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Younger Siblings Can Be Good for Your Health: An Examination of Spillover Benefits from the Supplemental Nutrition Program for Women, Infants, and Children (WIC)

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Abstract

The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is a food assistance program designed to help pregnant (or postpartum) women and young children consume a nutritious diet. With WIC’s emphasis on providing healthy foods, and food being (generally) a communal commodity, age-ineligible children may benefit from living with a WIC participant. This paper used data from the third National Health and Nutrition Examination Survey to examine whether age-ineligible children who lived in WIC households were in better health than similar children who lived in households that did not participate in the program. Results suggested that older males received a health benefit as a result of living in a WIC household; however, no similar effect was found for younger males or for female children.

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Notes

  1. See Wight et al. (2010).

  2. Alternatively an individual can qualify by being a current participant in SNAP, Medicaid, or the Temporary Assistance to Needy Families (TANF) program.

  3. All information about WIC enrollment and funding was gathered from the United States Department of Agriculture’s Nutrition Program Facts report, 2011 update. Accessed 10 January 2012.

  4. In a related vein, Chaudhuri (2009) explored the potential for a benefit spillover (arising from a public health program) in rural Bangladesh.

  5. The HEI is an analytical tool designed by the USDA’s Center for Nutrition Policy and Promotion (CNPP) to measure compliance with dietary guidelines. The index assigns points based on a person’s reported daily consumption of 10 dietary components (grain, vegetables, fruits, milk, meat, fat, saturated fat, cholesterol, sodium, and variety) as well as an aggregate score. Each component’s score indicates the degree of compliance with a score of 10 indicating that the individual has consumed (at least) the daily recommended value for that component, while a score of 0 indicates that an individual has not consumed any food belonging to that group. A HEI score of 100 would indicate that an individual has consumed at least the recommended daily values of all components.

  6. As of 2011 the USDA’s Food Guide Pyramid was replaced by the MyPlate guide.

  7. Stratified estimation was preferred to pooled estimation with controls for race as it is more flexible and does not restrict the coefficients for non-group dummy variables in the model to be the same for all groups. A similar approach was employed by Corman et al. (1987) who found that WIC participation affected the birth outcomes of black families to a greater extent than it did for white families. They also found that the slope coefficients were different for white and black families.

  8. For a detailed description of the literature relating to households’ resource allocation decisions see Bryant (1992) and/or Zick (1992).

  9. For the purposes of this study those children between the ages of 5 and 11 years (inclusive) were considered to be young children while those children between the ages of 12 and 17 years (inclusive) were considered older children.

  10. With the data at hand a causal relationship between a household’s WIC status and the health of older male children could not be determined (for a more detailed discussion see Sect. 5 below). Regardless, having knowledge of a link between a household’s WIC status and the health of an older male child would be valuable when evaluating WIC policies and resource distribution decisions. It should also be noted that research on household decision making and resource allocation has lent support to a causal relationship. However, establishing such causality empirically was beyond the scope of this paper and as such, was left for future research.

  11. Part of WIC’s mission is to educate individuals and families about nutrition. To this end the WIC program offers participants the opportunity to participate in at least two nutrition classes per 6 month period for which they or their children are enrolled. These programs are not mandatory, however, and are not tied to benefit receipt.

  12. Although there have been more recent waves of the NHANES (i.e., the Continuous NHANES), the NHANES III data was chosen because it offered a variable that allowed the data for each family member to be linked together, which in turn made family level analysis feasible. In more recent waves, family ties were intentionally severed, which eliminated the ability to perform household level analysis.

  13. This ranking has also been used in previous economics literature (e.g., Carlson and Senauer 2003; Case et al. 2002).

  14. A household was considered WIC eligible if it had an income-to-poverty ratio (PIR) below 1.85. This indicated that the household’s income was equal to or below 185 % of the federal poverty line, which constituted the USDA’s income threshold for program eligibility.

  15. Such an approach was also employed by Corman et al. (1987) who argued that stratified estimation limits the potential for multicollinearity that may exist between race and input use.

  16. Ponthiere (2011) provides a nice summary of literature related to the inter-generational transmission of health and lifestyle behaviors.

  17. Individuals are considered to be food insecure if they have concerns about their ability to obtain enough food to sustain life. For a nice review of literature related to food insecurity see Coleman-Jensen (2011) and Guo (2011).

  18. An expanded model including the mother’s overall health was also estimated. Results were not affected and are available upon request.

  19. This effect would be more pronounced for black families than for white families if black children were at greater risk or started off in poorer health than white children.

  20. The same effects were not present for younger children, which may be the result of inequality in resource control. Research has shown that older children have greater influence over household decisions and receive a larger share of financial assets than younger children (Dauphin et al. 2011; Haan 2010; Mangleburg 1990). Thus, it could be the case that the older (age-ineligible) children received a larger share of the WIC benefits which in turn, increased their likelihood of receiving a spillover benefit. Lifestyle factors may have also played a role. Younger, age-ineligible children likely grew up in an environment that was similar to the current environment. For these children, living with a WIC participant may not have significantly altered the household’s behavior. The same may not have been true for older age-ineligible children. For them, the influx of WIC benefits may have substantially impacted their living environment, lifestyle, and subsequent health outcomes.

  21. Despite the fact that females may have also suffered from poor health habits and may have consumed a risky diet, they did not receive the same benefits as male children. This likely resulted from inequality in intra-household resource allocation decisions which often favor males. Resource allocation decisions have been heavily studied and research in this area has identified several reasons for this discrepancy (for a detailed discussion of the gender differences see the comprehensive reviews of Behrman 1992; Haddad et al. 1996; Lampietti and Stalker 2000).

  22. Determining causality is an important step in identifying the full benefit of WIC participation and is left for future research.

  23. For a nice summary of development literature highlighting gender issues and intra-household resource allocation see Behrman (1992), Haddad et al. (1996), and Lampietti and Stalker (2000).

  24. For a detailed discussion of intra-household nutrient allocation from an anthropological perspective see Messer (1997).

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Acknowledgments

I am grateful to Nicole M. Coomer, Ardeshir Dalal, Jonathan Gilbert, Taylor Hennessy, Reed Neil Olsen, Sharmistha Self, and two anonymous reviewers for their helpful comments and suggestions. All remaining errors are my own.

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  1. Department of Economics, Missouri State University, STRO 372, 901 South National Avenue, Springfield, MO, 65897, USA

    Christina Robinson

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Robinson, C. Younger Siblings Can Be Good for Your Health: An Examination of Spillover Benefits from the Supplemental Nutrition Program for Women, Infants, and Children (WIC). J Fam Econ Iss 34, 172–184 (2013). https://doi.org/10.1007/s10834-012-9325-0

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