Departments of Epidemiology and Biostatistics,
Family and Community Medicine, and.
Pediatrics. 2021 Feb;147(2). doi: 10.1542/peds.2020-1853.
The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), one of the largest US safety net programs, was revised in 2009 to be more congruent with dietary guidelines. We hypothesize that this revision led to improvements in child development.
Data were drawn from a cohort of women and children enrolled in the Conditions Affecting Neurocognitive Development and Learning in Early Childhood study from 2006 to 2011 (Shelby County, TN; = 1222). Using quasi-experimental difference-in-differences analysis, we compared measures of growth, cognitive, and socioemotional development between WIC recipients and nonrecipients before and after the policy revision.
The revised WIC food package led to increased length-for-age scores at 12 months among infants whose mothers received the revised food package during pregnancy (β = .33, 95% confidence interval: 0.05 to 0.61) and improved Bayley Scales of Infant Development cognitive composite scores at 24 months (β = 4.34, 95% confidence interval: 1.11 to 7.57). We observed no effects on growth at age 24 months or age 4 to 6 years or cognitive development at age 4 to 6 years.
This study provides some of the first evidence that children of mothers who received the revised WIC food package during pregnancy had improved developmental outcomes in the first 2 years of life. These findings highlight the value of WIC in improving early developmental outcomes among vulnerable children. The need to implement and expand policies supporting the health of marginalized groups has never been more salient, particularly given the nation's rising economic and social disparities.
妇女、婴儿和儿童特别补充营养计划(WIC)是美国最大的安全网计划之一,于 2009 年进行了修订,以使其更符合饮食指南。我们假设这次修订导致了儿童发育的改善。
数据来自于 2006 年至 2011 年参加儿童早期神经认知发育和学习状况研究的妇女和儿童队列(田纳西州谢尔比县;=1222)。使用准实验差分法分析,我们比较了政策修订前后 WIC 接受者和非接受者的生长、认知和社会情感发展的衡量标准。
修订后的 WIC 食品包导致怀孕期间接受修订食品包的母亲的婴儿在 12 个月时的长度-年龄得分增加(β=0.33,95%置信区间:0.05-0.61),并在 24 个月时改善了贝利婴幼儿发展量表认知综合得分(β=4.34,95%置信区间:1.11-7.57)。我们没有观察到 24 个月或 4 至 6 岁时的生长或 4 至 6 岁时的认知发育的影响。
这项研究提供了一些首批证据,表明在怀孕期间接受修订后的 WIC 食品包的母亲的孩子在生命的头 2 年中发育结果有所改善。这些发现突出了 WIC 在改善弱势儿童早期发育结果方面的价值。实施和扩大支持边缘化群体健康的政策的必要性从未如此突出,尤其是考虑到美国日益扩大的经济和社会差距。