The Impact of WIC Food Package Changes on Access to Healthful Food in 2 Low-Income Urban Neighborhoods

Abstract Objective To evaluate the impact of the 2009 food package changes for the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) on the availability of healthful food. Design Survey of all food stores in the study area before and after the changes were implemented. Setting Two low-income neighborhoods in Philadelphia, 1 predominantly African-American, the other predominantly Hispanic. Participants One hundred forty one supermarkets, grocery stores, and non-chain corner stores identified through field enumeration. Main Outcome Measures Nutrition Environment Measure Survey for Stores (NEMS-S) to determine availability, price, and quality of fruit, vegetables, milk, cereal, beans, canned fish, meat, whole grains, and juice. Analysis Comparison of NEMS-S scores before and after food package changes using t tests and ordinary least squares regression to understand the role of supermarket status, WIC participation, and racial and income composition in predicting NEMS-S scores; geographic information systems to calculate proximity of residents to food stores. Results The availability of healthful food increased significantly in stores, overall, with more substantial increases in WIC-authorized stores. Supermarket status, WIC retail status, and NEMS-S scores at baseline were significant predictors of NEMS-S scores after the food package changes. Conclusions and Implications Changes in the WIC food package were associated with increased availability of healthful food in 2 low-income neighborhoods.