10. This table contams data on percent of poveny level for the general US population, for American families, and for families w1th children under six years of age National data are drawn from the US Census Bureau's Cu"tnt Population Survey. In generaL m this country, slightly more than 5.0 percent of the population falls into the 0-to-50 percent poveny level. The rate increases to 9.9 percent for families with children under SIX years of age. In 1994, over one-third (36.3 percent) of all WIC pan1c1pants reponed incomes falling anto the 0-to-50 percent of poveny range. Chapttr Four: ln.:omt of PC94 W/C PartiCipant, .Jl E.<hibit 4 . 7 Distribution of Percent of Poverty Level of WIC Participants by Participant Category Pregnent 8reestfaeding Women Postpenum Total Women Women Women Infanta Children Totel WIC Percent of Cumulative Cumuletiva Cumulative Cumulative Cumuletlva Cumulative Cumulative Poverty level Percent Percent Percent Percent Percent Pet cent Percent Percent Percent Percent Percent Percent Percent Percent Percent by pet11clpent category 0 06% 06% O.J% OJ% 0 .7% 07% 0.6% 0.6% 07% 07% 05% 06% 05% 05% 50 JO 6 31.2 28.5 28.8 37 6 38 J J2.4 J3.0 36.7 J7.4 36.8 37 .J 36 8 36 3 51 100 27.8 58.9 29 6 58.4 27.4 66.7 28.0 60.9 26 4 63 7 28 6 65 9 27 9 64 2 101 IJO 11 0 69.9 12.J 70.7 10.1 75 .8 11.0 71.9 9J 73.0 10 0 76 0 10 1 74 2 131 160 5.5 75 .5 5.7 76.4 4 .5 80.3 6.2 77.1 3.9 76 .9 46 ao 6 4 6 7a a 151 1a5 58 81 J 5 1 81 4 40 84.3 6.1 82.2 34 80 3 4 J a4 9 4 2 aJ 0 1a6 200 OJ a1 6 0 1 81 6 02 84 6 0 .2 82.5 0 1 80 4 0 1 85 0 0 1 a3 2 201 225 OJ a1 9 0 .1 81 7 02 8i16 0.2 82 7 0 1 80 5 0 1 as 1 01 a3 3 226 250 02 82 0 0.1 81 7 0 1 84 7 0 1 82 8 0 1 80 6 0 1 as 2 0 1 83 4 Over 250 02 82 2 0 1 81 9 01 84 8 02 8J 0 0 1 80 7 0 I as 3 0 1 a3 5 lncom!' reported as Ja 86 1 2 s 84 4 2 4 87 2 32 86 1 3 J 84 1 20 a7 3 26 86 2 zero' Not reporlecJ' 1J 9 100 0 15.6 100 0 12 8 100 0 13 9 100 0 15 9 100 0 12 7 100 0 1J 8 1000 US WIC 82J.605 275, 159 491 ,999 1,590, 762 1.1:t52,455 J ,464.632 6,907 849 Notes Povert'( level c alculatrons ere bned on income. lncoJme period, e nd household site u reported by Stela WIC egenctts. II percent or poverty is 11 OOS or below. it appears es tero lOI rn th rs tat.rle • Zero incomes are e~cluded horn these income calculations In 42 o l 84 reporting agencres. 1110 may be used to lndrcete rnrssrng rnfnrmllron so thet PC94 cannot dr5trngur5h between households lor wltortt States drd not report rnconre amJ households lor whorn States reported zero Income • Not reported rndrclles the percentage or partrcrpants by parttcipant ca tegory lor whom no d111 on rncome, Income ptttod, or s11e or economrc unrt ere reported Cltt~pltr Four: lttcome of PC94 W/C Participants 4J Exhibit 4.8 Distribution of Percent of Poverty level of WIC Participant• by Participant Category and Racial or Ethnic Characteristics Pregnent Women Cumuletlve Percent Percent Amerlcert lrtdillrt or At.1hn Netlve 0 1 50 51 100 101 130 131 150 151 185 186 200 201 225 226 250 Over 250 Income reporlld 11 zero' Nol reported• Tote/ WIC As/ert or , •cHic lst.nder 10% 36 0 28 4 10 0 52 52 02 04 0 1 02 36 10 7 0 OJ% 1 50 20 8 51 100 390 101 130 11 6 131 150 57 151 185 59 186 200 0 1 201 225 0 4 226 250 0 I Over 250 0 3 Income reported es zero' 2 7 No I reportPd' I 3 3 Tote/ WIC 10% 36 0 64 4 74 4 79 5 84 7 84 9 85 3 85 5 85 6 89 3 1000 12.045 03% 20 9 59 9 71 5 77 2 83 I 83 2 83 6 837 84 0 86 7 100 0 21. 156 lr111tf11dlng Women Cumulethre Percent Percent 04% 41 2 29 1 10.2 4 3 3 7 02 0.2 0 1 02 1.7 88 02% 21 5 36 1 133 70 65 02 0 1 00 0 1 3.0 12.1 04% 41 6 70 7 80 9 85 2 88 9 89 I 89 J 89 4 89 5 91 2 1000 5.501 02% .l1 7 57 8 71 2 78 I 84 6 84 8 84 9 84 !I 85 0 87 9 100 0 7,378 Poltpertum Totel Women Women Cumulative Cumuletlve Percent Percent Percent Percent 14% 43 8 28 1 86 34 33 02 02 00 00 2 2 10 8 02% 24 8 42 9 117 58 4 7 0 1 0 1 00 00 2 3 78 14% 45 1 71 2 79 8 83 3 88 5 86 7 86 9 87 0 87 0 892 1000 5,855 02% 24. 177 79 4 85 2 89 9 900 90 1 901 90 1 124 100 0 14.881 09% 38 I 28 0 97 45 4 4 02 03 0 1 0 1 28 10 3 03% 22 1 39 8 11 9 60 56 0 I 03 00 02 28 11.1 09% 39 5 87 5 772 81 8 86 2 86 3 86 7 86 8 86 9 89 7 100 0 23.201 03% 22 4 82 2 74 I 80 I 86 7 85 8 86 0 86 I 86 2 88 9 100 0 43.215 lnfenu Cllmuletlve Percent Percent 09% 42 8 27 3 9 2 36 29 0 1 0 I 0 1 02 2 2 10 5 OJ% 28 8 38 9 98 4 1 3 5 0 1 0 I 00 0 1 2 2 12 8 09% 43 8 71 1 80 3 83 9 88 8 86 9 87 1 87 1 87 3 89 5 100 0 27,071 0 .3% 288 877 773 81 4 84 8 84 9 85 0 85 0 85 2 87 4 100 0 52.570 Cltopttr Fot1r: '"""'" of PCU WIC PartiCIJXI"ts 44 Total Children Pertlctpenl s Cumuletlve Cumuletlve Percent Percent Percent Percent 08% 42 9 30 8 92 36 3 5 0 I 0 I 0 I 0 \ I 2 7 7 02% 28 4 43 2 9 2 4 \ 3 7 0 1 0 I 00 0 1 1 3 95 0 8% 0 9% 0 9~. 42 9 72 J 81 6 85 4 88 9 89 0 89 2 89 J 89 4 91 2 43 7 42 0 74 5 29 4 63 7 9 3 67 3 3 8 90 8 3 5 90 8 0 1 91 0 0 2 91 1 0 1 91 2 0 1 92 3 1 7 tOO 0 6 8 66.645 0 2% 0 2% 28 6 26 9 71 8 41 1 81 0 10 0 85 2 4 6 88 9 4 1 89 0 0 1 89 1 0 1 89 1 0 0 89 2 0 1 90 5 1 9 100 0 10 8 83.789 100 0 116 916 0 2"• 27 2 68 J 78 3 82 8 86 9 87 0 87 1 8 7 2 8 7 J 89 2 1000 I 79 574 Exhibit 4 .8 (contlnuedt Distribution of Percent of Poverty level of WIC Participants by Participant Category and Racial or Ethnic Characteristics tiled fnort HIJptnkl 0 1 50 51 100 101 130 I 31 150 151 185 186 200 201 225 226 250 Over 250 Income 11•porled IS 1ero' NrJ I repmted' Totti WIC HiJptmlc 0 1 50 51 100 101 130 131 150 151 185 186 200 201 225 226 250 Over 250 Income reported 111 zero' Not rrpurted• Pregn1nt VYomen Cumuletlve Percent Percent 10~ 40 4 23 3 7 2 3 5 35 0 1 0 1 0 I 02 4 1 16 4 01% 28 0 32 7 10 4 4 3 3 7 0 1 01 0 1 01 50 15 4 10% 41 4 64 6 71 9 75 4 79 0 79 1 79 3 79 3 79 5 83 6 1000 197,006 01% 28 1 60 8 71 2 75 5 79 2 79 4 79 5 79 5 79 6 84 6 100 0 228.286 llreutleeding VVomtn Cumui1Uve Perunt Percent 04% 38 3 25 6 88 40 33 0 1 0 1 00 0 1 23 17 1 01% 30 1 32 7 92 34 2~ 0 1 0 1 00 00 39 17 8 04~ 311 7 64 2 731 77 0 80 3 80 4 80 5 80 6 80 6 82 9 100 0 36,838 01% 30 2 62 9 7'2 75 5 78 0 78 1 78 2 78 2 78 2 82 2 1000 99.209 Po11p1r1um Totel VYomen VV~n Cumuletlve Cumuletlve Percent Percent Percent Percent 09% 51 7 20 1 58 2 5 2 1 0 1 0 1 00 0 1 2 1 14 0 01% 33 7 34 6 94 3 5 29 0 1 0 1 0 1 0 1 40 118 09% 52 8 73 3 79 1 81 5 83.8 83 1 83 8 83 8 83 9 88 0 100 0 122.948 01% 3311 884 7711 111 3 84 2 114 3 84 4 84 4 84 5 88 4 1000 117.855 09% 44 1 22 6 89 3 2 3 .0 0 1 0 1 0 1 01 32 15 8 09% 45 0 87 6 745 111 801 80 8 110 9 81 0 81 2 844 100 0 356.791 01% 30 0 33 2 99 39 3 2 0 1 0 t 00 0 1 4 5 14 9 01% 30 1 63 J 73 2 110 80 3 80 4 110 5 80 5 eo 6 85 1 100 0 445.350 lnlenU Curnutt live Percent Ptrcent 1 3% 411 1 18 5 52 2 2 1 II 0 1 01 00 0 1 38 18 8 1 3% 495 879 73 2 75 4 7 7 1 772 773 77 3 77 4 81 2 1000 486.394 01% 34 8 32 0 7 5 24 1 II 0 1 0 1 00 0 1 4 7 16 7 01% 34 7 66 8 741 76 6 78 3 711 4 78 4 78 4 78 5 83 3 1000 511.398 Cllopttr Four: l"comt ofi'C94 WIC PortiCipG,.ts 4$ Tot•l ChWdren Perticlpenu Cumulethte Cumul1tlve Percent Percent Percent Percent Ot% 49 5 23 0 8 3 28 2 2 0 1 0 1 0 1 01 20 13t 01% 37 0 33 4 78 2 8 22 0 1 01 00 01 3 6 12 7 09~ 10% 1 o•. 49 0 10 7 76 8 79 4 81 7 81 8 81 9 81 9 82 0 84 8 50 3 48 0 734 217 79 1 6 1 82 3 2 6 84 5 2 3 84 6 0 1 84 7 0 1 84 7 0 0 84 9 0 1 86 9 2 8 100 0 15 2 911017 0 1% 01% 37 1 34 6 70 6 33 0 78 4 a 2 81 2 3 0 83 5 2 3 83 5 0 1 83 6 0 1 83 6 0 0 83 7 0 1 87 J 4 1 1000 144 1000 1, 754 ,101 0 , ."' J47 67 6 75 9 78 9 81 2 81 J 81 J 81 4 81 4 85 6 100 0 839,702 1,802,450 Exhibit 4.8 (continued) Distribution of Percent of Poverty level of WIC Participants by Participant Category and Racial or Ethnic Characteristics White (non·Hilpllnlcl 0 1 50 51 100 101 130 131 150 151 185 186 · 200 201 225 226 250 Over 250 ln~:ome reported as zero• Not reported' Tot11l WIC R11cilll d11t11 not r11port11d 0 1 50 51 . 100 101 130 131 150 151 . 185 186 - 200 201 . 225 226 . 250 Over 250 lnt:ome reported es zero' Not rep orted' Tot11l WIC Notu Pregnent Br .. atf .. dlng Poatpertum Totel VVomen VVomen VV~en VVo~n Cum•oletln Cumuletlve Cumufetlve Cumuletlve Percent Peocent Perunt Percent Percent Percent Percent Perunt 0. 7·~ 27.4 26.5 13 5 7 4 84 04 0.5 0 .3 03 30 11.5 07% 28.1 54.6 68 1 75.5 83 9 84 4 84.9 85 1 85.4 88 5 100.0 360.454 01% 18.9 24 1 7 7 4.2 4.3 0.2 0.1 0.1 0.4 4 .4 35.4 l .1% 19 0 43 1 50 8 55 0 59 3 59.5 59 7 59.7 60 1 64.6 100 0 4,658 0.5% 25 .0 28 .8 16 4 8 .3 7 8 0.2 0 .2 0 .1 0.2 1.5 11 .1 0 .1% 6.6 8 1 2.9 1.1 1.0 0.0 0.0 0.0 00 08 79.4 0 .5% 25.4 54 2 70 6 78.9 86.7 86 9 87.1 87 2 87.4 88.9 100 0 120,931 0.1% 66 14 8 17.7 18 8 19 8 19 8 19 8 19 8 19 8 20 6 100 0 5,301 0.9% 33.1 26 5 12 8 6 2 5.7 02 0.2 0 1 0.2 1.8 12.3 0 .9% 34.0 60.5 73.3 79.5 85.2 85.4 85.6 85.8 85.9 87.7 100." 227,295 0.1" 12.1 119 3.1 1.3 1.5 00 0.0 0 .0 00 1.6 68.5 0.1% 122 24 .1 27.1 28.4 29.9 29 9 29 9 29.9 29.9 31 .5 100.0 3,566 0 .7% 28.8 26.9 13.8 7 .2 7.4 • 0.3 0 .3 0.2 0 .3 2.4 1 .7 0.7% 29.5 56 4 10 2 77.4 84 8 85.1 85.5 85.7 85 9 88 3 100.0 708,680 01% 12 3 146 4.6 2.2 2.3 0 .1 0.0 0.0 02 2.3 61 .4 0.1% 12 4 27 0 31 .6 33 8 36.1 36 2 36.2 36.2 36 4 38 6 1000 13,525 Totel lnfentl Children Pertlclpents Cumuletlve Cumuletlve Cumullllve Percent Perunt Percent Percent Percent Percent 0.7% 31 .4 26.8 13.1 6 1 5 .5 0.2 02 01 0 .2 2.2 13.7 0 .1 .. 24 1 25 2 7.8 33 2.7 00 0 .1 0.1 0 . I 40 32.0 0.7% 32.0 58.8 71 .9 78.0 83.5 83.6 83.8 83 9 84.1 86.3 100.0 754,892 0.1% 24 8 50.0 57.8 61.0 63 7 63.7 63.8 63.9 64 0 68.0 100.0 14,130 0 .4% 30.9 29.7 14.1 7.1 7.1 0.2 0 .2 0 1 0.2 1.2 8.9 0 4% 0.6% 31 .3 30.5 61 0 28.3 75 .2 138 82 3 6 .9 89 3 6 8 89.5 0 2 89 7 0 2 89 8 0.1 90 0 0.2 91 1 1 7 100 0 10 8 0 6 ~~ 31 1 59 3 73 I 80 0 86 7 87 0 8 7 2 87 3 87 5 89 2 100 0 1,482,994 2,946.566 00% 4.8 55 1 4 0.6 06 00 00 0 .0 00 06 86 5 00% 48 10 3 11 .7 12.3 12 9 12 9 12 9 12 9 12 9 13.5 100 0 80.485 OO'Yo 83 92 2 6 1 2 1 1 00 00 00 0 .1 1 2 76 2 o o ·~'«» 84 17 6 20 2 21 3 22 4 22 5 22 5 22 5 22 5 23 8 1000 108.141 Poverty level calculahons are based on InCOme. 10come peuod. and household arre ., reporled by State WIC agancl81 II peftant ol pover1y os 11 00!» or below, tt IPPIIII es ltro 101 in this table • ZefO 111comes are ucludld lrom t'-1<1 income clllculetione. In 42 of 14 repclf1tng agencl81. re~o may be ulld to lndtcate mi111ng inlonnrttoon 10 that PC94 tennot disttngulah between households lo• whom States d1d not r61JUtl 1101.111108 "'"' households for whom Statu reported raro income • Nut reponed 1ndtcates the perce11tage of parllcipants by por11t1p1nt cotego•y 101 whom no dall on oncome. inc.,... pe,.od, Of 1111 ol econorn1c un<l ••• reo0111d ClltJpl" Four: lttcom• of PC94 WIC Pa,'!!ripents 46 Exhibit 4.9 Distribution of Percent of Poverty Level at Certification for WIC Participants Reporting No Other Benefit Receipt• Percent of Poverty laval Braaalfaading Poatpenum Pregnant Women Woman Women Total Woman Infanta Children Total WIC Number Percent Number Percent Number Percent Number Percent Number Percent Number Parcel t Number Percent Percent by participant utagory 0 2,572 0 .8% 327 0 .3% 1,191 0.8% 4.090 0.7% 5.506 09% 6,174 06% 15,770 07% 1-50 60,645 19.4 19,242 1 7.0 26,995 17.9 106,881 18.5 143,626 22.5 184,190 16.8 434,697 18.8 51 -100 82,645 26.4 32,581 28.8 43,667 29.0 158,793 27.5 182.913 28.7 301 ,541 27.5 643,247 27 8 101 -130 51,369 16.4 21 ,085 18.6 27,612 18.3 100,066 17.3 103,251 16.2 201 ,858 18.4 405,175 17.5 131 -150 29,845 9.5 11 ,261 9.9 14,716 9.8 55,822 9.7 50,683 7.9 113,136 10 3 219,541 9 5 151 -185 32,370 10.3 10,467 9.2 13,572 9.0 66,410 9.8 44,726 7.0 113,039 10.3 214,175 93 186-200 631 0 .2 126 0.1 212 0.1 969 0 .2 690 0.1 1,334 0 1 2,993 0 I 201-225 597 0.2 118 0 1 179 0.1 893 0 .2 636 0.1 1,210 0 1 2,740 0 I 226-260 278 0 .1 61 0.1 76 0 .1 414 0 .1 328 0 1 617 0 1 1 359 01 Over 250 656 0.2 200 02 140 0.1 996 0 .2 1,070 0.2 2,008 0 .2 4,073 02 Income reported as zero' 26,808 8.2 6,738 60 10,942 7.3 43,489 7.5 51 ,264 8.0 50,638 46 145,291 63 Not reported' ,5,518 8 .2 11 ,044 98 11 ,380 7.6 47,942 8.3 53,773 8.4 118,965 10 9 220,680 96 Total WIC 312,833 100 113,249 100 150,682 100 576,765 100 638,365 100 1,094,610 100 2,309,740 100 Note a • Thts table excludes tndtviduals for whom no data regarding paructpatton in AFOC, Food Stamps, • • .J Medtcaid are reported. ' Zero incomes are excluded from these income calculations. In 42 of 84 reporttng agencies, zero may be used to ~ndicate mtssing informatton so that PC94 cannot dtstingUt
Object Description
Page/Item Description
Title | Part 1 |
Full-text |
COMPLETED
MAR 1 5 l99&
n reo Srotes
Aporrmel'lr or
Ag• cult .. re
Food ono
Consumer
SPrvrce
Olfi::e of
Analysis and
Evaluation
Study of WIC Participant and
Program Characteristics 1994
STUDY OF WIC PARTICIPANT
AND
PROGRAM CHARACTERISTICS
1994
Prepared for
Office of Analyses and Evaluation
Food and C0l'.Sumer Service
U.S. Depanment of Agriculture
3101 Park Center Drive
Alexandria, Virginia 22302
December 1995
Bonnie Randall
Lyria Boast
Laurin Holst
With the assistance of
Frederick deFriesse
Liya IsaJcov
Tracy Olcott
Douglas Taylor
FNS 53-3198-9-002
Prepared by
Abt Associates Inc.
55 Wheeler Street
Cambridge, Massachusetts 02138
ACKNOWLEDGEMENTS
The 1994 study of WIC pantctpant and program characteristics. like irs
predecessors in 1990 and 1992, must be dedicated to our friends and colleagues
in State WIC agencies. They provtde all of the data presented in this repon and
its appendices. We gratefully and humbly acknowledge their cooperauon and
conunend the diligence of the WIC Program m creating and maintairung vaable.
practical client infonnation systems.
Denise Thomas, the project officer at the Food and Consumer Service (FCS), has
been unstinting in providing suppon and guidanc-: and has maintained her sense
of humor for the past eighteen months. Others at FCS who have given
generously of their time and knowledge include: Julie Kresge, Laurie Hickerson,
and Matthew McKeam.
At Abt Associates, Nancy Burstein and Michael Puma provided technical
guidance and useful commento-ry; Eileen McEnaney ably and cheerfully assisted
in repon production.
• I Aclcnowltdrtmtnts 1
J I
The 1994 Study
EXECUTIVE SUMMARY
The Spectal Supplemental Nutnuon Program for Women. Infants. and Children
(WIC) is administered by the Food and Consumer Serv1ce CFCS) of the US
Department of Agriculture (USDA). The WIC Program provides a combination
of direct nutritional supplementation. nutrition educauon and counse!ing. and
increased access to health care and social service providers for pregnant.
breastfeeding, and postpartum women: infants; and children up to the age of five
years. WIC seeks to improve fetal development and reduce the incidence of low
binhweight, short gestation. and anemia through intervention during the prenatal
period. Infants and children who are at nutritional or health risk receive food
supplements. nutrition education. and access to health care services to maintain
and improve their health and development.
To receive WIC benefits, an individual must be categorically eligible; that is. the
person must be a pregnanl. breastfeeding, or postpartum woman; an infant up to
the age of one year: or a child aged one through four years. In addition. each
applicant must be found to be income eligible and at nutritional risk. Eligible
applicants receive supplemental food usually in the fonn of vouchers or checks
which allow them to obtain specific types of food (milk, juice. cereal. for
example) from participating retail grocers.
The WIC Program was established in 1972 by an amendment to the Child
Nutrition Act of 1966. WIC has greatly expanded since its inception. and. m
April 1994, WIC served almost seven million participants at an annual cost of
over three billion dollars.
Public Laws 99-500 and 99-591, enacted in 1986, require FCS to submit bienmal
repons to the Congress on current participant and program characteristics in the
WIC Program. This legislation specifies that each biennial report must include·
• Infonnation on the income and nutritional nsk
characteristics of WlC participants.
• Data on WIC program participants for m1grant fann
worker families.
• Other infonnatlon on WIC pantctpauon that 1s deemed
appropnate by the Secretary of Agnculture.
This publication is the founh repon which has been prepared to meet the
legislative mandate to provide infonnation on WIC panicipants and programs to
the Congress.
The 1994 study of WIC program and participant charactenstics CPC94), like the
1992 study (PC92), is substantially different from earlier effons to collect data on
WIC participants. PC94 employs the prototype reponing system which was
developed by FCS for the 1992 study and which routinizes the collection of
panicipant information from State WIC agencies. Earlier FCS studies of the WIC
Program-in 1984 (PC84), 1988 (PC88), and 1990 CPC90)-were based on
PC94 Encutivt Summary ,;,
nationally representative samples of WIC pan1c1pants and programs. PC94. like
PC92, contains information on a near-census of WIC pan1cipants m Apnl I 994
Participant Records. The current system for reponmg pan1c1pant data 1s based
on the automated transfer of an agreed-upon set of data elements. State WIC
agencies download routinely collected information which is on their existing
automated client and management information systems. State and local WIC staff
use these data to cenify applicant eligibility for WIC benefits and to 1ssue food
vouchers and checks. This Minimum Data Set (MDS), which consists of eighteen
items, was developed by FCS working with the Information Committee of the
National Association of WIC Directors (NAWD).
For the month of April 1994, each State WIC agency submitted MDS data on
either a representative sample or a census of its WIC panicipants. In Apnl of
1994, there were eighty-four State WJC agencies: the fifty States. the District of
Columbia. Guam. Pueno Rico. and the American Virgin Islands. along wnh th1ny
Indian Tribal Organizations (ITOs). All eighty-four WIC agencres prov1ded data
for PC94.
Two of the eighry-four submitting agencies chose to repon on representative
samples rather than censuses of their WIC participants. These States mclude
Connecticut and Montana and account for about 1.3 percent of PC94's participant
records. These data are weighted so that the total numbers of WJC panrcipants
reponed here correspond to the total US WJC population m April 1994.
The State-maintained automated information systems from which PC94 data are
drawn do not always contain complete information on every individual enrolled
in the WIC Program. Unreponed PC94 data may be unavailable for a variety of
reasons which may indicate that participants in any of the not-reponed categories
may be different from those individuals with data reponed. Assumpdol"l'i
regarding missing data vary by the nature of the variable and by the category ol
WJC participant. To account for these anomalies. a uniform strategy has been
adopted for preparing all tables m this repon. Data not reponed are included m
the calculation of percentage distributions for each characteristic. While mcludmg
missing data in the denominators for all calculations tends to place estimates for
each characteristic at a lower bound, th1s approach has allowed consistent
presentation of tabulations throughout the repon. Funher. it assures that all
information needed to calculate upper-bound estimates is readily available m
every table. Caution should be used in companng results across groups; m1ssmg
data must always be considered m gaugmg differences between. among, or across
groups or categones of WIC pan1cipants.
A second note of caution must be sounded here. Because of data quahty 1ssues
in one large State, it is likely that the PC94 estimate of number of one-year-old
WIC enrollees is 0.008 percent high. As a result. the PC94 estimate of number
of WIC infants is about 1.0 percent low.
PC94 Encu1111e Sumnuuy 1v
The 1994 WIC Program
Participant Characteristics
in 1994
Summary of State Programs. The 1994 study. like earlier studies. mcluded a
survey of State WTC agencies which obtamed infonnauon on WIC program
characteristics. This survey was conducted by mail. with telephone followup.
Data were collected on State WIC operaung policies and procedures for mcome
detennination. food package tailoring, food instrument Issuance. and average
monthly food package costs by participant category.
All of the eighty-four State WIC agencies operating in April 1994 completed the
survey questionnaire. During the two-year period between April 1992 and Apnl
1994, little change has occurred in WIC program operations and procedures.
In 1994, WIC services were delivered in the fifty States. the District of Columbia.
Pueno Rico, Guam. and the American Virgin Islands as well as by thiny Indian
Tribal Organizations. These eighty-four State WIC agencies operated 2,129 local
WIC agencies where staff delivered WIC serv1ces at about ten thousand serv1ce
sites. Just about half (49 percent) of all WIC participants receive services in mne
States~alifomia. Aorida. Georgia. Illinois. Michigan. New York. Pennsylvama.
Ohio, and Texas. In fact. more than one-quarter (28.3 percent) of WIC
participants can be found in three states~alifomia. New York, and Texas. This
proponion has grown from 2.5.3 percent in 1992.
In April 1994, 6,907,848 women, infants. and children were enrolled in the WIC
Program-a 20 percent increase over WIC enrollment reponed in 1992. A
caution must be raised with regard to comparing PC92 and PC94 with their near
censuses of WIC enrollees to findings from earlier studies. Previous proJects have
generally reponed program participation as measured by food instrument Issuance.
PC92 and PC94 provide infonnation on all individuals listed as WIC Program
enrollees on management and client infonnation systems maintained by State WIC
agencies. It is likely that, in most States. food instruments were not issued to
small percentages of these enrollees. Some of the increase in WIC participation
from 1990 to 1994 can be attributed to this difference in measurement. Some of
the 1992-to- 1994 growth is the result of targeung cenain States to receive
increased funding in order to serve larger proponions of eligible populations.
Half (.50.2 percent) of WlC participants are children. infants account for 26.8
percent and women 23.0 percent. This d1stnbution contams a slightly higher
propon10n of children than seen in 1990 and 1992 and a somewhat lower
proponion of infants (30.1 in 1992 and 29.8 in 1990). This shift may reflect
declining US binhrates.
Women were funher divided into pregnant (11.9 percent of all participants).
breastfeeding (4.0 percent of all partiCipants), and postpanum (7.1 percent of all
panicipants). The percentage of postpartum participants increased by 2
percentage points from PC92. while the percentage of pregnant WIC panicipants
decreased by 1.6 percentage points. See Exhibit E. I.
PC94 E.rtcutivt Sumnuuy v
Exhibit E.1
Distribution of Individuals Enrolled in the WIC Program
April1994
Poatpllrtum Women
Pregnant Women
Children
N•U07,141
Most (82 percent) of the pregnant women pan.cipating m WIC are between the
ages of 18 and 34 as are high proponions of breastfeeding (83.7 percent) and
postpartum (83.0 percent) "omen. Only I 0 3 percent of women WIC clients are
aged seventeen or younger. Over three-quarters (84 percent) of all infant WIC
participants were cen1fied for WIC benefits during their first three months of hfe.
Child participation decreases as age mcreases-most (40 percent) ch1ld
participants are one year of age.
It is imponant to reiterate here that the findings reponed in this volume must be
interpreted through the lens of unreponed data. For example. with regard to age.
information to calculate this variable was not reponed for 1.5 percent of women.
3.0 percent of infants, and 2.5 percent of children.
PC94 ExtcUIIIIt Summary 111
About the same propomons of pregnant WIC participants enrolled m the program
during their first (38.9 percent) and second (40.1 percent) tnmesters. These
figures represent a 5.2 percentage point mcrease m first tnmester enrollment smce
1992 and a 1.5 percentage pomt decrease m second tnmester enrollment. Data
needed to calculate trimester were not reponed for 10.3 percent of pregnant WIC
participants. In 1992. the not-reponed percentage was 8.8.
Race and Ethnicity. In the 1994 study, as in previous studies. whites made up
the largest percentage of WIC participants ( 42.7 percent), followed by Hispan1cs
(26.1 percent), blacks (25.4 percent), Asian or Pacific Islanders (2.6 percent). and
American Indian or Alaskan Natives ( 1.7 percent). Race/ethnicity data were
reponed for 98.4 percent of WIC panicipants. This distribution indicates small
increases, since PC92, in the percentages of Hispanic and Asian or Pacific
Islanders with corresponding decreases among black and white enrollees.
Household Size. The mean household size of WIC participants m April 1994
was 4.0. a slight increase from the 3.8 average reponed in I 992. The percent of
pregnant women certified as one-person households was 17.8 percent-about the
same as reported in PC92. OveraJI, information on household size was reponed
for 98.9 percent of WIC participants.
Income. Among WIC participants reporting some income. the average annualized
income of families/econom1c units of persons enrolled m the WIC Program m
April 1994 was $9,684, an increase l)f $393 since 1992. This increase in current
dollars is probably a decrease in real dollars, that is, the higher average most
likely reflects inflation rather than increased income. Across participant
categories, breastfeeding women reponed the highest average income at S 1 I .032;
postpartum women exhibited the lowest average income at $9.197. lllese
findings replicate PC92 results. As in I 988. 1990. and 1992, black participants
displayed the lowest average income-$7 ,281 for families or economic umts. a
decrease from $7.329 reported for PC92. As they did in the 1992 study. Asian
or Pacific Islander participants had the highest average annualized mcome at
$11,667. Findings about income must be interpreted with caution given the high
proportion of unreported information. For PC94. income cannot be calculated for
16.4 percent of WIC participants-virtually the same proportion ( 16.7 percent) of
unreported income data as in PC92.
ParticipatioP in Other Programs. WIC legislation allows mcome ehg1biluy
requirements to be met by participation m means-tested programs such as the
Medica1d, Food Stamp, and Aid to Families wuh Dependent Children (AFOC)
Pro gran ~s. In 1994, about two-thirds of WIC participants received benefits from
at least one other public assistance: program. With regard to participation m each
program, 53 percent of WIC clients rece1ved Medicaid benefits; 37 percent
participated in the Food Stamp Program: |