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. 2021 Sep;24(13):4212-4219.
doi: 10.1017/S1368980020005200. Epub 2020 Dec 22.

The role of income and neighbourhood poverty in the association between the 2009 Special Supplemental Nutrition Program for Women, Infants and Children (WIC) food package change and child obesity among WIC-participating children in Los Angeles County, 2003-2016

M Pia Chaparro  1 , Shannon E Whaley  2 , Christopher E Anderson  2 , May C Wang  3 , Catherine M Crespi  4
Affiliations

The role of income and neighbourhood poverty in the association between the 2009 Special Supplemental Nutrition Program for Women, Infants and Children (WIC) food package change and child obesity among WIC-participating children in Los Angeles County, 2003-2016

M Pia Chaparro et al. Public Health Nutr. 2021 Sep.

Abstract

Objective: To determine whether a previously reported association between the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) food package change and reduced child obesity risk among WIC-participating children in Los Angeles County holds across levels of family income and neighbourhood poverty.

Design: Analysis of prospectively collected WIC administrative data. The outcome was obesity at age 4 years (BMI-for-age ≥ 95th percentile). Poisson regression was applied to a matched sample (n 79 502) to determine if the association between the WIC food package change and child obesity was modified by family income (<50 % federal poverty level (FPL), 50-100 % FPL, >100 % but <185 % FPL) and neighbourhood poverty.

Setting: Los Angeles County, California.

Participants: Children who participated in WIC in Los Angeles County between 2003 and 2016; children were grouped as receiving the old WIC food package (2003-2009) or the new WIC food package (2010-2016).

Results: Receiving the new WIC food package (i.e., post-2009) was associated with 7-18 % lower obesity risk across all family income categories. Neither family income nor neighbourhood poverty significantly modified the association between the WIC food package and child obesity. However, certain sub-groups seemed to benefit more from the food package change than others. In particular, boys from families with income above poverty but residing in the poorest neighbourhoods experienced the greatest reductions in obesity risk (relative risk = 0·77; 95 % CI 0·66, 0·88).

Conclusions: The WIC food package revisions were associated with reduced childhood obesity risk among all WIC-participating families in Los Angeles County, across levels of income eligibility and neighbourhood poverty.

Keywords: Effect modification; Income; Los Angeles; Neighbourhood poverty; Obesity; Women, Infants and Children.

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Figures

Fig. 1
Fig. 1
Flow chart of WIC-participating children included in the study
See this image and copyright information in PMC

References

    1. Taylor J (2006) Updating the WIC Food Packages: It’s About Time. National Health Policy Forum, Issue Brief no.819. https://hsrc.himmelfarb.gwu.edu/sphhs_centers_nhpf/177 (accessed February 2006). - PubMed
    1. Chaparro MP, Crespi C, Anderson C et al. (2019) The 2009 Special Supplemental Nutrition Prorgram for Women, Infants and Children (WIC) food package change and children’s growth trajectories and obesity in Los Angeles County. Am J Clin Nutr 109, 1414–1421. - PubMed
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    1. Nobari TZ, Whaley SE, Prelip ML et al. (2018) Trends in socioeconomic disparities in obesity prevalence among low-income children aged 2–4 years in Los Angeles County, 2003–2014. Child Obes 14, 248–258. - PMC - PubMed

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