Abstract

The food retail environment has been directly linked to disparities in dietary behaviors and may in part explain racial and ethnic disparities in pregnancy-related deaths. The Special Supplemental Nutrition Program for Women, Infants and Children (WIC), administered by the United States Department of Agriculture, is associated with improved healthy food and beverage access due to its requirement for minimum stock of healthy foods and beverages in WIC-eligible stores. The selection and authorization criteria used to authorize WIC vendors varies widely from state to state with little known about the specific variations. This paper reviews and summarizes the differences across 16 of these criteria enacted by 89 WIC administrative agencies: the 50 states, the District of Columbia, five US Territories, and 33 Indian Tribal Organizations. Vendor selection and authorization criteria varied across WIC agencies without any consistent pattern. The wide variations in criteria and policies raise questions about the rational for inconsistency. Some of these variations, in combination, may result in reduced access to WIC-approved foods and beverages by WIC participants. For example, minimum square footage and/or number of cash register criteria may limit vendors to larger retail operations that are not typically located in high-risk, under-resourced communities where WIC vendors are most needed. Results highlight an opportunity to convene WIC stakeholders to review variations, their rationale, and implications thereof especially as this process could result in improved policies to ensure and improve healthy food and beverage access by WIC participants. More work remains to better understand the value of state WIC vendor authorization authority, particularly in states that have provided stronger monitoring requirements. This work might also examine if and how streamlining WIC vendor criteria (or at least certain components of them) across regional areas or across the country could provide an opportunity to advance interstate commerce and promote an equitable supply of food across the food system, while ensuring the protection for local, community-oriented WIC vendors.

Highlights

  • The food retail environment has been directly linked to disparities in dietary behaviors and may in part explain racial and ethnic disparities in pregnancy related deaths [1,2,3]

  • United States Department of Agriculture (USDA) Special Supplemental Nutrition Program for Women Infants Children (WIC) is the largest public health nutrition assistance program focused on reducing infant mortality and improving health of women who are pregnant, postpartum and/or breastfeeding, infants, and children up to age five who nutritionally are at risk and living in or near poverty [4]

  • WIC is designed to influence lifetime nutrition and health behaviors in a targeted, highrisk population; the wide range of vendor selection and authorization criteria raises questions about the rationale for the inconsistency found by the current research, given the importance of local access to healthy foods and beverages

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Summary

Introduction

The food retail environment has been directly linked to disparities in dietary behaviors and may in part explain racial and ethnic disparities in pregnancy related deaths [1,2,3]. The. United States Department of Agriculture (USDA) Special Supplemental Nutrition Program for Women Infants Children (WIC) is the largest public health nutrition assistance program focused on reducing infant mortality and improving health of women who are pregnant, postpartum and/or breastfeeding, infants, and children up to age five who nutritionally are at risk and living in or near poverty [4]. The federally funded, state-operated nutrition program was authorized initially in 1972 as a two-year pilot program as part of the amended. Child Nutrition Act of 1966 (P.L. 92-443) [5]. In 1975, WIC was made permanent (P.L. 94-105). Is part of the forthcoming Child Nutrition Reauthorization [5,6]

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