Title page
Contents
Abstract 3
Acknowledgments 3
Summary 5
Introduction 7
WIC Overview 8
Participant Eligibility 8
Certification Periods 10
Participant Benefits 10
Farmers' Market Nutrition Program 13
Program Operations 13
Administration 13
Funding 14
Food Benefit Delivery Systems 14
Recent Legislative and Regulatory Changes to WIC 16
Program Trends 17
Expenditures 18
Participation 20
Coverage Rates 21
Participation in Other Programs 23
Poverty Status 24
Factors Affecting Access to WIC Services 26
Food Costs 26
Food Access 27
State and Local Policies 29
Revisiting the Impacts of the 2009 Food Package Revisions on Participant Food Purchases and Diet Quality, Child Obesity, and Breastfeeding 32
The Economic Impacts of Increased Breastfeeding in WIC 37
WIC and the Infant Formula Market 38
Infant Formula Market Competition and Concentration 39
The Costs of Infant Formula to WIC 41
Infant Formula Supply Chain Disruptions 42
USDA, ERS Investments in WIC Research 46
Looking Ahead 48
References 49
Appendix A 58
Appendix B 59
Appendix C. USDA, ERS-Supported Data Resources 61
Table 1. WIC participant eligibility criteria 9
Table 2. Nutritional risk criteria for WIC eligibility 9
Table 3. Types of foods included in each WIC food package 11
Table 4. Number of States with Medicaid income eligibility higher than 185 percent of the Federal poverty guidelines 31
Figure 1. Total U.S. population and number of WIC participants, by WIC participant category, 2021 7
Figure 2. Federal expenditures for WIC before and after infant formula rebates, fiscal years 1974-2022 19
Figure 3. Average monthly participation in WIC, fiscal year 1974 to fiscal year 2022 21
Figure 4. Coverage rates by WIC participant category, 2005 to 2020 22
Figure 5. WIC coverage rates by State, 2020 23
Figure 6. Percent of WIC enrollees reporting participation in other programs at certification, 1996-2020 24
Figure 7. Distribution of WIC participants by percent of poverty level, 1996-2020 25
Figure 8. Infant formula manufacturers' market shares, 1987 and 2022 41
Figure 9. Share of WIC households with infants affected by the infant formula shortage by how the households dealt with the shortage 44
Figure 10. Year-over-year percentage change in numbers of WIC infant participants, October 2019-September 2022 46
Table A.1. WIC income eligibility guidelines for the 48 contiguous States, Alaska, and Hawaii (effective July 1, 2022 to June 30, 2023) 58
Table B.1. WIC legislative, regulatory, and policy timeline 59
Table C.1. Description of USDA, Economic Research Service datasets 61
Table C.2. Description of USDA, Economic Research Service Resources allowing for Linkages Across Datasets 63