Exploring the association between state-level WIC coverage and household food security: Demographic and geographic patterns

While studies to date have shown evidence that participation in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) has a significant impact on food insecurity among participating families, the relationship between WIC participation and food insecurity remains poorly understood at the population-level. This study examined the relationship between WIC coverage and household food security in the United States and the District of Columbia at the state-level cross-sectionally from 2000 to 2010(N = 561). This study was a secondary analysis utilizing data sources including the Current Population Survey, USDA Economic Research Service reports and US censal and intercensal estimates. The study model included WIC coverage rates, household food security rates and covariates including state geography and indices representing state-level family composition, demographics and economics. Generalized estimating equations were used to explore the relationships among study variables. There were two key findings: (1) WIC coverage differs significantly by US census division (p < 0.001) and (2) There is a significantly stronger relationship between WIC coverage and household food security in states with large populations of Hispanic origin and/or large populations of foreign-born immigrants (p = 0.003). These findings illustrate the impact of healthography as a state’s physical geography and demographics significantly impacted its WIC program participation and rates of household food security when controlling for all socio-demographic indicators in our model. Both policy makers and public health practitioners need to take the demographic and geographic characteristics of each state into account when creating WIC policy and implementing WIC programming.