Diet Quality during the First Two Years of Life and the Women, Infants and Children Program

OBJECTIVES: The impact of the Women, Infants and Children (WIC) program on children's diet quality during critical window of opportunity of up to two years of life is largely unknown primarily due to the selection problem polluting the estimation of treatment effects and data scarcity. This research uses novel data from a large prospective cohort study of African-American and White mother-children dyads (N = 1503) conducted in Memphis, Shelby county, TN to estimate the impact of WIC on Healthy Eating Index-2010 (HEI-2010) dietary outcomes in children up to 24 months.

METHODS: We address concerns related to non-random selection in WIC via the use of first-difference estimators combined with a rich set of time-varying covariates. Four main sensitivity tests were implemented: (a) permutation tests, (b) placebo tests, (c) tests for selection on unobservables, and (d) tests for coefficient stability.

RESULTS: We provide empirical evidence to conclude that WIC participation is associated with a statistically significant increase in child HEI-2010 total scores of 4.65 points (roughly 0.4 standard deviations). WIC is associated with increased intake of seafood, plant proteins, refined grains, and lowered sodium consumption.

CONCLUSIONS: Overall, participation in WIC contributes to improved nutritional outcomes up to 24 months. WIC has the potential to decrease early-life nutritional inequalities across the socioeconomic spectrum.