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Search - Rethinking WIC: An Evaluation of the Women, Infants, and Children Program (Evaluative Studies.)

Rethinking WIC An Evaluation of the Women Infants and Children Program - Evaluative Studies.
Author: Douglas J. Besharov

Book Summary In Rethinking WIC, Douglas J. Besharov and Peter Germanis analyze the research on the effectiveness of the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). Their assessment challenges the conventional wisdom that WIC is a uniquely successful program and demonstrates that many claims about WIC's effe... more »ctiveness are misleading exaggerations. Moreover, the health, nutrition, and policy communities are now paying increased attention to childhood obesity and overweight--a concern that underlies many of the book's recommendations. Besharov and Germanis do not argue that WIC should be abandoned but that policymakers should undertake a sustained effort to make the program more effective. Since its inception in 1966, WIC has grown into a $5 billion per year program that serves about 7.3 million women and children, providing healthy foods, together with nutrition education, counseling, and referral services, to needy pregnant and postpartum women and to their children under age five. Although WIC is a program of the U.S. Department of Agriculture, most of its grantees are state health departments. Those state agencies, in turn, fund WIC services through local health-related agencies such as health departments, hospitals, public health clinics, and community health centers. WIC's popularity stems from the widespread belief that research studies have proved that WIC "works." But how well founded is this belief? Besharov and Germanis examine the existing evaluation research on WIC and make the following points: *Studies of WIC's impact are almost entirely nonexperimental. Instead, they have been based on statistical comparisons between those who received WIC benefits and those who did not, an approach that is subject to severe methodological problems, such as selection and simultaneity bias, which undermine the reliability of the findings. Moreover, most of the studies are based on the program and caseloads as they existed more than a decade ago, limiting their applicability to assessing the current program. *WIC probably makes at least a small improvement in the diets and behaviors of some pregnant women, especially the most disadvantaged; that improvement, in turn, may improve the birth outcomes for some infants. *WIC probably increases the nutritional intake of some infants, especially those who would not have been breastfed, but the health consequences of the increases are not clear. Moreover, WIC may reduce breastfeeding, which can have negative health consequences. *Over all, WIC probably makes little significant difference in the diets of one- to four-year-old children, but it may affect some groups more noticeably, especially those children whose intake of nutrients one might otherwise consider inadequate. *WIC has expanded beyond the truly disadvantaged, even though new participants are unlikely to need or benefit from the services it provides. *WIC is largely irrelevant to the most serious nutritional problem facing disadvantaged Americans: overweight. *WIC does not produce the major cost savings that its advocates claim, and it may not even pass a basic benefit-cost test. Even if WIC were as effective as its advocates claim, the program still must do much more to improve diet-related health outcomes for low-income Americans. In fact, from 1986 to 1998, the incidence of low birthweight increased by 12 percent. Besharov and Germanis believe that we should strive for a WIC program that is as effective as possible. To increase WIC's positive impacts, the authors propose a series of possible reforms, recommending that each approach be assessed though carefully designed and executed evaluation studies. Reforms offered for consideration include: *Services should be targeted to the more needful families, the group that seems to benefit most from WIC. *State and local WIC agencies should have more flexibility to expand the basic food package and to intensify nutritional counseling. *WIC should seek to prevent overweight and obesity through education, counseling, and food preparation classes. *WIC should cover children over the age of four, because problems like overweight worsen as children get older. *Counseling should be more directive, because many nutritional problems are caused by unhealthy behaviors rather than by lack of food. *WIC should try different types of service providers, such as health care providers, that can offer a full range of health and nutrition services. *All the foregoing programmatic reforms should be rigorously evaluated, preferably through randomized experiments. WIC's weaknesses do not justify abandoning or even cutting the program, the authors conclude. On the contrary, policymakers should undertake a sustained effort to make the program more effective. Congress should begin that effort by debating the role and impact of WIC and by granting greater flexibility to state and local WIC agencies to open the program to innovation and experimentation. In addition, policymakers should carefully evaluate any changes. Furthermore, the federal government should conduct a series of randomized demonstrations to determine more definitively the impact of each of WIC's program components--with particular attention paid to key groups such as very poor families, minority families, and single-parent families. If evaluations prove those ideas sound, the result could be a major shift in who gets served and how. But, the book concludes, that consideration should not prevent needed evaluation and reform of the program.

ISBN-13: 9780844741482
ISBN-10: 0844741485
Publication Date: 12/1/2000
Pages: 180
Rating:

0 stars, based on 0 rating

Publisher: AEI Press
Book Type: Hardcover
Members Wishing: 0
Reviews: Amazon | Write a Review

Genres:

Nonfiction >> Current Events >> Poverty >> Social Services & Welfare

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