妇女特别补充营养计划,婴儿,和儿童(WIC)是为生活贫困的妇女和儿童提供营养支持和教育的重要来源;尽管WIC的参与带来了明显的健康益处,目前,只有50%的合格妇女和儿童获得WIC。2010年,国会规定,到2020年将WIC福利从纸质凭证过渡到电子福利转移(EBT)卡,使用起来更方便,可能会减少污名化,并可能提高WIC的参与度。
评估从纸质凭证到EBT的过渡与随后的WIC参与之间的州级关联。
这项关于2014年10月1日至2019年11月30日期间参与的国家级WIC月度效益汇总管理数据的经济评估,比较了在此期间实施和未实施WICEBT的州。差异回归模型允许关联自政策实施以来随时间变化,并包括对关键亚组的分层分析(孕妇和产后妇女,小于1岁的婴儿,和1-4岁的儿童)。所有模型都包括表示状态的虚拟变量,Year,和月份作为协变量。数据分析于2020年3月1日至6月15日进行。
从WIC纸质凭证到WICEBT卡的全州过渡,按月份和年份指定。
每月在WIC注册的州居民人数。
在研究期间之前或期间,共有36个州实施了WICEBT。EBT和非EBT州的贫困和粮食不安全基线率相似。在全州WICEBT实施三年后,与未暴露状态相比,暴露状态的WIC参与增加了7.78%(95%CI,3.58%-12.15%)。在分层分析中,孕妇和产后妇女的WIC参与率增加了7.22%(95%CI,2.54%-12.12%),1岁以下婴儿中4.96%(95%CI,0.95%-9.12%),1至4岁儿童的比例为9.12%(95%CI,3.19%-15.39%;交互作用P=0.20)。结果对于州失业率和贫困率的调整是稳健的,人口,以及医疗补助扩张状况。
在这项研究中,从纸质凭单到WICEBT的转变与入学人数的显着和持续增加有关。简化福利赎回过程的干预措施对于解决WIC和其他政府福利计划的低入学率至关重要。
The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is an important source of nutritional support and education for women and children living in poverty; although WIC participation confers clear health benefits, only 50% of eligible women and children currently receive WIC. In 2010, Congress mandated that states transition WIC benefits by 2020 from paper vouchers to electronic benefits transfer (EBT) cards, which are more convenient to use, are potentially less stigmatizing, and may improve WIC participation.
To estimate the state-level association between transition from paper vouchers to EBT and subsequent WIC participation.
This economic evaluation of state-level WIC monthly benefit summary administrative data regarding participation between October 1, 2014, and November 30, 2019, compared states that did and did not implement WIC EBT during this time period. Difference-in-differences regression modeling allowed associations to vary by time since policy implementation and included stratified analyses for key subgroups (pregnant and postpartum women, infants younger than 1 year, and children aged 1-4 years). All models included dummy variables denoting state, year, and month as covariates. Data analyses were performed between March 1 and June 15, 2020.
Statewide transition from WIC paper vouchers to WIC EBT cards, specified by month and year.
Monthly number of state residents enrolled in WIC.
A total of 36 states implemented WIC EBT before or during the study period. EBT and non-EBT states had similar baseline rates of poverty and food insecurity. Three years after statewide WIC EBT implementation, WIC participation increased by 7.78% (95% CI, 3.58%-12.15%) in exposed states compared with unexposed states. In stratified analyses, WIC participation increased by 7.22% among pregnant and postpartum women (95% CI, 2.54%-12.12%), 4.96% among infants younger than 1 year (95% CI, 0.95%-9.12%), and 9.12% among children aged 1 to 4 years (95% CI, 3.19%-15.39%; P for interaction = .20). Results were robust to adjustment for state unemployment and poverty rates, population, and Medicaid expansion status.
In this study, the transition from paper vouchers to WIC EBT was associated with a significant and sustained increase in enrollment. Interventions that simplify the process of redeeming benefits may be critical for addressing low rates of enrollment in WIC and other government benefit programs.