After WIC Required Healthier Food, Arizona Children Obesity Rate Declines

The obesity rate among young Arizona children in the Women, Infants, and Children (WIC) nutrition program declined from 2010 to 2016 after the program changed its rules to require healthier food, a new report says.

Arizona was not alone.

The Centers for Disease Control and Prevention report said 41 states saw childhood obesity drop following the changes to WIC’s Special Supplemental Nutrition Program. Arizona’s decrease – from 15% of kids in the program who were considered obese in 2010 to 12.1% in 2016 – was seventh biggest among states.

Experts say a 2009 change to foods eligible under the WIC program that increased access to fresh fruits and vegetables, whole grains and reduced-fat milk, among other items, is largely responsible for the “really encouraging” results.

“It’s a start,” said Will Humble, executive director of the Arizona Public Health Association.

He said the 2009 change was the “biggest factor” in the childhood obesity decline in Arizona and the nation. Nationally, the obesity rate among 2- to 4-year-olds in WIC, the group studied in the report, fell from 15.9% to 13.9%.

Arizona State University professor Maureen McCoy, a specialist in nutrition and childhood obesity, welcomed the drop in obesity numbers, but also noted that a decline in WIC participation over the period could have an impact on the data. Enrollment fell in all states but North Carolina, the report said, with the number of Arizona 2- to 4-year-olds in the program dropping from 72,933 in 2010 to 58,054 in 2016.

“A lot of people would like to enroll in SNAP because it’s a little easier,” McCoy said, referring to the Supplemental Nutrition Assistance Program. “There’s not as much paperwork and then you don’t have the requirements on what you can buy and check-ins with nutritionists.”

McCoy also said the “public-charge” rule the Trump administration is planning to implement could be driving people away from WIC. That rule would deny citizenship or legal permanent residence for anyone likely to become dependent on the government for assistance.

Federal judges in three states – New York, California and Washington – blocked the rule from taking effect in October, and WIC would not fall under the rule as it is a program for children. But McCoy believes fear has contributed to the dip in WIC participation in Arizona.

“If they’re not legal citizens, they don’t want to be on the blacklist, so I think that’s led to a lot of decreases,” she said.

To be eligible for WIC, participants must live in the state where they apply for the benefit, have household income less than 185% of the federal poverty level or be eligible for other federal assistance programs.

While the Trump administration has proposed revising SNAP eligibility requirements, experts agreed that WIC is safe – for the time being.

“WIC definitely has a lot of support because it is such a vulnerable young population,” said Katherine Hempstead, senior policy adviser at the Robert Wood Johnson Foundation.

Hempstead said the 2009 WIC changes have helped, but are not solely responsible for the “sustained decrease” in childhood obesity rates.

“I don’t think we can attribute the decline in obesity to WIC but it has done a lot of really important things that are helpful,” she said.

Hempstead is hopeful the downward trend in childhood obesity continues and urges decision-makers to acknowledge the importance of nutritional education in younger populations.

“A lot of eating habits are formed in early childhood, so it’s important to give them better food,” she said.

The CDC report said that while the decreases are a positive sign, “obesity prevalence remained high in most states in 2016,” and called for “multiple approaches” to deal with the issue.

McCoy said, in addition to a commitment to quality food, educating parents about the program is key to ensuring its continued success.

“A lot of people that could qualify for WIC aren’t doing it,” she said. “We haven’t solved obesity in any way, shape or form.”

Humble was director of the Arizona Department of Health in 2009 and supervised the state’s implementation of the rule, which he said was the first change to the WIC food package in decades. He said more needs to be done, but the results in the new report are encouraging.

“For most of my career, it just kept getting worse and now you can see that some of the interventions that happened are starting to at least make some progress,” he said.

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