Increased WIC Cash Value Benefit is Associated with Greater Amount and Diversity of Redeemed Fruits and Vegetables among Participating Households
Christopher Anderson, Lauren E. Au, Catherine E. Yepez, Lorrene D. Ritchie, Marisa Tsai, Shannon E. Whaley
Abstract
Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) food packages for children ages 1-4 years include a cash value benefit (CVB) redeemable for fruits and vegetables (FV) with participating vendors. The CVB value was increased beginning in June 2021. This study evaluated associations of the augmented CVB with the amount and diversity of redeemed FV. Price look-up codes (PLU) in redemption data determined outcomes including any redemption (any, none), amount redeemed (United States Dollars (USD)/month), and percent of total CVB redemption (percent) in 54 FV commodity groups among a cohort of 1,770 WIC-participating children in Southern California. Outcomes across all commodity groups for fresh fruits, fresh vegetables, and all FV were evaluated including dollar amount redeemed, percentage of redemption, and diversity of produce redeemed (variety and balance among items redeemed). Comparisons were made between augmented CVB periods (35 USD/month in June-September 2021, 24 USD/month October 2021-June 2022) and the pre-augment period (9 USD/month in June 2020-May 2021). Associations were tested in multivariable generalized estimating equation Poisson (any redemption) and linear (amount, percent, diversity) regression models. The augmented CVB was associated with higher any redemption prevalence and amount redeemed for 53 of 54 commodity groups at both 35 USD/month and 24 USD/month compared to 9 USD/month. Redemption diversity increased for both fruits, vegetables, and all produce during both augment periods, and modestly greater increases in redeemed fruits relative to vegetables were observed at 35 USD/month. The most commonly redeemed vegetables were tomatoes, onions, cucumbers, peppers and avocados and the most commonly redeemed fruits were bananas, apples, grapes, limes and melons. The augmented CVB was associated with greater redeemed FV amount and greater redeemed FV diversity. Data on FV intake diversity among WIC-participating children are needed to understand dietary impacts of the CVB increase.