Evaluating Economic Subsidies to Improve Dietary Intake among Low-income Families


In an effort to improve dietary intake and address the high prevalence of obesity among low-income children, the United States Department of Agriculture Food and Nutrition Service (USDA-FNS) published an interim rule in the Federal Register revising the food packages in the Special Supplemental Nutrition Program for Women Infants and Children (WIC). WIC provides supplemental food to more than 8 million low-income children women. In response to recommendations from the Institutes of Medicine, the USDA Food and Nutrition Service proposed to align WIC food packages with the Dietary Guidelines for Americans. Among the revisions are changes in the fat content (e.g., reduced fat milk) and the fiber content (e.g., whole grain bread) and the addition of a fruit and vegetable voucher.

This study examines the effect of the revised WIC program on consumption of fruits, vegetables, fiber, and reduced-fat foods by low-income children compared to consumption levels under the current WIC program, and examines individual, interpersonal, and community mechanisms that affect dietary intake. This study is important for several reasons:

  1. It provides a rare opportunity to evaluate the impact of a national policy shift in food assistance to support healthy eating in low-income families. This has the potential to improve healthful eating and may be particularly important in addressing diet-related health disparities, particularly obesity, among low-income individuals.
  2. Policymakers are increasingly expressing interest in the use of economic subsidies to improve dietary intake and health outcomes. From a comparative effectiveness perspective, we will be able to assess whether improving access to healthy food changes food intake and ultimately, weight status.
  3. The study builds on a pilot project (Chicago WIC Food Environment Survey) we are currently conducting in collaboration with the Illinois Department of Human Services (IDHS), which is responsible for WIC administration in the state, and the Catholic Charities of the Archdiocese of Chicago, the group responsible for WIC distribution in Chicago. The pilot, scheduled for May-July 2009, provides essential baseline data (0 months) for evaluating the WIC program prior to implementation of the new policy in August 2009.
  4. In conjunction with these two agencies, we have the ability to link longitudinal voucher pick-up and voucher redemption data with reported dietary intake, important social contextual variables, and child weight gain trajectory over the first 18 months of the policy (with informed consent).
Principal investigator
Funding Agency

National Cancer Institute of the National Institutes of Health with funding from the American Reinvestment and Recovery Act of 2009  (Grant No. RC1CA149400)

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Related publications

See publications supported by this grant on this PubMed list

Kong A, Vijayasiri G, Fitzgibbon ML, Schiffer LA, Campbell RT. Confirmatory factor analysis and measurement invariance of the Child Feeding Questionnaire in low-income Hispanic and African-American mothers with preschool-age children. Appetite. 2015 Jul;90:16-22. [See abstract.]

Kong A, Odoms-Young AM, Schiffer LA, Kim Y, Berbaum ML, Porter SJ, Blumstein LB, Bess SL, Fitzgibbon ML. The 18-month impact of special supplemental nutrition program for women, infants, and children food package revisions on diets of recipient families. Am J Prev Med. 2014 Jun;46(6):543-51. [See abstract.]

Odoms-Young AM, Kong A, Schiffer LA, Porter SJ, Blumstein L, Bess S, Berbaum ML, Fitzgibbon ML. Evaluating the initial impact of the revised Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) food packages on dietary intake and home food availability in African-American and Hispanic families. Public Health Nutr. 2013 Apr 2:1-11. 2014 Jan;17(1):83-93. [See abstract.]

Kong A, Odoms-Young AM, Schiffer LA, Berbaum ML, Porter SJ, Blumstein L, Fitzgibbon ML. Racial/ethnic differences in dietary intake among WIC families prior to food package revisions. J Nutr Educ Behav. 2013 Jan-Feb;45(1):39-46. [See abstract.]