effects of the revised food packages for women, infants, and children (wic) in connecticut.
Special Supplementary Nutrition Program for Women, Infants and Children (WIC) Healthy food ( Packaged through WIC food) , Nutrition education and medical referrals were about half of American-born babies, 25% of children under the age of 5, 29% of pregnant women, and 26% of postpartum women ( Oliveira and Fraser, 2009). By creating demand for a limited number of specific healthy foods among millions of low-income people Income families, WIC has a great ability to influence the purchase of WIC Prescribed food, their supply at the WIC store, and ultimately get healthy food for WIC and non-WICIndividual WIC. In 2009, WIC implemented the revised food packaging as recommended by the Institute of Medicine ( Institute of Medicine, 2005) This better reflects the dietary advice of WIC participants and promotes good nutrition and healthy weight. Major changes include cash availability- Voucher of value of fruits and vegetables, addition of whole grain and bean products, some restrictions on milk fat content, and reduction of milk and juice allowance. This is the most important change in WIC food packaging since the project was launched in 1972 and provides a unique natural experiment to evaluate their low- Income community. This article briefly reviews the results of research on how the revision of WIC food packaging affects the retail landscape of Connecticut food and access to healthy food. The Connecticut study aims to understand the impact of the revised WIC food packaging on the food environment and access to healthy foods ---proxied by WIC- Approved Food category- Andreyeva and others (2012) Pre-made Post-evaluation of inventory at convenience stores and grocery stores ( Outside the supermarket) In Connecticut. The study included all food stores from five Connecticut towns selected to represent communities with different income and food retail features. The researchers completed a 245 inventory of non-Wave Systems 2009 Spring grocery chain convenience store-- Before the implementation of the WIC food packaging revision in Connecticut on October 1, 2009-- Spring 2010 and spring 2011? About 6 months and 18 months after implementation. Number of WIC- Approved stores range from 30 in 2011 to 36 in 2009. Supermarkets are not part of this analysis because there are healthy foods in these stores before the WIC policy changes. Trained raters use standardized inventory tools to assess the availability, price and variety of 65 foods and produce quality. 65 kinds of food including various WIC Approved Food, such as milk, whole wheat bread and tortillas, fresh/canned/frozen fruits and vegetables, cereals, tofu, soy milk, brown rice, juice, eggs, peanut butter, dried beans, cheese, baby food and canned fish. The assessment also includes alternatives that are not very healthy for WIC White rice, white bread and other recognized food. The method follows the protocol for the survey of nutrition environment in the store (NEMS-S) This proved to have a high degree of interaction. rater and test- Retest reliability (Glanz, et al. 2007). To summarize multiple dimensions of food supply, such as availability, diversity, price and quality, the study developed a comprehensive score of healthy food supply ( Described in Andreyeva and others. 2012). The score-weighted availability and diversity of whole-grain products, fruits and vegetables is the most serious, as these foods are particularly lacking in the diet of many Americans ( Institute of Medicine, 2005). Considering that the lack of fresh produce in convenience stores is a bigger problem, the score gives fresh fruits and vegetables a greater portion than frozen and canned fruits and vegetables. Change of WIC composite score- Authorized stores and stores not involved in WIC measure the effect of the revision of WIC food packaging. The estimate is based on three Horizontal linear random intercept model for controlling store size and participating in supplementary nutrition assistance programs (SNAP) And WIC, and a set of control variables that describe the food environment around each store. These measures include proximity to supermarkets, population density, household income from the census, and competition between food and fast food outlets in the region --- Measured by the kernel density of competitors within half a mile of each store. As WIC has been revised within six to seven months after the implementation of the new WIC food packaging, the opportunity to obtain healthy food has improved significantly, the healthy food supply at Connecticut convenience stores and grocery stores has improved significantly. Most of the improvements took place at WIC- Authorized store, though not WIC stores have also made progress. Despite the availability of many assessed healthy foods- Fresh fruits and vegetables includedfat milk-- WIC food packaging in WIC increased after revision Authorized stores, the most profitable food products. Only 8% of WIC- Authorized convenience stores and grocery stores-- Regardless of size-- Whole Wheat/whole wheat bread at baseline; 81% do so after the amendment takes effect. The minimum inventory requirement for the Connecticut WIC program is that at least six packs of WIC are stored at each WIC store- Whole wheat or whole wheat bread approved at any service time ( WIC project, Connecticut, 2012). At 81% in stock, only 2010 of WIC stores have any whole wheat/whole wheat bread in stock, indicating that some stores do not meet the requirements. Anecdotal evidence suggests that the month of the total supply of whole wheat flour/Whole Wheat Bread-oz loaves--the only WIC-allowed size-- In the short term after the implementation of the new WIC packaging, there is a problem with the manufacturer starting to produce 16 ounces of bread. Typical bread weight is 18 or 24 ounces before implementation, some shops- Smaller stores in particular Unable to ensure a stable supply of WIC 16 oz whole wheat/whole wheat bread. 2011 The results of the inventory confirm this assumption as all WIC stores at that time had the required 16- Whole wheat or whole wheat bread. WIC minimum inventory requirements explain some but not all improvements provide new Approved for WIC food. Another new product in the revised WIC food package-brown rice is not part of the minimum inventory required for WIC, so the WIC store has the option of not carrying it. Nevertheless, the supply of WIC convenience stores and grocery stores increased from 22% in 2009 to 94% in 2010 and 100% in 2011, indicating that customer needs encourage WIC stores to store this healthy product. Longer shelves The longevity of brown rice and bread may be another reason why more shops sell this product rather than bread. What\'s interesting is that WIC\'s revised WIC stores carrying whole wheat/whole wheat bread and brown rice also increased to 35% and 25%, compared to 25% and 15% at baseline in 2009. These stores are not subject to WIC minimum inventory requirements and do not provide services to WIC customers who exchange coupons for newly approved WIC foods. However, many people choose to add whole wheat/whole wheat bread and brown rice to their inventory, although this ratio has declined compared to WIC Authorized stores. Competition with the WIC store may explain this spillover effect. In addition, as suppliers begin to bring new WIC food to serve all small stores, higher demand for WIC stores may improve the distribution chain. Better access to whole wheat products in the store is expected to translate into increased purchases and consumption of whole grains, which helps to reduce insufficient whole grain intake for WIC participants. For example, data from 19992004 countries show that the United States has less than 5%S. Adults meet dietary advice and eat at least three whole grains a day (O\'Neil, et al. 2010). In addition to increasing availability, varieties of whole grain products- Brown rice, whole wheat/whole wheat bread, whole wheat cereal, whole wheat tortillas-- In addition, the average variety of WIC stores increased from 4 to an average of 7, and the variety of non-WIC stores increased from 3 to 4WIC stores. Whole grain is the main reason for the increase in the number of whole grain products --- Two and three, respectively. - They are in Africa WIC stores accounted for 50% of the increase in variety. The main reason for the growth of whole grain products in WIC store is brown rice. An important result of the revision of WIC food packaging is that it has a greater positive impact on those who most need to improve access to healthy food. Low- At baseline, the income community chose less healthy food in convenience stores and grocery stores, but after WIC revision, experienced a richer supply and variety of healthy food and quality of production Between 2009 and 2010, the WIC store\'s health food supply composite score increased by 16% Low-income areas and 39% peopleincome areas. Food choices in nearby stores are particularly important for low-income people Income residents who do not have enough transportation have to rely on these shops. Greater improvements in the provision of healthy food Income communities may help reduce income Differences in food acquisition and health. For many Americans, poor dietary quality and associated overweight remain barriers to healthy living, especially among people with lower socioeconomic status. Previous studies have shown that the food environment in which people choose food is related to their nutrition (Booth, et al. 2001), body weight ( Robert and Reither, 2004) And chronic health ( Diez Roux and others. 2001). Within 6 to 7 months of implementing the revision of WIC food packaging, improvements observed in the provision of healthy food were measured. A year later, in the spring of 2011, a second measurement was taken to determine whether the improvements seen in the short term have been maintained and may increase. Among all the measures to provide healthy food, including the comprehensive score of healthy food supply and the diversity of healthy food, there was no significant change in WIC or non-WIC from 2010 to 2011WIC stores. Shortly after the revision of the WIC in 2010, all improvements to access healthy food were sustained a year later. This shows that beneficial changes in food access have been accepted and integrated into the food retail sector in the context of the relevant policy environment, and may maintain this process in the future. At the same time, the improvement in 2010 did not expand further in 2011. Other states have also seen similar beneficial results of the revision of WIC food packaging for the supply of healthy food. A four- The state assessment study at the Altarum Institute completed a pre- Post-store inventory assessment of New Hampshire, Pennsylvania, Wisconsin and Colorado small food stores (Gleason, et al. 2011). Most new availability After the implementation of the revised WIC food packaging, there has been an increase in approved healthy WIC food. For example, WIC stores have significantly increased their supply of soy milk, whole wheat bread, whole wheat tortillas and brown rice in New Hampshire, Pennsylvania and Wisconsin (Gleason, et al. 2011). Low-fat (1%) Increased milk supply at stores in New Hampshire and Wisconsin, both states do not allow WIC participants to purchase reduced milkfat (2%)milk. In the three study states, the supply of fresh fruits has improved, the supply of vegetables is more than at baseline, and the room for improvement is smaller (Gleason, et al. 2011). All WIC in Connecticut Approved stores have fresh fruit after revision- From 50% at baseline, supply of fresh and frozen vegetables also increased significantly. Differences in baseline availability and WIC minimum inventory requirements may explain some of the differences in the results of the state surveys. For example, Connecticut requires WIC stores to store at least one fresh fruit and one fresh vegetable, but not all states have the same requirements for fresh produce from WIC stores. From a public policy perspective, it is important to demonstrate the sustainability of any positive changes that arise from new policies or projects. It is well- As we all know, the effectiveness of some policies may decline over time so that their costs can no longer justify their benefits. While the study in Connecticut did not find any further improvement in the supply of healthy food between 2010 and 2011, it did find that the successful results in 2010 were achieved a year later This is for WIC decision makers, WIC participants, and low- Income community. Future studies should examine whether the impact of WIC revisions can be sustained and increased over the long term, especially when new participants and stores are filtered through WIC plans. It is also important to know how to further expand the impact of WIC revisions on access to healthy foods. In conclusion, the revision of the WIC food packaging has successfully increased the supply of many healthy foods as they address the demand and supply issues for access :(a) They have created a demand for new healthy foods by providing WIC coupons to WIC participants, and (b) They immediately improved supply through minimum inventory requirements for WIC Authorized stores. Food retailer\'s practices attitudes and beliefs about healthy food supply food retailers, such as convenience stores and groceries, are an integral part of the food environment and may be to improve low- Income community. Previous studies have shown that purchase decisions in such stores can be associated with the dietary outcomes of store customers. For example, living near convenience stores selling fruits and vegetables is related to higher agricultural product intake among store customers living in the area (Bodor, et al. 2008). In order to better understand the inventory decisions of small food retailers and their barriers to providing healthy food, the inventory study in Connecticut includes a study of WIC- Authorized convenience stores and grocery stores outside supermarkets. In addition, control Select the WIC store to match according to the type of store and the proximity to the WIC store, usually within the same census ( Andre and others. 2011). In- Interviewer (30-45 minutes each) Completed with 68 shopkeepers or managers directly involved in ordering food. All WIC- Convenience and non-authorization Grocery chain (n=40) Recruited and 35 agreed to participate ( Response rate 88%). More non- WIC control stores were recruited, of which 33 were participating in the survey ( Response Rate 65%). To assess pre- Due to the revision of WIC and the change of position, the interview was completed before and after the implementation of the revised WIC food packaging --- Spring 2009 and spring 2010. Interviewed the subject\'s business practices, attitudes and beliefs about the supply of healthy foods, supplier networks, perceived needs and profits for different categories of foods, barriers to carrying healthy foods, and WIC- Related issues, including the implementation of the revised WIC food packaging. To explain the limited supply of healthy foods in convenience foods and small grocery stores, it is important to understand the needs and supply prospects of these businesses. From a limited supply network to insufficient storage capacity or cold storage, small neighborhood stores may face significant obstacles in storing healthy food. Another reason for not storing nutritious food may be the lack of demand from store customers. Previous focus group evaluations indicate that retailers store healthy foods if they believe there is sufficient demand ( Gittelsohn, etc. 2006). The WIC revision provides a unique opportunity to test the assumption that demand or supply determines availability by generating new requirements Approved WIC food- Through new subsidies- Therefore, the biggest obstacle to the storage of healthy foods is supply restrictions. In a study in Connecticut, small retailers highlighted both demand and supply. However, customer demand has always been the main business factor behind inventory decisions, suggesting that retailers have little to say about customers\' perception of healthy food needs, explaining that before these stores make WIC revisions, there are very few choices for healthy food. Survey respondents said the demand for healthy foods such as fruits and vegetables and whole wheat products was significantly reduced Fat milk compared to soda and salty snacks. It is reported that supply barriers are secondary in explaining the limited supply of healthy food. Less healthy foods are also considered to offer higher margins ( Andre and others. 2011). There is a big change in the types of suppliers used, from convenient chip and soda manufacturers to their own delivery Fresh fruits and vegetables are served. At baseline, WIC- Authorized convenience stores and grocery stores in Connecticut are not expected to have any problems in meeting new WIC requirements to provide more healthy WIC optionsapproved foods. Retailers already have suppliers to supply these foods or can identify new suppliers as needed. Most people are confident in finding extra shelf space or equipment to deliver new WIC food. Some stores do not have enough equipment for some new requirements, such as carrying fresh fruits and vegetables at any time, which may cause them to lose their WIC authorization status. Knowing how to deal with and store products is a skill that some small retailers see as lacking ( Andre and others. 2011). Post- An implementation survey of the same store showed that none of the WIC- Due to the inability to meet the new WIC requirements, the authorized store has withdrawn from the program. Most of WIC- The authorized store successfully implemented the revised WIC food packaging, increased the supply of healthy food, and reported higher demand for many new healthy WIC foods. Similar findings were also reported in two studies that interviewed managers or owners of small WIC stores in eight US cities (Ayala, et al. 2012; Gittelsohn, etc. 2012). Most respondents reported an increase in sales of new companies Regardless of the supply mechanism used, approved WIC food. The increased project requirements are not a deterrent to the store, and the increased demand for WIC participants is an important incentive to serve these customers and continue to participate in WIC projects. In fact, in the spring of 2012, when Connecticut opened its registration as an authorized WIC store, hundreds of non- The WIC store applied and many successfully joined the WIC program. Countries that have access to healthy food may improve further. Authorized WIC stores must carry some healthy WIC foods that may not have been put on shelves before. Long to understand The long-term impact of WIC revisions on WIC stores, ongoing monitoring of store engagement and inventory, and strategies to find ways to overcome supply barriers are important for future research. WIC policy needs and supply changes improve access to healthy foods review of the impact of WIC food packaging revisions on access to healthy foods findings indicate immediate and potential long-termterm success. Policies aimed at promoting healthy food consumption and addressing supply issues have improved the supply of healthy food in communities with inadequate services. The recent revision of WIC food packaging has subsidized the consumption of important healthy foods for low-income people Income for women and children, while addressing supply issues by requiring retailers to store a minimum number of certain nutritious foods. As a result, great improvements have been made in the measurement and provision of many healthy foods-- To a lesser extent-non- WIC convenience stores and grocery stores in the state of Connecticut, especially at low- Income community. These findings provide evidence of the potential of national food aid and nutrition programs to increase demand for healthier food choices and improve the food environment through policy changes. National food policies that promote healthy food consumption, but also need to change supply, can improve the local food environment of project participants and non-participants. Due to the design cost of the revised version of WIC food packaging- Neutral, this can happen without the taxpayer increasing the cost. JEL Classification: Q18 Keywords: food policy, WIC, food acquisition, nutrition, demand, supply of more information, Luedicke, J. A. Central Delton. E. , Long, M. W. And Schwartz, M. B. (2012). The revised Special supplementary nutrition programme for women, infants and children food has had a positive impact on access to healthy food. Journal of the American Society of Nutrition and diet, 112 (6), 850-858. Andreyeva, T. , Middleton, A. E. , Long, M. W. , Luedicke, J. And Schwartz, M. B. (2011). The practices, attitudes and beliefs of food retailers about healthy food supply. 14 (Public Health Nutrition6), 1024-1031. Ayala, G. X. , Laska, M. N. , Zenk, S. N. , Tester, J. , Rose, D. , Odomsyung, A. , McCoy, T. Gittelsohn, J. , Foster, G. D. And Andre, T. (2012). Inventory features and sales growth perceptions of small food store managers/owners are related to the introduction of new foods approved by the Special Supplemental Nutrition Program for Women, Infants and children. Public Health Nutrition, May 14, month-9. Bodor, J. N. , Rose, D. , Farley, T. A. , Swalm, C. , and Scott, S. K. (2008). Supply and consumption of fruits and vegetables in the neighborhood: the role of small and medium-sized food stores in urban settings. 11. Public Health Nutrition (04), 413-420. Booth, S. L. , Sallis, J. F. , Ritenbaugh, C. , Hill, J. O. , Birch, L. L. , Frank, L. D. , Glanz, K. , Himmelgreen, D. A. , Mudd, M. , Popkin, B. M. , Rickard, K. A. , St Jeor, S. , and Hays, N. P. (2001). Environmental and social factors that affect food selection and physical activity: Justification, impact, and leverage points. Nutrition Review, 59 (3 Pt 2), S21-S65. Connecticut WIC project(2012). Minimum inventory and pricing requirements for WIC suppliers. Available online: ct. Gov/dph/lib/dph/wic/supplier/minimum stock- Price requirements. Pdf Diez Roux, A. V. , Merkin, S. S. , Ar nett, D. , Chambless, L. , Massing, M. , Nieto, F. J. , Sorlie, P. , Szklo, M. , Tyroler, H. A. And Watson, R. L. (2001). The place of residence and the incidence of coronary heart disease. New England Journal of Medicine, 345 (2), 99-106. Gittelsohn, J. , Laska, M. N. , Andreyeva, T. , Foster, G. , Rose, D. , Tester, J. , Lee, S. H. , Zenk, S. N. Young Odom. , McCoy, T. , and Ayala, G. X. (2012). 2009 the views of small retailers on food packaging for women, infants and children\'s programs have changed. American Journal of Health Behavior, 36 (5), 655-665. Gittelsohn, J. , Dyckman, W. , Tan, M. L. , Boggs, M. K. , Frick, K. D. , Alfred, J. , Winch, P. J. , Haberle, H. And N Palafox. A. . (2006). Development and implementation of a food store Basic interventions to improve the diet of the Marshall Islands Republic. Practice of health promotion (4), 396-405. Glanz, K. , Sallis, J. F. , Saelens, B. E. , and Frank, L. D. (2007). Survey of nutrition environment in stores (NEMS-S) : Development and evaluation. American Journal of Preventive Medicine, 32 (4), 282-289. Gleason, S. , Morgan, R. , Bell, L. J. , Puller. (2011). Impact of revised WIC food packaging on small WIC suppliers: from 4- Status Assessment. I\'m Portland: The Altarum Institute; Internet access: File/pub_resources/fourstatewicfoodpackage evaluation-Full%20Report-20May11. pdf. Institute of Medicine, National Academy of Sciences. (2005). WIC Food Packaging: it\'s time to change. Washington, DC. Oliveira, V. Early with flora, E. (2009). WIC project: Background, trends and economic issues, version 2009. U. S. Ministry of Agriculture: economic research services. Report No. Economic Research Report No. 73. O\'Neil, C. E. , Zanovec, M. , Cho, S. S. And Nicholas, T. A. (2010). Total grain and fiber consumption in American adults is associated with weight loss: National Health and Nutrition Examination Survey 1999-2004. Nutrition Research, 30 (12), 815-822. Robert, S. A. And others, E. N. (2004). Multi-level analysis of American adult race, community disadvantage and body mass index. Social science and medicine, 59 (12), 2421-2434. U. S. Ministry of Agriculture. (2012). Food and nutrition services. Annual cost of WIC project. Available online: USDA. Gov/pd/37WIC_Monthly. Author information Tatiana Andreyeva (tatiana. andreyeva@yale. edu) He is director of economic planning at the Rudd Center for Food Policy and Obesity at Yale University in New Haven, Connecticut. The research described in this review is funded by a grant from the Bureau of Economic Research (ERS)at the U. S. Ministry of Agriculture. The point put forward in the paper is the author\'s point of view, not necessarily the point of view of ERS or USDA. The author thanks Dr for the very helpful comments Dr. Elizabeth Fraser David Witherspoon Special thanks to all the researchers and research assistants working on this study, as well as the food stores that participated in our interviews and stocktaking.