Department of Social, Behavioral and Population Sciences, School of Public Health and Tropical Medicine, Tulane University, 1440 Canal St. Suite 2210, New Orleans, LA, 70112, USA.
Department of Health Systems and Population Health, School of Public Health, University of Washington, 305J Raitt Hall, Box 353410, Seattle, WA, 98195, USA.
Matern Child Health J. 2024 Feb;28(2):315-323. doi: 10.1007/s10995-023-03829-8. Epub 2023 Nov 13.
To assess trends in food insecurity between 2005 and 2017-a period including the Great Recession-by participation in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC).
Data from the California Health Interview Survey (CHIS), 2005-2017, were used, including 7421 households: WIC participants (n = 4184)-those participating in WIC only (n = 2315) and in the Supplemental Nutrition Assistance Program (SNAP) in addition to WIC (n = 1869)-and WIC-eligible non-participants (n = 3237). Multivariable logistic regression models were run with food insecurity as the outcome, WIC participation and survey year as predictors, and adjusted by children's and family's demographic and socioeconomic variables. Interactions between WIC participation and survey year were tested.
WIC + SNAP participating households had higher crude food insecurity prevalence across time compared to WIC only and WIC-eligible non-participant households. In fully adjusted models: (1) food insecurity was higher between 2009 and 2017, compared to 2005, for all groups; (2) WIC participating households had higher odds of food insecurity than WIC-eligible non-participants (OR = 1.23, 95%CI = 1.10-1.38); (3) when WIC participants were split into WIC only and WIC + SNAP, WIC + SNAP households had higher odds of food insecurity than WIC-eligible non-participants (OR = 1.45, 95%CI = 1.27-1.66); and (4) the association between food insecurity and WIC participation did not change across time (interaction p-value > 0.10).
Food insecurity increased post-Great Recession among low-income households with children in California, with those participating in WIC, particularly in WIC + SNAP, at higher risk. WIC should consider additional referrals for households who participate in WIC + SNAP.
评估 2005 年至 2017 年期间（包括大衰退时期）妇女、婴儿和儿童特别补充营养计划（WIC）参与情况与粮食不安全之间的趋势。
使用来自加利福尼亚健康访谈调查（CHIS）2005-2017 年的数据，共包括 7421 户家庭：WIC 参与者（n=4184）——仅参加 WIC 的人群（n=2315）和除 WIC 以外还参加补充营养援助计划（SNAP）的人群（n=1869），以及符合 WIC 条件但未参加 WIC 的人群（n=3237）。将粮食不安全作为结果，WIC 参与情况和调查年份作为预测因子，采用多变量逻辑回归模型进行分析，并根据儿童和家庭的人口统计学和社会经济变量进行调整。测试了 WIC 参与情况和调查年份之间的交互作用。
在整个研究期间，WIC+SNAP 参与家庭的粮食不安全粗发生率均高于仅参加 WIC 和符合 WIC 条件但未参加 WIC 的家庭。在完全调整的模型中：（1）与 2005 年相比，2009 年至 2017 年期间所有组别的粮食不安全发生率均升高；（2）与符合 WIC 条件但未参加 WIC 的人群相比，参加 WIC 的家庭粮食不安全的可能性更高（OR=1.23，95%CI=1.10-1.38）；（3）当将 WIC 参与者分为仅参加 WIC 和 WIC+SNAP 两类时，WIC+SNAP 家庭粮食不安全的可能性高于符合 WIC 条件但未参加 WIC 的人群（OR=1.45，95%CI=1.27-1.66）；（4）粮食不安全与 WIC 参与之间的关联在整个研究期间没有变化（交互作用 p 值>0.10）。
大衰退后，加利福尼亚州有子女的低收入家庭的粮食不安全状况有所增加，其中参加 WIC 的家庭，特别是参加 WIC+SNAP 的家庭，风险更高。WIC 应考虑为参加 WIC+SNAP 的家庭提供更多的转介服务。
